Hi, I'm Bob Bowen. I'm from the Menninger Clinic in Houston and in the Baylor College of Medicine. I'm here with Joan Anzia. Joan, would you like to introduce yourself? Hi, I'm Joan Anzia. I'm a professor and vice chair for education in the Department of Psychiatry and Behavioral Sciences at Northwestern University at Feinberg School of Medicine. I'm glad to be here with Bob. Great. And we want to really thank the APA for asking us here to keep you all informed about what's happening at the American Board of Psychiatry and Neurology, especially about certification and continuous certification. So here we go. First of all, I would want to note that we're both, Joan and I, are both on the Board of Directors of the APPN. So we are kind of representing them here. And Dr. Anzia is the chair of the Committee on Continuing Certification. I'm also on the committee. So here's what we're going to cover. I'm going to review the existing APPN Continuous Certification Program and its components. This part should be reviewed, but if you're like me, reminders about this are always a good thing. Then Dr. Anzia is going to tell you about the APPN pilot that's been ongoing and will soon be an option, hopefully, for all of us. And then we'll take some questions at the end. I know people have lots of questions in their mind. We're going to try to anticipate what some of those might be. But first, this is fairly hot off the press. If you have already heard, the APPN has extended the deadline for people who need to recertify. So if you were due in, say, last year or this, you could defer to 2022. This is in recognition of the burden of the pandemic that we've all been facing. And for many of us, I know that certification activities just haven't been a priority lately. Now, for those of you planning to certify for the first time, you can delay a year. And if you already signed up for the exam, you can transfer to a later time without penalty. The APPN is monitoring the situation and trying to assure us that the options for taking the test in 2021 will be available for those who want it. Now a little bit about continuous certification. In case you're wondering where the APPN does why they do this and how they came up with the standards, well, this is how. The APPN and most of the specialty boards are overseen by the American Board of Medical Specialties, or the ABMS, who defined the standards last in 2015. The goal, as you can imagine, is to balance quality and credibility with convenience and cost. And of course, diplomate satisfaction is important, which I think is best. And I'm most satisfied if the process seems relevant and helpful to my own practice. I'm sure you would feel the same way. Finally, it'll be more helpful to us all if the activities for MOC also fulfill other requirements, such as, say, for state licensure or hospital credentialing. Now, I do want to stress that the APPN does not lobby or try to influence hospitals or states to make board certification a requirement for credentialing or licensing. However, if the activities for board certification also happen to meet those for one or the other two, well, all the better. Then we get a twofer. So here are the standards. We're listing them here. And in the next slides, I'm going to go into more detail. But briefly, you have to have unrestricted medical license, do a patient safety activity, take an exam every 10 years, and perform the continuous certification activities every three years. This is what's current. Those activities include doing a CME and a subset of those being self-assessment CME. You also have to do a performance and practice activity, either a clinical or a feedback-related one, and attest these on your portfolio and pay the annual fee. Currently, the fee is $175. The good thing being that after you've paid this amount, which is, I think, rather modest each year, you don't have to pay a big exam fee in 10 years. It's already covered. Now, you'll notice, by the way, I keep referring to this process as continuous certification, CC. You might wonder what happened to MOC, or maintenance of certification. Well, we changed the name. I think continuous certification, or CC, is really more descriptive of what we want it to be an ongoing process of lifelong learning, as opposed to, you know, just something you do every 10 years and then just forget about. So a bit more detail to remind us of the components of continuous certification. According to the ABMS, we all have to show proof of our professionalism. In the ABPN, we do this by requiring everyone to have an unrestricted medical license, which we consider a measure of professionalism, overseen by state boards, of course. And as you can see in our definition, professionalism does go beyond that. And we believe that this is a whole process of ongoing commitment to excellence and self-improvement, which is really part of professionalism. And as we know, we all have to do ongoing self-assessment. 