Sunday, June 28, 2009
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Monday, June 22, 2009
Thursday, June 18, 2009
How Aggressively Do Residency Programs Promote Oral Exam Technique?
Dr. Alvin Schamroth, MD, FACOG
This is a follow-up to an informal poll conducted by Dr Schamroth to Residency Co-ordinators of OB/GYN programs. The initial finding of this study was that of those programs that feel oral exam training is important, only 60% actually provide this training. The article addresses the extent to which they provide this training.
Question 1 (Of the 60% of programs who provide oral exam training), how frequently do you provide oral exam technique training?
Once/week 56%
Once/month 17%
Once/year 26%
Question 2 (In an attempt to assess the intensity of mock oral training provided by those 60%), how aggressive are your M+M meetings?
Mildly aggressive 53%
Moderately aggressive 47%
Severely aggressive 0%
(Although the oral exam is not necessarily aggressive, practicing for it with an aggressive environment is probably more beneficial)
Are Residency Programs Preparing Candidates for Their Final Board Exam?
Dr. Alvin Schamroth, MD, FACOG
Residency Coordinators feedback regarding residency programs preparing candidates for the oral exams
Residency Coordinators feedback regarding residency programs preparing candidates for the oral exams
What are the criteria to assess the success of an OBGYN residency program? CREOG scores, Written or Oral board pass rates, residency drop out rate, departmental income generation?
Residency programs have a vested interest in their residents passing the written OB/GYN board exam. Reason: if they have a low collective percentage pass rate by their residents, they run the risk of losing their residency program status. This can have a major impact on their ability to attract faculty, staff, physician and departmental income. Is the written board exam pass mark the correct bench mark? There are some who would argue that passing the final oral board exam is the ultimate reflection of a residency program! To this extent, an informal study was recently undertaken by Dr Schamroth FACOG to determine the extent to which residency programs prepare residents for the ‘oral’ medium of the final board exam.
E-mail questionnaires were sent to the residency coordinators of 191 OB/GYN residency programs throughout the
A total of 58 responses were received.
Question #1: Do you feel there is a need to train residents in oral exam technique?
Response: Yes = 82% yes, No = 14% (4% = no response)
Question #2: Does your program train residents on oral exam technique?
Response: Yes = 60%, No = 40%
Conclusion: Although a majority of respondents feel there is a need to assist residents train for their oral exam, a significant percentage of residency programs are not following through on this need. This conclusion could be stronger, since those programs that do not promote oral exam training may be more inclined not to respond to the poll.
Dr Schamroth is a board certified OB/GYN and Director of ExamPro, the leading authority in OB/GYN board prep.
The Maintenance of Certification Process Part 2: As Easy as ABC
Dr. Alvin Schamroth, MD, FACOG
Probably the majority of the nation’s OB/GYNS are now involved in the Maintenance of Certification (MOC) Part 2 process (lifetime education). This article aims to provide the basic information for those not yet obligated, and also to give some lesser known facts for those who are already involved in this process.
The MOC Part 2 portion has been in existence since 1998, but was previously known as the ABC (Annual Board Certification) exam. It is designed to encourage diplomates to read prescribed articles and thereby continue with lifetime learning. It caters to those engaged in general OBGYN as well as subspecialty practice. This portion of MOC is conducted by ABOG and is completed online by logging onto www.abog.org and signing on with your ABOG ID number and personal password. Access to the articles is only made available after ABOG has received payment (via check or credit card). The fee is $235 for the year and the deadline was February 26! A late fee of $110 will extend the application deadline to June 30. An additional late fee of $110 (total late fee $220) will buy you an extension to August 30. Similarly, a third $110 late fee (total now $330) will delay the deadline to September 29. Failure to complete this portion of the MOC process will result in a withdrawal of board certification status.
The MOC Part 2 consists of 3 sets of articles per year. Each set comprises 15 articles and a total of 60 associated questions (for an annual total of 180 questions). These 15 articles (each with 4 associated questions) typically have 5 articles dedicated to each of GYN, OB and ‘Office’ categories. The 3 sets of articles are issued in January, April and July of each year. OB/GYN generalists may select articles from 2 or all 3 categories (OB, GYN and ‘Office’) in each set of articles. The candidate must select enough articles to answer at least 120 questions (this can be obtained from just 2 sets if so desired) each year to fulfill the MOC requirement. Once an article is selected, the diplomate must complete all questions associated with that article. Diplomates are respectfully warned that failure to answer a single question from a selected article will result in an automatic failing grade (even if the actual grade is above the 70% pass mark!). One is thus encouraged to make sure that a minimum of 120 questions (and all questions from any selected article) have been submitted by the September 30 deadline. Also, be aware that once an answer has been submitted, it cannot be changed. Completion of 120 questions with a passing grade confers 25 hours of CME. The remaining 60 questions are optional and will confer extra CME credit for an additional fee.
