Well it is now May and more than ¼ into the calendar year. The deadline for completing the Pediatrics MOC (Maintenance of Certification) cycle including the exam is looming. Since I do need to leave a margin of error, I have decided now is the time to get through Part 2 of the MOC cycle and begin thinking about Part 4. Recall, I already completed Part 1 by having a medical license.
I discovered that Parts 2 and Parts 4 are intimately linked like Heckle and Jeckle
Between Parts 2 and Parts 4, I must complete 100 points divided as follows:
-Part 2 – Lifelong Learning Cognitive Expertise: 40 Points
-Part 4 – Performance in Practice: 40 Points
Therefore, I must get at least 40 points through Part 2 Activities. There is an additional 20 points that I can decide between Part 2 and Part 4 Activities. At this point I am not sure which way I will go with this. This is because Part 4 Performance in Practice is a large unknown.
This still begs the question, if Parts 2 and 4 are activities done in concert with each other, why aren’t these PARTs 2 and 3 with the exam being Part 4. As if the process isn’t convoluted enough.
This is like Billy Crystal in Analyze This asking “How can we talk about the first thing without discussing the 2nd thing first???”
Part 2 is primarily questions and answers on relatively known territory.
At the time of that writing I didn’t pay any particular attention to the details of these 3 options. That was because I wasn’t personally going through the process. I now have learned more and will share that with you now.. Boy this has more subplots and number patterns than an episode of Touch.
The components are as follows with my analysis of each:
Knowledge Self Assessment -While there are a variety of options which you can search for the one I suggest as a no–brainer is the “American Board of Pediatrics General Pediatrics Comprehensive Knowledge Self- assessment, 2013” which consists of 200 multiple choice questions selected from the secure exam (aka Part 3) pool. You get to kill 2 MOC birds with 1 stone. You get 10 “Part 2 points” while practicing for the test and assessing your areas of strength and weaknesses.
You are also told that your chances of passing the secure exam can be predicted based on how you do on this set of questions as follows:
| Your score | Likelihood of passing the Secure Part 3 Exam |
| 80% or greater | Likely |
| 66% -79% | “Uncertain |
| 65% or less | FUGGETABOUTIT [1] |
The best part of all is there is no minimal number correct to pass. You can also take this as many times as you want and essentially know these questions cold. You get “immediate feedback“ which simply means you will be told either you answered the question correctly or you answered it incorrectly. In addition, you will be told which answer was correct.
However, you will not be provided with detailed answers. This is where a good review book will come in handy. You can take notes or study in real time regarding the details of the topic being questioned and learn it for the next time the concept is tested or when you come across it clinically, which is supposedly the point of all this.
I was so excited about this that I re-enrolled for another set of questions. After answering the questions again, I got a confirmation of completion email from the ABP which stated that I can check my dashboard to see how it was applied. I assumed I would be getting 10 more points. WRONG! You only get credit for this set of questions once and once only.
I really do suggest you take the time to write down the specific topics you do not do well on and START with those topics when reviewing for the Part 3 recertification exam requirement. There are also a limited number of images you have to click on for some of the questions, much like you will have to do on the actual exam.
There are other sets of questions you can choose from. To my own peril I thought the same rules applied that no passing grade was required. At this point it appears, that for the other options you need to get 80% correct. Unlike other CME question sets, you do NOT get to answer them over and over until you get them right. Here you only get ONE more opportunity to answer the questions you got wrong. If you still don’t reach the 80% threshold, that module is not available for you this year.
So I decided to try my hand at the next option which are:
Subspecialty Questions
Well here again, you have to get at least 80% correct and do not have unlimited attempts to answer the questions you got wrong. After a humiliating attempt to answer subspecialty questions I decided to try my hand at the 3rd Part 2 activity, which is:
Decision Self Assessment Skills
This is worth 20 Part 2 points and is more in line with General Pediatrics. Interestingly, it actually is fun.
Here you are given a patient brief history and are provided with a medical history , physical findings and diagnostic studies. There are 50 such questions.
You then have to either pick a diagnosis, or decide what study to do next etc. There are more than 4 choices here. After going through all this, you are either right or wrong.
Here you also have to get 80% correct which means you can only get 10 wrong in order to hit the bell and get your 20 points.
If you do not get 80% you get to take it again. However if you still get less than 80% on your second chance, you are done and will have to find other activities to get your Part 2 card punched.
In this case you ARE given detailed explanation and summary but only after you have committed to an answer.
I am currently in the middle of this and will update my status with the next blog. If I successfully complete this activity I will have 30 total points (20 here and 10 from the General Pediatric Knowledge Self Assessment)
I will still have to choose another activity worth 10 points to get my 40 Part 2 points.
I will need another 20 Part 2 points if I choose my combination points to be Part 2 rather than Part 4.
Once I complete the Decision Skills section… hopefully successfully I will write about my next steps on the road to MOC.
By the way we invite you to discuss your experiences and if you found any relatively painless approved activities for completing the Part 2 requirement.
[1] Outside of Brooklyn the phrasing is different.