24 CME credits required every three years, so averaging about eight credits per year. Now you get these credits by doing approved activities, and you can find a list of the ABPN on the ABPN website of all the different approved activities, and they include a lot of free or inexpensive options that are sponsored by, say, the APA or other professional societies and subspecialty organizations. At least once you also have to do a patient safety activity, and I'll say more about that in a bit. In addition to doing the approved self-assessment activities, there are a bunch of other equivalent things you can do to get some of the credits. For example, you can take an exam. That counts for eight credits. Or getting a peer-reviewed grant funded, or publishing a peer-reviewed article, being part of a peer supervision group, or being on a peer supervision committee that reviews clinical performance. That also counts towards eight credits. Finally, being part of an approved registry, such as the one developed by the APA, that counts too. For those of you who are part of the pilot program, which Dr. Ronzi is going to discuss pretty soon, that also counts. So you can get up to 16 credits by doing two of these alternative activities. In addition to the self-assessment, well, you also have to get 30 Category 1 CME credits each year. The point of self-assessment and then CME, if you want it to be most helpful, is to complete a cycle, which I'm illustrating on the next slide. You should use self-assessment to identify your knowledge gaps and then look for CME activities to fill them. Now, I know it's hard to do that sometimes. We all like to do CMEs about things that are in our own comfort zone. But if we really want to be true to the spirit of lifelong learning, we should be using our CME to learn things that we don't know well or deepen our understanding of the things that we do. As I mentioned, we also have to do a patient safety activity. Now, this is a newer requirement. It applies to those of us certifying or recertifying in or after 2016. It is a one-time requirement and it should occur within the first three years of our continuous certification process. Again, there is a list of approved activities on the ABPN website, but many of us already do these things as part of our hospital or other institutional credentialing, and those can count, too, if they're being done by an accredited institution. Finally, there's the exam, which, as you know, is a secure proctored exam given at a testing center, and this takes place every 10 years. To be eligible for the exam, you have to do all that other continuous certification activities that I just described and attest them in your physician portfolio on the ABPN website, and if you haven't looked at your portfolio lately, well, right after this presentation might be a good time. Just go to the ABPN website at abpn.com, click on the physician portfolio. This will take you to a login screen, and once you get past all the security and stuff, you can view your personalized data. Then there's this final part of continuous certification, the performance in practice. You have to do one activity every three years, and that can be either a clinical module or a feedback module. Again, you can find a list of approved modules, you know, on the ABPN site. Sounding familiar, right? And doing one has three steps, initial assessment of example, you know, some aspect of your clinical practice or feedback on your practice. Then you use that data to identify areas for improvement, and you implement those and you reassess yourself. So here's a graphic example. You might review, say, patient care data to see if you're meeting standards of care, such as seeing if your approach to, I don't know, that depression treatment is consistent with the APA guidelines or other guidelines, and then from that you can identify something that you could do better, such as, I don't know, incorporate a treatment algorithm to make sure that you don't wait too long for in cases of non-response. Then you can reassess your data after a time, say a year, to see if things have actually improved. Now, if you just graduated from an ACGME accredited fellowship and passed a board exam for that, we have a grace period of three years before you need to start continuous certification activities. Also, if you have a lifetime certificate, what used to be called grandfathering, you're not required to do continuous certification, but you can choose to by either taking the exam or by starting the new article-based pathway. That last part, the article-based pathway, is, I think, the most exciting part of this, and I'm going to let Dr. Anzia take over and tell you more about it. Joan? Thanks, Bob. It is exciting. Of course, we have, we're a little bit biased in that we've been part of the launch of this program. This is the American Board of Psychiatry and Neurology Continuing Certification Part 3 pilot project that's been ongoing since 2019. The exciting news is that, I want to get ahead of myself, but very soon, all diplomats will be eligible to participate in this form of the knowledge and skills assessment. So, we recreated this as an optional alternative to the ADPM secure proctored exam that we're all used to taking every 10 years at Pearson VUE, you know, studying for it and