The MOC Part 2 is an ‘open book test’. Candidates are required to read the article and then answer the 4 questions. They must attest to having read the article themselves in order to answer the questions, and may not use any commercial services that provide article summaries for the purpose of completing the ABC exam. The physician is encouraged to check the bottom of their individualized ABC web page, where they will find a summary of the number of articles they have read, the number of uncompleted questions and their score. Most will find that even with a nominal expenditure of intellectual energy, they will be well over the minimum passing grade of 70%.
It is fair to assume that these articles are chosen by ABOG for their relevance to current clinical practice, and that ABOG would like the OB/GYN profession to be familiar with these practices. As such, most diplomats find these articles to be interesting, valuable and highly worthwhile. There is an added benefit: these articles can reasonably be expected to play some part in the MOC Part 3 examination. Consequently, many may choose to read all articles from all 3 sets and not only the minimum requirement (equivalent of 2 sets).
In the (expected rare) case of a diplomate failing to achieve a passing grade, he/she will be notified in November and will be allowed a retake examination. Failure to achieve a passing grade in this reexamination will result in withdrawal of board certification status. This in turn will preclude membership with ACOG.
Subspecialists should have applied for the MOC Part 2 exam in November 2008. Whereas the subspecialty registration fee is greater ($295), the late fee and deadlines are similar to generalists (discussed above). Each of the 3 sets of articles for subspecialists will comprise 2 subsets: 1) general OB/GYN articles (as described above) and 2) subspecialty articles with 30 questions per subset. A subspecialist must annually answer a total of 150 questions: 60 questions derived from the ‘generalist’ list of articles and all 90 questions associated with their ‘subspecialty’ list of articles. Again the pass mark is 70% and 25 CME credits are provided.
While this portion of the MOC process does require a commitment of time on the part of the diplomate, this should result in greater awareness of current standards and hopefully, improved clinical practice.
Probably the majority of the nation’s OB/GYNS are now involved in the Maintenance of Certification (MOC) Part 2 process (lifetime education). This article aims to provide the basic information for those not yet obligated, and also to give some lesser known facts for those who are already involved in this process.
The MOC Part 2 portion has been in existence since 1998, but was previously known as the ABC (Annual Board Certification) exam. It is designed to encourage diplomates to read prescribed articles and thereby continue with lifetime learning. It caters to those engaged in general OBGYN as well as subspecialty practice. This portion of MOC is conducted by ABOG and is completed online by logging onto www.abog.org and signing on with your ABOG ID number and personal password. Access to the articles is only made available after ABOG has received payment (via check or credit card). The fee is $235 for the year and the deadline was February 26! A late fee of $110 will extend the application deadline to June 30. An additional late fee of $110 (total late fee $220) will buy you an extension to August 30. Similarly, a third $110 late fee (total now $330) will delay the deadline to September 29. Failure to complete this portion of the MOC process will result in a withdrawal of board certification status.
The MOC Part 2 consists of 3 sets of articles per year. Each set comprises 15 articles and a total of 60 associated questions (for an annual total of 180 questions). These 15 articles (each with 4 associated questions) typically have 5 articles dedicated to each of GYN, OB and ‘Office’ categories. The 3 sets of articles are issued in January, April and July of each year. OB/GYN generalists may select articles from 2 or all 3 categories (OB, GYN and ‘Office’) in each set of articles. The candidate must select enough articles to answer at least 120 questions (this can be obtained from just 2 sets if so desired) each year to fulfill the MOC requirement. Once an article is selected, the diplomate must complete all questions associated with that article. Diplomates are respectfully warned that failure to answer a single question from a selected article will result in an automatic failing grade (even if the actual grade is above the 70% pass mark!). One is thus encouraged to make sure that a minimum of 120 questions (and all questions from any selected article) have been submitted by the September 30 deadline. Also, be aware that once an answer has been submitted, it cannot be changed. Completion of 120 questions with a passing grade confers 25 hours of CME. The remaining 60 questions are optional and will confer extra CME credit for an additional fee.
The MOC Part 2 is an ‘open book test’. Candidates are required to read the article and then answer the 4 questions. They must attest to having read the article themselves in order to answer the questions, and may not use any commercial services that provide article summaries for the purpose of completing the ABC exam. The physician is encouraged to check the bottom of their individualized ABC web page, where they will find a summary of the number of articles they have read, the number of uncompleted questions and their score. Most will find that even with a nominal expenditure of intellectual energy, they will be well over the minimum passing grade of 70%.
It is fair to assume that these articles are chosen by ABOG for their relevance to current clinical practice, and that ABOG would like the OB/GYN profession to be familiar with these practices. As such, most diplomats find these articles to be interesting, valuable and highly worthwhile. There is an added benefit: these articles can reasonably be expected to play some part in the MOC Part 3 examination. Consequently, many may choose to read all articles from all 3 sets and not only the minimum requirement (equivalent of 2 sets).
