Continuing medical education, long an integral component of a neurosurgeon’s professional career, took on new significance when the American Board of Medical Specialties announced its maintenance of certification mandate. The purpose of MOC, which affects all 24 member boards, is basically to assure the public that medical practitioners adhere to a standardized system of lifelong learning. As an ABMS member, the American Board of Neurological Surgery announced its own MOC program in 2002.
Compliance with MOC requirements, a vigorous CME component among them, is a hot button issue for all practicing neurosurgeons and for AANS members as well. As a member benefit, two years ago the AANS established the Education and Maintenance of Certification Committee, which specifically is charged with interfacing with the ABNS regarding tracking of CME information and potentially transmitting this information to the ABNS for credit recognition. It was and remains my privilege to chair this committee and to work through the CME evolutionary process on behalf of the membership.
I have prepared this article to inform you, our members, of where we stand; what we have already done to make compliance with MOC as easy, streamlined, and productive for you as we can; and what we have planned for the next 12 months. I also will answer a number of frequently asked questions about AANS member benefits and how they complement the ABNS MOC program.
AANS members have traditionally obtained CME credits because of their commitment to staying current, continuing lifelong education, and acquiring new knowledge. To my mind the joy of learning is the primary purpose of CME. However, over the years CME requirements necessarily have evolved. AANS members currently are required to satisfy two separate sets of CME requirements. First, acquisition of category 1 CME credit has always been required as a condition of ongoing membership in the AANS. For this membership requirement we specify 60 credits of category 1 neurosurgical CME for every three-year cycle. Second, ABNS diplomates certified in 1999 and after (and who may or may not be AANS members) will be required to obtain 150 CME credits for every three-year ABNS cycle. This is only one of the requirements of the ABNS MOC process. I will not discuss further the ABNS requirements regarding MOC since that information really needs to be disseminated to diplomates by the ABNS itself. For the purposes of this article, I will primarily discuss the CME requirement for AANS membership.
It is important for Active and Active Provisional AANS members to understand that the AANS CME requirements for membership (toward the AANS Continuing Education Award in Neurosurgery), and the ABNS CME requirements for its MOC program are different both in terms of the number of hours required and the type of CME that is acceptable. As I said, the AANS requires 60 credits per three-year cycle of category 1 neurosurgical CME. The ABNS has informed us that they will accept other types of CME credit in different categories. One thing is certain: All category 1 CME credits counted toward AANS membership will also count toward ABNS MOC. What our members need to know now is that the AANS, as a member benefit, will log and track all CME credits for members at www.MyAANS.org, even those credits that don’t meet the AANS membership requirement.
The AANS does and will continue to accept paper transmission of CME documents to be logged in a member’s file that ultimately will be transmitted to the ABNS as part of the MOC cycle. The process of doing this implies that members will send in some CME credit verification certificates that do not currently fulfill the AANS membership requirement. Let there be no confusion about this. We are happy to track, log, and transmit this information to the ABNS. However, for the purposes of AANS membership, the AANS has established criteria regarding acceptable CME credits. These criteria are flexible and inclusive. I will discuss this process in somewhat greater detail later. In addition, you will note that the number of credits required for AANS membership is significantly lower in the three-year cycle than the number of credits required for ABNS MOC requirements.
The next question on the member’s mind is, no doubt, “What qualifies for what?” As I said, I am going to limit my comments to credits that are acceptable for the AANS Continuing Education Award in Neurosurgery. When the EMCC was formed, its members specifically looked for ways to maximize the number of available offerings to members and to make this as clear as we could to the membership. We canvassed members of all the AANS/CNS specialty sections to ask which meetings they thought were appropriate for credit and what would be of value to members in the specific subspecialty disciplines. As we did this we kept in mind the four basic principles, mandated by the AANS Board of Directors, delineating quality CME for members. These principles were outlined in then-President Robert Ratcheson’s message in the Winter 2004 issue of the AANS Bulletin, and I will repeat them here:
- The program is of importance for neurosurgeons.
- The program is not sponsored by a commercial entity.
- The program must have meaningful neurosurgical input in the planning stage.
- The sponsoring organization must be an accredited provider of CME.
| AANS Education and Maintenance of Certification Committee (EMCC)
Chair Christopher M. Loftus, MD Mitchel Berger, MD Julius Goodman, MD Robert Harbaugh, MD David Jimenez, MD Paul McCormick, MD Jon Robertson, MD James Rutka, MD Joni L. Shulman, AANS Clarence Watridge, MD |
In addition, the EMCC has worked hard to provide alternative methods and a broad repertoire of offerings, besides meeting attendance, for members to obtain category 1 CME credits that fulfill their AANS membership requirement. You will note on the AANS Web page that the online journal Neurosurgical Focus now has a CME component that allows AANS members to accrue category 1 CME credit, without charge, by reading the journal online and taking a true-false test. We plan to have this benefit available for the Journal of Neurosurgery as well within the next six months. Later this year we expect to have no-charge patient safety programs online which qualify for category 1 CME credit for AANS membership and which likewise may help members fulfill the requirements of their state medical societies regarding patient safety and professionalism competencies.
