Dr. Scheurer
Table 1: Requirements for Recognition of Focused Practice in Hospital Medicine
Dr. Scheurer
Table 2: Content of Hospital Medicine secure exam
Dr. Scheurer
Table 3: Pass rates for the Hospital Medicine exam, by year
By now, most hospitalists have at least heard about the Recognition in Focused Practice in Hospital Medicine (RFPHM), which is offered as a variation in certification for internal medicine- and family medicine-trained graduates who are pursuing Maintenance of Certification (MOC). Although the requirements are relatively straightforward, it may not be abundantly clear exactly why a hospitalist would pursue this pathway. As a recent “graduate” of the first cycle of the program, I can testify it is wholly worth the time and energy for the following reasons:
1. The requirements are relatively easy. Table 1 outlines the requirements for eligibility for enrolling in the program through the American Board of Internal Medicine (ABIM); enrollment through the American Board of Family Medicine (ABFM) also is available. These are basic requirements, and most practicing hospitalists will easily qualify simply by doing their daily jobs. Enrollment does require an administrative fee, but many HM programs can—and should—reimburse you for these fees, so be sure to ask if your program will cover the cost.
After enrolling and paying the fee, your next step is to accumulate points toward certification. Of note, the 100 points do not all have to be accumulated prior to sitting for the exam, but accumulating these points generally prepares you for the exam, so it is a good idea to complete this task before the exam, in most circumstances.
The medical knowledge modules can be completed through ABIM/ABFM, the Society of Hospital Medicine (SHM), or the New England Journal of Medicine.1 A repertoire of clinical and non-clinical modules are offered by ABIM, and there are two modules on quality-patient safety offered by SHM. You can attend a number of pre-courses offered at local-regional-national HM meetings; these modules can be completed individually or in a group setting. A list of available group learning sessions can be found at www.abim.org. You can earn CME credit for completing these modules. Not only are the medical knowledge modules readily available, but they are also well written, are easy to complete, and prepare you well for the exam.
The practice performance modules can be completed through ABIM/ABFM or through a number of medical centers that participate in the American Board of Medical Specialties “Portfolio Program.” For organizations that participate in the program, hospitalists within the organizational network who have completed a quality improvement project may qualify for module credit. A list of these sponsoring organizations can be found at http://mocportfolioprogram.org/approved-portfolio-sponsors.
Hospitalists can earn practice improvement module (PIM) credit for being involved in a number of large collaborative projects, including SHM’s mentored implementation programs (e.g. glycemic control, VTE, and Project BOOST).3
For those completing a PIM through the ABIM, the most straightforward are the self-directed PIM or the completed project PIM.2
2. The exam content is known. Table 2 lists the content categories of the secure exam, published by ABIM, with approximate percentages of the content within overall categories and subcategories. This information helps you focus your efforts in preparing for the exam and is aligned with what most hospitalists practice on a daily basis.
3. The exam preparation is easy. Not only is the content outlined in the blueprint in Table 2, but practice exams are available online from the ABIM and a tutorial can be found at www.abim.org/hospital-medicine-tutorial. This tutorial simulates the actual exam, to enhance preparation and reduce testing anxiety.