going down to the center and spending a day. So, we want to, we really wanted to create a program that was much more flexible, feasible, relevant to physician practice, and particularly physicians could do on their own time and really use in their own practices. So, when we launched this pilot program in 2019, it was only for psychiatry, adult psychiatry, child psychiatry, neurology, and child neurology. So, we really had four committees working on this to select the articles and write questions. So, the pilot program, it will last three years. It will end, well, it was supposed to end at the end of this year, 2021, but because of the pandemic, we've extended people's time to complete the three-year pilot till 2022. So, all of the diplomats who participated in the pilot also meet all the other continuing certification requirements like a non-restricted license, etc. And the eligible folks to participate in this pilot were all the continuing certification diplomats who passed the exam in 2012 to 2014. So, they were all allowed to participate. And then the 10-year diplomats who certificates expired in 2019 to 21. Next slide, Bob. So, this group, this really is, it was designed as an open book exam in that I know many of you have probably participated that we've created a list of current articles on 10 major clinical areas. And the diplomate has to read 30 out of 40 articles during the three-year pilot. And then after they read each article, complete a mini quiz of five questions. And in order to pass, they need to get four out of five answers correct, which really is interesting is that physician can read the articles and do the mini quizzes whenever and wherever they would like to. Once they start the mini quiz, they have to finish it before moving on to the next quiz. And they also get feedback on their answers afterwards, find out right away whether they passed or failed, and then can choose another article. But ultimately, in order to complete, successfully complete the pilot, diplomates have to read and pass 30 of the mini quizzes, the articles, of 30 out of 40. So, let's, next slide, to give you an idea of how many people signed up. So, again, they wrote, they have been reading five multiple choice questions on 30 to 40 articles. It's an online open book format. And those folks who participate will receive credit for the 30 articles. They will be excused from the 10-year, that 10-year examination. This is really an option alternate to the 10-year examination. Okay, next slide. So, this was, we're really pleased that this past October, the American Board of Medical Specialties approved the pilot as a permanent alternative to the 10-year multiple choice exam, which is really terrific, which means we can, we can, it's no longer a pilot. We can, in 2022, open this to all diplomates, which is really exciting. We've decided to name it, after some discussion, ABCC. We thought about ABC squared, but that doesn't translate well, or the article-based continuing certification pathway. Okay, next slide. So, this gives you an idea of how many people who are eligible actually enrolled. So, for adult psychiatry, there are about 14,000 psychiatrists who were eligible to do the pilot, and about 70% of these folks have enrolled in the pilot, and of those, 70% have completed at least one mini-exam, and about 40, the gunners, 43% of those who enrolled actually have completed the whole thing. So, and it's really interesting, because the percentage of folks in neurology, child neurology, and child and adolescent, they're really about the same, about 70, and child neurology, 80% of those chose to participate in the pilot. So, really large numbers have chosen this to do the article-based pathway, as opposed to taking the 10-year exam, and I'm going to show you some of the feedback. Next slide. It was really striking to all of us to find that the overwhelmingly positive response to this alternative pathway, for example, articles easy access, 96% agreed, or strongly agreed, article is helpful to my practice, 93%. So, we were really pleasantly surprised that this was very well received by people who were participating, and in fact, we received individual feedback on situations in which the article that folks had read had been helpful in a clinical encounter that they had recently had. I think in terms of the quality of the questions, those of us who are question writers are working at getting better. These are very different than questions we used to write, because we're writing four articles. So, I'm hoping that the quality of the questions will continue to improve. Next. Okay. So, this is clearly, the pilot has been successful in every way we can think of. Now, the challenge is, how are we going to incorporate all and include all diplomates who want to participate starting in 2022? This is a really difficult challenge because of how there are diplomates who have multiple certificates, who are really not in sync with others' certification and recertification. So, this has been an enormous challenge for the ADPM staff. Fortunately, Bob and I did not have to do this. So, we're going to roll this