Climbing the MOC Mountain

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I just received an important notice from the American Board of Pediatrics (ABP) about my Maintenance of Certification (MOC) schedule. The great news is that I don’t need to take my recertification test again until 2017. The not so great news is that I now have more steps of the MOC Mountain to climb before I can recertify. One step in particular has me a little concerned.

The notice from the ABP informed me that by 2014, I have to complete Parts 2 and 4 of the MOC process (a full explanation of what MOC entails is available at www.abp.org). Part 2 requires “participation in an activity that enhances one’s medical knowledge.” This part is easy for me because I subscribe to and complete the American Academy of Pediatrics’ (AAP) PREP Self-Assessment on a yearly basis. Part 4 requires “participation in a quality improvement (QI) project.” I am a little apprehensive about this part, not because I am anti-QI. In fact, as a Pediatric Residency Program Director, I am involved in resident QI projects throughout the year, every year—these are not “official” Part 4 activities. I’m concerned because I have read and heard some negative comments about Part 4. Two of the most common complaints are that it is excessively time consuming and it doesn’t make any difference to some practices, especially practices that already consistently look for ways to improve health care delivery. For now, I am keeping an open mind because I haven’t personally participated in an approved Part 4 activity yet. Is it really that time consuming?

In order to fulfill Part 4 of MOC, I intend to participate in an AAP-sponsored activity on how to improve influenza vaccine administration rates. The activity requires the following steps: registering; downloading from the ABP Web site 2 different questionnaires (a parent one and a physician one) and making 10 copies of each of them; completing the 2 separate questionnaires for 10 separate patient encounters; implementing an intervention in clinic that is intended to improve influenza vaccination for at least 3 weeks; making copies of the 2 questionnaires so that another 40 of them will be completed at another 40 separate patient encounters after the intervention has been in effect; entering the answers online to all 100 questionnaires (50 parent plus 50 physician ones); and there are more steps, but I will stop here. Although the questionnaires are brief, all of this does sound overwhelming and, yes, time consuming! During this past week, I had intended to start the process, but I did not have a long enough stretch of time while I was in the clinic to register and download the questionnaires. Maybe next week…

Again, my mind is open, and I’m approaching this with a positive attitude.  As we all know, I will pay a $1000 plus to be able to participate in MOC. So, I will track the number of hours spent on these activities, note any difficulties I encounter, and post a future update as I proceed through the process. Every pediatrician’s experience will be unique, depending on their career path and work schedule, and each pediatrician will have their own opinion of MOC. Readers’ comments about their experiences with MOC are welcome and may help the rest of us "climb the mountain."