As Simple As Possible – AANS CME Plus MOC Equals Education Innovation

Robert A. Ratcheson, MD

Albert Einstein, one of history’s great minds, reportedly observed that “Everything should be made as simple as possible, but not simpler.” This dictum makes sense when considering how best to provide neurosurgical continuing medical education in the 21st century.

My column in the fall Bulletin followed neurosurgical CME as it evolved through the 20th century and offered comments on the rationale associated with the new maintenance of certification requirements which have been mandated by the American Board of Medical Specialties, and adopted by the American Board of Neurological Surgery. As noted in the column, there are complexities associated with MOC, as with nearly every aspect of CME today, and just as sure, some of these complexities are not easily simplified. This is where the American Association of Neurological Surgeons can be most effective on your behalf.

The AANS understands that significant concerns exist among neurosurgeons regarding the time and cost that will be necessary to fulfill these new requirements. Our members need, if not a simple solution for handling CME, then at least a solution that is as simple as possible.

The AANS has been working with the ABNS to ensure that AANS members’ participation in the CME aspect of the ABNS MOC Program will be as seamless as possible. Extensive planning by the AANS over the last few years will come to fruition in 2005 when AANS members start their new three-year CME cycle on Jan. 1, and ABNS diplomates are scheduled to receive the first MOC application on July 1. I would like to highlight for you the AANS services which have been developed to augment fulfillment of CME requirements and MOC.

The AANS has developed a CME program that has undergone considerable expansion and will meet the needs of its members. The AANS already offers secure, online CME tracking at MyAANS.org. In addition, there are several innovations to the AANS CME programs that you will find beneficial.

The AANS CME Mechanism for Diplomates The AANS will continue to track credit for educational activities that are jointly sponsored and endorsed by the AANS and also for those that the ABNS has deemed acceptable for MOC credit. The service is free of charge for AANS members; however, a fee will be charged for this service to nonmembers. The AANS also is tracking CME by subspecialty, as a service for those members who need this information to satisfy state and local CME subspecialty requirements. MyAANS.org additionally provides information on the state CME requirements and offers the ability to track your CME for relicensure.

“The AANS has developed a CME program that has undergone considerable expansion and will meet the needs of its members.”

New CME Content for MOC The AANS CME program includes a newly created category of endorsed CME programs which not only will be acceptable for category 1 credit toward the membership requirements of the AANS, but will also offer members considerable assistance in obtaining the requisite credits to satisfy the MOC requirements of the ABNS. Programs sponsored or jointly sponsored by the AANS will be accepted for MOC credit. In addition, upon application, the AANS Education and Maintenance of Certification Committee will review ACCME-accredited programs for endorsed status.

In general, programs eligible for AANS endorsement will have to meet the following criteria:

• The program is of importance for neurosurgeons.
• The program is not sponsored by a commercial entity.
• The program already has ACCME accreditation.
• The program must have meaningful neurosurgical input in the planning stage.

Meetings fulfilling these criteria should be eligible for category 1 neurosurgical credit that would be acceptable for the membership requirement of the AANS through the endorsed and cosponsored CME program. All accredited providers of CME would be eligible to fill out an application, with only a nominal fee to have their meetings endorsed by the AANS. The review by the Education and Maintenance of Certification Committee would be less comprehensive and costly than for a direct or jointly sponsored program. All nonaccredited providers of CME will still have to apply to the AANS for joint sponsorship.

On a parallel course, the ABNS is developing criteria for CME courses. Since MOC will require credits in addition to those required for AANS membership, the ABNS will accept some courses that do not fulfill either AANS membership requirements or ABNS neurosurgical credit requirements. I suspect that many category 1 educational courses that meet the American Medical Association’s guidelines for the Physician’s Recognition Award will be acceptable toward MOC. That decision, however, remains in the hands of the ABNS. It is important to remember that the distinction between CME offerings that meet AANS membership requirements and CME offerings that meet ABNS MOC requirements may not be identical. It is also important to remember that ultimate discretionary power regarding ABNS Maintenance of Certification CME approval rests with the ABNS and that the AANS may suggest, but does not accredit CME offerings for the ABNS.

I would like to review with you some additional features of the AANS’ CME program.

• New CME Content for MOC The AANS Committee on Education and Maintenance of Certification continues to implement our project to develop CME content whereby diplomates can obtain the requisite credits for the six competencies.
• Neurosurgical Focus Available for CME Monthly articles in the online journal Neurosurgical Focus have been enhanced with a CME test. Takers read the articles and then access the test questions in “My AANS.org” Web site for immediate uploading into the members CME record. One category 1 credit is available per month with a maximum of 12 credits per year. We anticipate that the same process will be implemented for the Journal of Neurosurgery beginning in 2005.

We believe that the addition of online, no cost CME credits for AANS members answers the concern expressed regarding additional expense and time away from practice necessitated by attending “AANS certified CME courses.” In fact, the number of online credits available could potentially reduce the need to attend some meetings.

For Further Information

American Association of Neurological Surgeons www.AANS.org/education AANS CME requirements and opportunities Breaking information on AANS programs and services related to the ABNS MOC Program American Board of Neurological Surgery www.abns.org/maintenance.html ABNS MOC Program information MOC brochure–includes important dates for MOC implementation American Board of Medical Specialties www.abms.org/moc.asp ABMS MOC information

I hope you find the above enhancements to the AANS CME programs both reassuring and desirable. However, please remember that the AANS is not prepared to accept every category 1 educational course to satisfy its membership requirements. We believe that the organization has the obligation to set membership standards which will assure the public of the organization’s commitment to appropriate continuing medical education specifically for neurosurgeons.

An excellent way to launch the new AANS CME cycle is to attend “Education and Innovation in Neurosurgery,” the 2005 AANS Annual Meeting, April 16-21 in New Orleans. This scientific meeting not only fulfills the requirement for neurosurgeon members to attend one AANS annual meeting every three years, but attendees also are eligible for 21.5 credits toward the AANS Continuing Education Award in Neurosurgery.

Of course, the core reason to attend the 2005 AANS Annual Meeting is simply to immerse oneself in the new ideas and techniques presented by our colleagues from around the world. For all of these excellent reasons, I hope you will join me in New Orleans.

Robert A. Ratcheson, MD, is the 2004-2005 AANS president. He is the Harvey Huntington Brown Jr. professor and chair of the Department of Neurological Surgery at Case Western Reserve University and at University Hospitals of Cleveland.

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