out. So, I'm going to start with a little bit of an advanced warning, and that is, this is a lot of information, and definitely, as my kids would say, TMI, perhaps too much information. The key is that you don't need to know at least half of this, because you'll have your individual information provided to you. Next slide. Okay. So, the pathway begins for everybody in 2022. So, the pilot included the four at the top, psychiatry, neurology, child neurology, and child and adolescent. But now, we have committees in all of these, 13, addiction, CL psychiatry, forensics, geriatric psychiatry, and then the neurology sub-specialties too, all except neurocritical care. So, we have committees, the ADPMS committees, they're folks nominated to have these committees select articles and write questions, but they're experts in all these areas who volunteer their time to select articles and write questions for them. So, the scale of this project is really quite large. So, this gives you just a breakdown of who is in the current, the pilot pathway now, just at the top, the pilot participants, and, but then there are folks who chose not to participate in the pilot or started it, but didn't, don't want to complete it, or were not able to pass the 30 mini quizzes out of the 40 articles. And then, of course, there were people who weren't eligible. They weren't in that, the group, they were there in the 2000 to 250, excuse me, 2015 to 2018 certification group. And then, we just didn't have enough committees to really provide for other sub-specialties. So, and then there were folks at the time who really weren't eligible for the pilot, folks who had lapsed certificates or lifetime diplomates. So, there were a lot of people who couldn't participate in the pilot and definitely let us know that they wish they could have, but their opportunity starts in 2022. Next slide. Okay. So, this is the basic design of the pathway. This, we're using the same structure as was used for the pilot. All certifications, every, and the sub-specialty certifications are going to have 10 content areas or categories. For example, for adult, there's psychosis, there's mood disorders, anxiety disorders, et cetera, et cetera. So, each of the specialty, sub-specialty areas are going to have 10 content areas, and there are going to be four to six articles in each content category. So, at least 40 to 60 articles in each content category. And you really need to spread out. You can't take like six articles in one particular area. You really need to limit yourself to taking four article assessments in a particular content area, such as psychosis or mood disorders. And then, as I mentioned, you have to answer four out of the five questions correctly on the first attempt. And I said, well, that sounds difficult, but this is an open book exam. While you're doing the mini quiz, you can have the article right in front of you. So, it's really about, you know, understanding, most of the questions are really about interpreting and understanding how to use the information in the article in clinical situations. So, this is not, this is really not about memorizing or trying to recall, it's really how do I use what I've learned from reading this article? And also, we're going to make sure that the same article with the same question doesn't appear in more than one specialty and subspecialty content area. Okay, next slide. All right, so this is where we get into the complicated part, but probably the most important thing for you to remember is that you're going to be in one of three groups. That's why I have three doctors sitting up there. The opening of this pathway to all diplomats begins in 2022, and you're all going to be in one of the three following groups of continuing certification block. The 2020 to 2022, the 2021 to 2023, or the 2022 to 2024. So you're going to be in one of those groups, and when you start reading the articles and how many articles you need to read, that will be dependent on which group you're in. Next slide. Oh, there you go. So this is kind of a graphic description of what we're talking about is the three different groups. Everybody ultimately has to read 30 articles for every three-year block. Your continuing certification is in three-year blocks, so you read 30 articles every three years and then another 30 articles the second three years. So at the end of six years, you will have read a total of 60 articles and passed the exam. So the expectation is that you're going to read 30 articles every three years. And so these, you know, give you the calculations. Next slide. Okay, so this is the transition process. I'm going to talk about this briefly, but you don't need to remember it. Those of us who participated in the pilot will retain our credit for the article assessments we did during the pilot project in between 2019 to 2021, and those will be applied to our first block in the pathway. Okay. In other words, you also have to complete all 30 articles and pass the exams in order to be excused from the 10-year exam. Next slide. So your article assessments are just going to become part of your continuous three-year continuing