Further, members who purchase the Vertebroplasty and Kyphoplasty book, released at the AANS Annual Meeting in New Orleans as the latest AANS Publications Committee offering, have an option to obtain CME credits by completing an online self-assessment test based on the text material. Also available in the AANS catalog is the Minimally Invasive Spinal Techniques DVD, which offers optional CME. The AANS Publications Committee will continue its efforts to produce enduring materials that offer CME. In addition, the AANS has partnered with Oakstone Medical Publishing, producers of CD ROM-based CME products, to make Oakstone products that qualify for category 1 neurosurgical CME available to AANS members at favorable rates.
| Acronyms and Abbreviations | |
| AANS | American Association of Neurological Surgeons www.AANS.org |
| ABMS | American Board of Medical Specialties www.abms.org |
| ABNS | American Board of Neurological Surgery www.abns.org |
| ACCME | Accreditation Council for Continuing Medical Education www.accme.org |
| AMA/PRA | American Medical Association Physician’s
Recognition Award www.ama-assn.org |
| CNS | Congress of Neurological Surgeons www.neurosurgeon.org |
| CME | Continuing Medical Education |
| EMCC | Education and Maintenance of Certification Committee |
| MOC | Maintenance of Certification |
| SANS | Self-Assessment in Neurological Surgery |
Let me go on to answer some frequently asked questions regarding CME for the AANS membership requirement.
Frequently Asked Questions
How do I get credit?
Attendance at any of the AANS sponsored or jointly sponsored meetings is automatically logged for all medical attendees. This information will appear on the member’s CME page at www.MyAANS.org, where it will be available for certificate generation. For meetings in the cosponsored-endorsed category, we ask the member to send in a certificate, which will be manually entered by AANS staff into the member’s record for accrual toward the AANS Continuing Education Award in Neurosurgery. AANS staff is prepared and pleased to do this as a member benefit. Certificates from meetings that do not qualify for the AANS award also should be sent in so that this information can be logged and tracked for state requirements as needed, as well as transmitted to the ABNS and counted toward the MOC requirement.
While this record-keeping service is a membership benefit for AANS members, neurosurgeons who are ABNS diplomates but who are not members of the AANS will be charged a fee. This is only appropriate, and it would be inappropriate for AANS members to shoulder the cost of providing this service to neurosurgeons who do not choose to be members of the association. Since you are reading this article in the AANS Bulletin, you are most likely a member of the AANS and don’t have to worry about this any further.
How is the AANS helping me meet my ABNS MOC obligation?
The AANS and the EMCC cannot make decisions on behalf of the ABNS. Only the ABNS Board of Directors can do this. Therefore, you, as a member, should understand that there most likely will always be a mismatch, albeit small, between what CME credits the AANS will accept toward AANS membership requirements and what the ABNS will accept for its MOC requirements. The ABNS basically will accept credits from more providers to fulfill its requirement of 150 credits per three-year cycle, while the AANS will accept a smaller repertoire of offerings, consistent with the four principles outlined above, but requires only 60 credits for its three-year cycle. ABNS diplomates, who must meet the ABNS requirements for MOC, should have no difficulty satisfying their CME requirement for AANS membership simultaneously since the AANS requires far fewer credits.
| CME on the AANS Web Site
CME Tracking aans.org/education/cme.asp CME Accepted by the AANS www.aans.org/education/educational/cme_list.pdf Cosponsored-Endorsed Activities www.aans.org/education/co_sponsor.asp Jointly Sponsored Activities www.aans.org/education/jointly.asp Home Study CME www.aans.org/education/home_study_cme_act.asp |
My meeting doesn’t appear on the list. What do I do?
From the EMCC’s inception, we did everything we could think of to be sure that all qualified meetings were included on the master list of jointly sponsored or cosponsored-endorsed meetings that count toward the CME requirement for AANS membership. We asked neurosurgeons and neurosurgical leaders in various specialties what they thought would be appropriate. We recognize that the process is evolutionary. We continue to include new meetings; for example, we recently have endorsed state neurosurgical meetings in Pennsylvania, Missouri and Texas.
So how does my meeting become a jointly sponsored or cosponsored-endorsed activity?
The organizers of any meeting of any neurosurgical CME offering should contact the AANS Education Department. There are two separate processes for attaining joint sponsorship and cosponsorship-endorsement. Information and an application for each process are available from the AANS Education Department and online at www.aans.org/education/co_sponsor.asp and www.aans.org/education/jointly.asp. A frequently updated list of jointly-sponsored and cosponsored-endorsed activities is available at www.aans.org/education/educational/cme_list.pdf. We ask that the application process be done so that we have documentation of the neurosurgical content and planning of the CME activity per ACCME requirements, and to make sure that the course is not commercially sponsored. The process is efficient, and jointly sponsored or cosponsored-endorsed status can be granted fairly easily. Regarding meetings at a local level, such as hospital grand rounds or departmental conferences, the AANS does not feel that we have enough oversight to place such meetings in the cosponsored- endorsed category. We still encourage members to send in these certificates for logging into their records at www.MyAANS.org for potential recognition by the ABNS as part of their MOC process.
I offer a final take-home message about the CME process at the AANS and the function of the EMCC: The EMCC has worked hard, and will continue to do so, to develop a process whereby members can easily and seamlessly acquire the necessary credits to maintain their AANS membership as well as satisfy the requirements of the ABNS MOC program. We are developing as many options as we can, as quickly as possible, so that members may obtain CME credits from national meetings, in meetings of their subspecialty, in meetings at the state level, and online or with enduring materials and CD activities. We will continue to develop this broad repertoire of options. We invite you to go online and take a look at www.MyAANS.org and your CME record. If you have a state meeting or a special offering and you’d like to seek cosponsored-endorsed status, by all means, contact us and we will make it as easy for you as we possibly can. CME tracking and CME offerings are member benefits, and we are taking our responsibility of providing these benefits very seriously. Let us know how we can help and we will do everything we can to do so.
Christopher M. Loftus, MD, FACS, is chair of the AANS Education and Maintenance of Certification Committee. He is chair of neurosurgery at Temple University in Philadelphia