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Building Strong Careers from Residency to Retirement

Monday, March 12, 2018 - 16:45

Pediatricians in practice have spent, on average, four years in medical school and have successfully completed three years in pediatric residency (plus another two-to-three years if they trained in a subspecialty).

These pediatricians have qualified for a medical license in each state in which they practice. And the majority have taken and passed an intense, seven-hour, 335-question exam to become certified by the American Board of Pediatrics (ABP).

This wealth of skills and knowledge provides a strong foundation on which to start a successful and rewarding career. 

Then, to remain current with evolving best practices, pediatricians must keep up with medical literature, confer with other pediatricians, and evaluate the outcomes of their own patients — in short, continue to build their medical knowledge and improve their practices so they can provide the best care possible for patients.

“Instilling the culture of continuous learning starts in residency,” says Ann Burke, MD, Professor of Pediatrics, Pediatric Residency Director, and Vice Chair for Pediatric Education, Boonshoft School of Medicine, Wright State University. 

“We have to make sure that our trainees are graduating from our residency programs understanding that what they know the day they graduate will change in five to 10 years — and maybe even in three months,” she says. “They need to be able to check their insights and self-assessments with physician colleagues, other staff, patients and families, and against objective data. And most importantly, they need to be open to learning new things.”

-Dr. Ann Burke

Keeping abreast of fast-paced advances is not easy, especially after pediatricians are out practicing on their own. The ABP supports their efforts through continuous certification activities. The four parts of Maintenance of Certification (MOC) are professional standing, lifelong learning and self-assessment, cognitive expertise, and improving professional practice.

“I finished my residency in 1987,” says Richard Shugerman, MD, Professor of Pediatrics, Seattle Children’s Hospital/ University of Washington, and Chair of the ABP’s Education and Training Committee. “The ways we practiced medicine then are radically different than they are now in 2017. If you really want to provide the best possible care for patients and families, you’ve got to find a way to stay up on the latest literature and adapt your practice to the latest approaches. It’s challenging, but it’s something that we all have to do.”

The best approach is to work learning into daily life, he says.


Keeping Current through MOCA-Peds

“What can you do in 15 minutes that’s going to advance your knowledge?” Shugerman says. “What can you do in 10 minutes between patients, rather than saying, ‘Well today I’m going to spend four hours reading.’ That’s why I think MOCA-Peds makes a lot of sense.”

MOCA-Peds (Maintenance of Certification Assessment for Pediatrics) is a web-based (and mobile) approach to assessing cognitive expertise that is currently being piloted by the ABP. MOCA-Peds delivers multiple-choice questions to pediatricians quarterly. Pediatricians have five minutes to answer and can use resources. They find out immediately if they answered correctly and get references to articles that support the correct answer.

Learn more about MOCA-Peds.

“The board is intentionally providing more learning opportunities,” says Carol Carraccio, MD, MA, ABP Vice President of Competency-Based Assessment. “MOCA-Peds is a great example of this. Rather than focusing only on assessment of learning, the ABP is balancing assessment of learning with assessment for learning.”

-Dr. Carol Carraccio



MOC Credit for What You’re Already Doing

Other examples of how the board is encouraging pediatricians’ continuous learning are through practice improvement activities — MOC Part 4. At Texas Children’s Hospital in Houston, Manish Shah, MD, and former pediatric emergency medicine fellow Megan Marino, MD, earned MOC credit for a project that implemented treatment guidelines they developed for first responders transporting children who are having seizures or anaphylaxis. To earn MOC credit, the doctors showed how the guidelines and training led to improved care.

“This is a great illustration of how the ABP was able to recognize and provide MOC credit for a project these pediatricians were already doing,” says Virginia Moyer, MD, MPH, ABP Vice President of Maintenance of Certification and Quality. “MOC activities should be relevant to practice, and with input from many pediatricians, we’re developing new ways to support their learning opportunities and practice improvements.”

Claim credit for the QI work you're already doing.


Feeling Prepared for Mental and Behavioral Health Cases

The ABP is trying to help pediatricians identify and fill gaps in their knowledge that could hinder their ability to help children and their families. For example, research shows that many pediatricians feel unprepared to diagnose and/or treat mental and behavioral health issues. The ABP is leading efforts to improve pediatric readiness to diagnose and manage these conditions. A variety of MOC activities are available to strengthen pediatricians’ knowledge of when and how to intervene.

Behavioral and Mental Health: Gaps and Challenges



Meanwhile, the ABP also is strengthening the connection between continuing medical education (CME) activities and MOC lifelong learning activities. Working with the Accreditation Council for Continuing Medical Education (ACCME) and CME activity providers, the ABP can now award MOC credit to pediatricians who complete qualifying CME activities.

Learn more about earning both MOC and CME.

Kenya McNeal-Trice, MD, Associate Professor of Pediatrics and Pediatric Residency Program Director at the University of North Carolina School of Medicine, says that continuous learning is essential for pediatricians in all stages of their career.

“Being a good pediatrician goes beyond just simply caring for patients. It also involves ensuring that we’re lifelong learners and that we’re engaged within our communities — not only to make sure our practice continues to improve, but to ensure that our medical systems continue to improve to provide higher standards of care.”