certification pathways. So this is going to take place at the end of your three-year block. You can only complete article assessments for your current block or catch up on a previous block. You can't work ahead. You can't decide, well, I'm going to read all 60 articles for the next three years in the next two months. You can't do that. So you can only do them for the three-year block that you've got in front of you. For those of you who are really ambitious, yeah, no, can't do that. Okay. So the other thing is all your other continuing certification activities are going to take place within the same three-year block. So everything occurs together. All right. Next slide. Another way in which we've found a way to make this easier for everyone is if you have two certificates or three certificates, they're all going to be within your three-year block. So oh, this is another thing about the pandemic, due to the pandemic, the 10-year subspecialty certificates expiring in 2020 and 21 are going to be extended through 2022. So if your subspecialty certificate expires at the end of 2020 or 2021, you can enter the ABCC pathway in 2022 and begin to complete the article exams during your first three-year block. So ultimately, all of your certificates will, if you have, let's say you have certificates in adult psychiatry and geriatric psychiatry, they're going to be together. Next slide. So here's an example. This is actually me. So my last exam date was 2014. That was the multiple choice exam. My next exam would be due in 2024, however, I am participating in the pilot. So I'm going to be entering the continuing certification activity block in 2022. So my group is 2021 to 2023. And so that gives me, I know how many articles I actually have to complete in each three-year block. Okay. Next slide. All right. So this is someone who has two, three certificates. The adult psychiatry has a lifetime certificate. So doesn't have to take a continuing certification exam. Also certificate in CL psychiatry and geriatric psychiatry. So he's going to be in the three-year continuing certification block in 2022. Same one I am, 2021 to 23, and then three-year blocks after that. So we're going to come up to this. It wouldn't seem fair, would it, that you would have to read 30 articles for each certificate. That's a lot. So actually, if you are, you have multiple certificates, we have a reduced number of articles that you need to read. So next slide. Oh, this is an important note. That a three-year block of continuing certification requirements, including all of them, the CME, the self-assessment, and the performance and practices, will be waived for diplomats who graduated from an ACG and the accredited subspecialty fellowship training program and to pass the subspecialty certification exam. So you're going to, those folks will receive a three-year block activity waiver for the current block they're in, the time they pass their exams. Next slide. Okay. So this just says that if you, those of us who complete the pilot project can waive some self-assessment, 16 self-assessment CME credits for their current block. And for the article assessment pathway that's starting in 2022, you can get 16 self-assessment CME credits upon completion of the full three-year block. So 16 out of 24 is not bad. So that's, okay. So you need to do that during the three-year block in order to qualify to have the credits. Next slide. All right. I know this sounds complicated. Just bear with me. One more thing. If you have more than, if you hold more than one certificate, this is the breakdown of how many articles you need to read every three years. If you have two certificates, say adult and forensics, instead of 60 articles, 30 for each one, you only need to read 50 articles, 20 in adult psychiatry, 20 in forensics, and then you can pick the other 10 from either specialty. If you have three certificates, you have to read 70 articles, 20 each in the subspecialty or the specialty subspecialty, and then an extra 10 from whichever you would like, and so on. There also is, you can see the assessment fee, it's a little bit more depending on how many certificates you hold. Next slide. So this is kind of a breakdown on how many attempts are going to be allowed to pass the article assessment. Basically, I'm going to just say the, you know, you have 40 articles if you're doing adult psychiatry, one certificate, you have 40 articles to choose from. You have to pass 30 out of the 40. Frankly, I think you have to try really hard not to pass 30 out of the 40, because it is an open book test, and the purpose is to learn, not to make people fail. So you can try the 40 articles. Let's say you've tried the 40 articles, and you still, you don't have 30, you don't pass 30 of the exams, you still have the option of taking the 10-year exam. So no, you don't lose your certificate, you're allowed to take the 10-year exam, so we are going to keep that. Okay. Next slide. Okay. Again, more than you probably wanted to know, but your article assessments are going to be evaluated at the end of the three years. If you don't earn 30 article credits in that