In the (expected rare) case of a diplomate failing to achieve a passing grade, he/she will be notified in November and will be allowed a retake examination. Failure to achieve a passing grade in this reexamination will result in withdrawal of board certification status. This in turn will preclude membership with ACOG.
Subspecialists should have applied for the MOC Part 2 exam in November 2008. Whereas the subspecialty registration fee is greater ($295), the late fee and deadlines are similar to generalists (discussed above). Each of the 3 sets of articles for subspecialists will comprise 2 subsets: 1) general OB/GYN articles (as described above) and 2) subspecialty articles with 30 questions per subset. A subspecialist must annually answer a total of 150 questions: 60 questions derived from the ‘generalist’ list of articles and all 90 questions associated with their ‘subspecialty’ list of articles. Again the pass mark is 70% and 25 CME credits are provided.
While this portion of the MOC process does require a commitment of time on the part of the diplomate, this should result in greater awareness of current standards and hopefully, improved clinical practice.
The Ominous MOC Written Exam of 2012!
Dr. Alvin Schamroth, MD, FACOG
The new Maintenance of Certification process (MOC) began in January 2008 and has several implications that will affect virtually all practicing Ob/Gyns. There are 4 parts to the process, but the 3rd component (Cognitive Expertise) is the one causing most anxiety! Why? Because this is a ‘closed book’ MCQ written test for which the candidate must obtain a passing score in order to maintain his/her certification!
The requirement to take this exam is dictated by the year of initial Ob/Gyn certification.
Those who became board certified in general Ob/Gyn between 1986 and 2001 received certification valid for 10 years. From 2001, certification was given for only 6 years. Thus, beginning in 2008, anyone who became board certified since 1986 is required to register for MOC. Those who were certified prior to 1986 are ‘grandfathered in’ and have no obligation to complete the MOC process.
This exam is expected by many to be somewhat similar to the written board exam, but more clinically focused. ABOG states that “the primary goal of MOC Part III Written Examination, is to ensure that “diplomates have retained and are currently employing basic information learned during their training as well as the new information obtained by their participation in the MOC Part II - Lifetime Education process.”1 It is thus reasonable to assume that much of the MOC Part 3 exam will be based on articles (and related topics) previously prescribed by ABOG for the Annual Board Certification exam (or ABC: MOC Part 2). Most physicians are currently enrolled in the ABC Part 2 MOC and are consequently familiar with these articles and the associated ‘open book’ test of MOC Part 2. It is worthwhile noting that although only 2 of 3 sets of ABC articles are required for qualification in MOC Part 2 (with 120 related questions), physicians may voluntarily choose to now complete all 3 books with 180 questions (as preparation for the MOC Part 3 exam).
It is critical to appreciate that the MOC process cycles through a 6 year period and the Cognitive Expertise (MOC Part 3) portion is taken only once during that 6 year period. A physician has the option to take it in the 5th or 6th year of the cycle. That makes 2012 the first opportunity for most Ob/Gyns to sit for the exam. A candidate may take the exam as often as is necessary during the 5th and 6th year in order to pass (ABOG anticipates offering the exam twice per year). It is thus expected that most physicians will opt to take the exam in the 5th year of the 6 year cycle (recommended by ABOG) so as to give themselves ample time to have a 2nd or even 3rd opportunity to take the exam, should this become necessary.
The written exam is expected to have 180-200 questions to be completed in 3-4 hours (specifics still pending). Of the approximately 180 questions, 100 are mandatory in the area of general Ob/Gyn. The balance of 80 questions will be derived from one of four categories (
Candidates for the 2012 exam must apply for MOC Part 3 online, in October or November 2011. A fee will be charged. ABOG has not yet announced whether they will publish any study guides to assist those preparing for this exam. ABOG does acknowledge that final details surrounding the exam may change as it is a ‘work in progress’.
Candidates who fail the MOC Part 3 exam will not be board certified until they successfully complete the exam. This will result in a hiatus in their certification status!
It is the candidate’s responsibility to make sure that he/she maintains his/her certification. Neither ABOG nor ACOG will contact physicians to initiate the process!
For those with specific questions, further information relating to MOC may be obtained by contacting:
Maintenance of Certification Department
The American Board of Obstetrics and Gynecology, Inc.
E-mail: recert@abog.org
Phone: (214) 721-7510
The slides of a lecture given by Dr Gilstrap (ABOG’s Director of Evaluation) introducing details of the MOC Process can be found online at the following URL address: http://www.abog.org/pdf/MOC%20Simplified.pdf
Important dates to be aware of, (for General Ob/Gyn MOC registration, 2009) are:
Feb 26: Application + $235 fee
Feb 27 – Jun 30: Application, fee + late fee ($110.00) = $345
Jul 1 – Aug 31: Application, fee + late fee ($220.00) = $455
Sep 1 – 29: Application, fee + late fee ($330.00) = $565
References
1) ABOG Bulletin for 2009: Maintenance of Certification
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