Maintenance of Certification Richard J. Shemin, MD Chair, ABTS

The mission of the American Board of Thoracic Surgery is to protect the public by promoting effective, safe and ethical thoracic surgical practice by maintaining high standards for education, training and knowledge through examination, certification and maintenance of certification.

CERTIFICATION CATEGORIES  Certified-Active successfully passed both Part I and II exams actively practicing cardiothoracic surgery Diplomates who are involved in direct or supervised cardiothoracic patient care, but whose practice does not include operative thoracic surgery (e.g., critical care, clinic or office practice, clinical research involving direct patient contact) required to participate in all parts of MOC (i.e., Parts I-IV).

Certified-Inactive Includes individuals who have applied and been accepted for inactive status. Diplomates who have temporarily interrupted their clinical practice due to illness/injury, administrative positions, graduate studies, elected/appointed political office, etc. Diplomates who have direct or supervise patient care in a field other than thoracic surgery. Diplomates in this category are required to participate in all parts of MOC except Part IV (evaluation of performance in practice). For additional information please refer to the Board’s Inactive Status Policy.

Retired and/or Disabled Includes individuals who are certified, but who have notified the Board of their retirement and/or disability Return to active practice or inactive practice is unlikely Not required to participate in MOC. However, Diplomates in this category who anticipate return to medical practice should consider changing their status to Certified-Inactive and participate in MOC before their certificate expires.

Not Certified Diplomates who have allowed their certificates to lapse and/or those whose certificates have been suspended or revoked. Diplomates who are no longer certified are not allowed to participate in the MOC process. Diplomates who hold lapsed certificates can only renew their certificate by retaking and passing the Qualifying (Part I) and Certifying (Part II) examinations. This category also includes all individuals who have not taken and passed both Part I and II certification exams. Individuals who have applied and been accepted for examination, but who have not yet taken and passed both Part I and II will be referred to as “in the certification process” without further clarification.

Maintenance of Certification (MOC) History Program of recertification All ABMS member boards agreed to evolve their recertification programs to one of continuous professional development (2000) All ABMS member boards received approval of their ABMS MOC program plans (2006) Ensures that board certified physicians maintain competency in a specialty Commitment to Lifelong Learning

Maintenance of Certification (MOC) ABTS Plan Initiated in 2008 “Responsible but Reasonable” 10-year cycle for ABTS Diplomates with a 5-year milestone No grandfathering for ABTS Diplomates Over 3000 CT surgeons have participated Reasonable cost Currently $275 a year for Maintenance of Certification Fees SESATS is provided at no cost to Diplomates completing the 5-year milestone

MOC Components Part I: Professional Standing Part II: Lifelong Learning and Self-Assessment Part III: Cognitive Expertise Part IV: Practice Performance Assessment

Five-Year Milestone Professionalism Active medical license Two letters of reference VP Medical Affairs/Quality Member on staff Life-long Learning and Self-Assessment 150 AMA Category I CME for previous 5 years Half of CME needs to be in broad category of Thoracic Surgery

Five-Year Milestone (cont.) Cognitive Experience Take and complete current version of SESATS Practice Performance Starting in 2016 participate in Practice Improvement Plan

Ten-Year Milestone Professionalism Active medical license Two letters of reference VP Medical Affairs/Quality Member on staff Life-long Learning 150 AMA Category I CME for previous 5 years Half of CME needs to be in broad category of Thoracic Surgery

Ten-Year Milestone (cont.) Cognitive Experience Successfully complete an online, secured modular SESATS exam based on your practice profile Able to take the modular exam 2 years ahead of the year certification valid-through date 15 hours; 10 Log in; at home from September 1 to October 31, 2015; secure monitoring; 100 questions in your specialty with critical care core

Ten-Year Milestone (cont.) Practice Performance Complete a case list of the past year Participate in an approved database Starting in 2016 participate in Practice Improvement Plan in lieu of database

Part IV-Database/Practice Improvement Plan “Gold standard” is STS database ABTS approved databases-listed on the website ABTS has voted to replace the requirement for mandatory database participation with Clinical Practice Performance Improvement Plan. This requirement will go into effect in January 2016. Examples: Use the STS database to perform and document a QI project, participate in a regional QI project (ie, Michigan Cardiac Surgery Collaborative), participate in the Multi-Specialty Portfolio Program with an approved QI project

ABTS Web Site

Certificate Expires in 2017

ABTS Web Site

ABTS Facilitating the Process MOC ABTS Facilitating the Process New interactive website Electronic application process E-commerce Continue providing a self assessment learning tool (SESATS) Working with STS and AATS to develop required learning modules, such as patient safety and Performance Improvement CME (PI-CME)

Summary of MOC An important and large part of the ABTS responsibility ABTS to protect the public and maintain high standards for our Board's Certificate Self regulation is better than CMS Life long learning with 10-year cycle and 5-year milestone The ABTS goal is to make MOC meaningful, but not onerous “Responsible, Defensible and reasonable”