first three-year block, you can actually catch up in your consecutive three-year block. So as long as you get the 60 article credits by the end of the six years, you're good to go. If you don't complete those, you can still take the exam, as long as you're meeting all the other requirements. If you continue, you can't, you don't complete the two, three-year blocks in succession, so you haven't earned the 60 article credits in six years, then you cannot continue with the article assessment pathway. You would automatically go to the, you know, what we're used to is the secure proctor 10-year exam, as long as you're in good standing with the other requirements. So it's pretty, it's pretty generous. Next slide. So to be clear, a diplomat will become not certified if he or she is not successful or doesn't complete the 60 article credits during the six-year consecutive period and is not meeting all the requirements or fails the 10-year exam two consecutive times in one year. That's a current policy. Or hasn't fulfilled other, the continuing certification program, CME, self-assessment, improvement in practice for six years, even if she has earned all the required article credits. So basically, you got to do the, make sure you've got the CME, unrestricted license, self-assessment, improvement in practice, and either the article assessment pathway or the 10-year exam. Next slide. All right. Now you are most likely very confused, so it's time for questions. I think they're really for individual diplomats. It's going to be very clear on the website what you need to do, and the ABPM will be sending out individual information to all diplomats, telling them exactly what they need to do. So Bob and I thought we would do some, since we really can't have this in an interactive milieu, we would try and make it interactive between the two of us, and so we're going to ask each other questions, thinking we thought about questions you might be asking at this point. Like, oh, my God, how am I, you know, really, what is this all about, and what does it mean? Okay. So the first question. All right. Thanks. Thanks. And I'm back. And by the way, Joan, thanks a lot for, you can see who drew the short straw there, took the hard part, telling you what we were already doing was much easier, but thanks. I think I kind of do understand things a little better just listening to you go through it, because it is indeed confusing. But there's still questions, and we're going to sort of try to anticipate some of the stuff that you might be thinking as well. Joan, you want to take the first one? Yeah. So the question I want to ask Bob is, how do I access all these articles and exam questions? Well, it's simple, Joan, even for people with limited tech skills, you know, like us. So, well, back at you. You can just see how this is going. You know, you just go to, we keep bringing up the ABPN site, once again, it's abpn.com. You log into Physician Portfolio, which I already sort of showed you, but once again, there it is, and look for the MOC CC information. So right now, if you just click on MOC Part 3 Pilot, you can still view the list of pilot journal articles and helpful tips on how to access them. I believe you're an APN member, Joan, is that right? I am. Yeah, all right, that was a question, yep. So, you know, you should be able to access, I think, most of the articles for free. Okay. All right, I'm going to do this next one. So let's imagine, like, I don't really want to, I don't like this, I just want to just not take the article-based exam, I just love just doing things in one shot every 10 years. So is the ABPN going to continue to offer a traditional 10-year research exam? Yes, Bob, for strange people like you who like taking a long, multiple choice exam, the ABPN is going to keep the 10-year multiple choice exam, and you can study for that and enjoy taking that exam. This is actually mine here, right? I find that coming up, yeah, oh boy. All right, well, there you go. But in fact, I think I'm the example that you showed for the number two of those people, so I better get on it if I'm going to change. Right. Okay, fair enough, because actually I do kind of like the pilot thing. All right, your turn. Okay, so, Bob, which group am I in and how many articles do I need to read by when? I mean, how do I figure that out? I mean, it just seems tricky. Right, well, despite your best efforts to explain it, I think it probably is a bit confusing to people, and it's understandable. You can imagine it's been challenging for everybody at ABPN to figure this out as everyone tries to get back into sync and stuff, since we're all not in sync right now. The ABPN staff is great. They are on this, and pretty soon you'll be able to log into your folio accounts. And once you look there, you should be able to know which groups you're in and how many articles you need to read by what date and when to start. That's not there yet, so please be patient. But you're also going to be able to see how many and which article assessments you completed and basically everything that you need to know to be able to sort of make your way through