American Board of Internal Medicine home page

Initial Certification indicates that physicians have met rigorous standards through intensive study, accredited training and evaluation and that they have the clinical judgment, skills and attitudes essential for the delivery of excellent patient care.

MOC is a professionally determined standard that attests that an internist is staying current in knowledge and practice throughout his/her career.

For more than 75 years, Certification by ABIM has stood for the highest standard in internal medicine and its 20 subspecialties.

Section: MOC Requirements

Focused Practice in Hospital Medicine

The Focused Practice in Hospital Medicine (FPHM) MOC program assesses, recognizes and sets standards for the specific knowledge, skills and attitudes of general internists who focus their practice in the care of hospitalized patients.

While the FPHM MOC program is not a subspecialty, it is a variation of Internal Medicine certification. Diplomates cannot participate in both the FPHM and Internal Medicine MOC programs simultaneously.

Completion of the program identifies diplomates as ABIM Board Certified in Internal Medicine with a Focused Practice in Hospital Medicine. The certificate will remain valid as long as you continue to participate in Maintenance of Certification (MOC).

Eligibility

To be eligible for entry into ABIM's Focused Practice in Hospital Medicine Maintenance of Certification (MOC) program, you must:

  • Be certified in Internal Medicine for at least three years,
  • Hold a valid, unrestricted medical license and confirmation of good standing in the local practice community, and
  • Not be participating in the ABIM/ABMS Reciprocal Credit for Dual-Boarded Diplomates program.

The FPHM MOC program is not intended for subspecialists practicing in a hospital setting. If you are a subspecialist who also practices as a general internal medicine hospitalist, you may apply to enter the FPHM program but your eligibility will be determined on a case-by-case basis by ABIM.

Program Entry

If you are eligible to apply to enter the program, a link will appear on your ABIM home page to guide you through the entry process. Sign in to see if you are eligible.

Entry into the FPHM MOC program requires two attestations stating that you meet the practice requirements to be a hospitalist:

The self-attestation confirms that you:

  • Have at least three years of unsupervised hospital medicine practice experience at the time of entry (formal fellowship training in a hospital medicine fellowship program can be counted toward the three-year practice experience criteria), and
  • Meet patient encounter thresholds in a hospital setting (see chart below).

Attestation by a Senior Hospital Officer (SHO) confirms the information you submit in your self-attestation is accurate. You will need to provide contact information for the SHO during the self-attestation process. Acceptable SHO titles include:

  • Division Director
  • Section Chief
  • Chief Medical Officer
  • Chair of Medicine
  • Service Line Chief
  • Medical Director
  • Chief Executive Officer
  • President
  • Chair of the Board of Directors

Patient Encounter Thresholds

There are two pathways - Direct Patient Care or Clinical/Systems:

Direct Patient Care
(i.e., full-time hospital practice)
Clinical/Systems (i.e., full-time hospital medicine
professional activity with part-time hospital practice)
Requires a minimum of 1,000 hospital patient encounters (limited to one encounter per patient day) per year for three years, or 3,000 over three years. Requires a minimum of 250 hospital patient encounters (limited to one encounter per patient day) per year for three years, or 750 over three years; these encounters must comprise at least 75% of total clinical activity, and at least 50% of the remaining non-clinical professional time must be directed toward improving the care of hospitalized patients.
  • The patient encounter volume thresholds must be fulfilled in the three years immediately prior to application for entry into the program.
  • ABIM reserves the right to conduct a random audit of all applications to ensure the program's patient encounter requirements are being adequately fulfilled.
  • If you do not currently meet these patient encounter thresholds, you must accumulate them before you can enter the FPHM program.
  • Subspecialists are not permitted to count subspecialty patient encounters toward the patient encounter volume requirements.

Earning Your Certificate

Once you have been admitted into the Focused Practice in Hospital Medicine MOC program, you can begin working on the requirements to earn your MOC certificate in Internal Medicine with a Focused Practice in Hospital Medicine.

To earn the certificate, you must:

  • Continue to hold a valid, unrestricted medical license,
  • Earn 100 MOC points in the past 10 years, 60 of which need to have been in the past three years,
  • 20 of the points completed in the last three years must be in Medical Knowledge,
  • Pass the Hospital Medicine MOC exam (you are eligible to take the Hospital Medicine MOC exam upon being approved to enter the program), and 
  • Have a self and senior attestation to meeting patient encounter thresholds on file in the past three years.

You do not need to complete requirements in any particular order. Your Hospital Medicine Progress Report will show our outstanding requirements for earning the certificate.

The FPHM certificate issued is contingent upon participating in Maintenance of Certification (MOC). The certificate will remain valid as long as you continue to participate in the MOC program.

Exam Information

  • You are eligible to take the Hospital Medicine MOC exam upon being approved to enter the program.
  • Only the Hospital Medicine MOC exam satisfies the exam requirement for the FPHM MOC program.
  • If you withdraw from the FPHM program after successfully passing the Hospital Medicine MOC exam, you will need to pass the Internal Medicine MOC exam prior to the lapse of your Internal Medicine MOC certification to remain certified.
  • If you are in the FPHM MOC program, you can also sit for the Internal Medicine MOC exam.
  • If you take the Internal Medicine MOC exam while in the FPHM MOC program, the Internal Medicine MOC exam and any valid MOC points will be applied to the Internal Medicine certification upon withdrawal from the FPHM program.

MOC Points

In order to achieve the designation of board certified in Internal Medicine with a Focused Practice in Hospital Medicine, in addition to passing the Hospital Medicine MOC exam and maintaining an unrestricted medical license, participants must earn 100 self-evaluation points in the past 5 years, 60 of which have to be in the past 3 years. Of the 60 points in the past 3 years, 20 points must be medical knowledge.

If you have previously enrolled in MOC and earned self-evaluation points, your points may automatically be applied toward the self-evaluation requirements for the FPHM MOC program.

Your MOC status report on the My Home Page section of Physician Login will track the valid self-evaluation points earned toward the new FPHM MOC program self-evaluation requirements.

Medical Knowledge Options

Approved Quality Improvement (AQI) Pathway

Additionally, diplomates can earn 20 points of Self-Evaluation of Practice Assessment credit for many third-party products or institutional programs through ABIM's Approved Quality Improvement (AQI) pathway and/or the Multi-Specialty Portfolio Program.

Recommended Web-based AQI products for Hospital Medicine, Focused Practice:

If you participated in a quality improvement effort at an Approved Portfolio Sponsor organization, you may be eligible to earn MOC points through the Multi-Specialty Portfolio Program.

Maintaining Your Certification

Once you have earned your certificate in Internal Medicine with a Focused Practice in Hospital Medicine, to maintain it you need to:

  • Earn MOC points
  • Some MOC activity every two years
  • A total of 100 every five years (at least 20 in medical knowledge)
  • Pass the Focused Practice in Hospital Medicine MOC exam every 10 years
  • Attest every five years that you continue to meet patient encounter thresholds (senior attestation also required):
  • Full-time hospital practice patient encounters must be at least 2,000 in the past two years
  • Part-time hospital practice patient encounters must be at least 500 in the past two years

Program Withdrawal

To withdraw from the Focused Practice in Hospital Medicine (FPHM) MOC program, uncheck the box for the Internal Medicine with a Focused Practice in Hospital Medicine certificate on your Manage Certifications page. If you withdraw from the program, you will need to select to maintain either your Internal Medicine certificate or a subspecialty certificate (if you have one). Points earned toward maintaining your Hospital Medicine certificate may be applied to other certificates you choose to maintain.