the exam without hopefully too much confusion. All right, my turn. So, Joan, who chooses these articles? And, you know, who writes the questions? All right, Jedi Masters. Here's a group of Jedi Masters. We write the – choosing the articles and writes the questions for the ABPN. Now, this lovely group of people right here are the directors and the CEO. All of us are heading up committees a bit. And the committees are made up of members who are nominated by various professional groups, such as the APA, all the subspecialty societies nominate members they think would be good for writing the questions and choosing the articles. So every one of those 13 areas mentioned has a committee. And these folks in the picture are responsible for ensuring that the committees do their work. There you have them. They look pretty normal, actually. Yeah, and these are just the directors. They're chairing different committees with the exception of Larry Faulkner there in the middle. But, yeah, and then lots of other hardworking people who give up their time to come and do this for us. All right, you want to ask me a question, Joan? Come on, question number five. So, Bob, does ABPN provide access to the journal articles? Seems only fair, yeah. Seems only fair. Yeah, well, of course not. Really, you know, we did look into the possibility. The bottom line is it would be super expensive and probably unnecessarily expensive for a lot of people. You know, the diplomats who are APA members who have affiliations with academic medical centers do have an advantage here because they're probably going to be able to access most of the articles for free. All I can say is that having been on these groups and helping to choose a lot of these articles, I think we really did go out of our way to try to find open access ones, like I'm showing you how we might search on PubMed to find ones that would be freely available to most people who get onto the web and download the articles. There are some that are just so good that we decided to include them even if not, trying to keep it as cheap as possible, basically. Okay, I'm going to ask you a question. All right, so can I participate in the article-based pathway if I have a lab certificate, which you saw my dates coming up, that could just well happen. Yeah, the answer is, next slide, yes, you actually can. It's going to require a little work on your part in that you're going to have to pay the fee and fulfill all the requirements for continuing certification, the license, the self-assessment, the performance in practice, and also read, if you've let it lapse, you have to read a total of 90 articles. But, hey, we know they're good articles. That is going to be the requirement, but I know you can do it, Bob. All right, well, I better not dawdle anymore, but they are pretty good articles and things I really feel like I should know and probably have read anyway, but it's nice to be forced by an outside organization, right? Right. Oh, would you like to ask me something, Joan? Yes, I would. If I participate in the article-based pathway for multiple certifications, are there reduced number of questions per certification? And, of course, I'm very happy to hear, since I'm in that situation, that the answer is yes, absolutely. So as Joan really did already explain, if you have two certificates, you can, instead of having to do 60, you can complete a total of only 50. So still a lot of articles, but not as many as you might have to do otherwise. It's 20 questions for each specialty. So I have specialty 10 questions that you can choose from just either set of articles. So those ones are kind of freebies in your choice. So even though we can't even begin to answer all your questions, all possible questions, it is a lot of information. I want to recommend that you check out the new and improved ABPM website. And also, as Bob mentioned, by the end of this year, all of your individual information will be in your folios about what group you're in, you know, how many articles you need to read and when you start. Overall, I think it's really going to be exciting. It's going to be a little bit of a challenge getting used to this new system, but I think people are going to like the article-based pathway much better and find it relevant and useful. Bob? Yeah, I agree. Thanks, everyone, for listening. This is the end of the presentation. Please don't hesitate to contact us at ABPM with any questions that you have. I am pretty excited about this. I think Joan really conveyed it very nicely because, at least in my opinion and certainly from some of the people I've talked to, reading articles about my specialty or my subspecialty is what I should be doing anyway, and it's kind of nice to sort of do something that I feel is very relevant and very helpful to my practice. So thanks, everyone, very much, and thank you, Joan, for doing all the work here. You're welcome, Bob.

American Board of Psychiatry and Neurology

continuous certification program

article-based pathway

lifelong learning

self-improvement

patient safety activity

self-assessment CME credits

performance and practice activities