Focused Practice in Hospital Medicine
The Focused Practice in Hospital Medicine (FPHM) Maintenance of Certification (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 patients in an inpatient setting.
While the FPHM MOC program is not a subspecialty, it is a variation of Internal Medicine certification. Physicians cannot participate in both the FPHM and Internal Medicine MOC programs simultaneously.
Completion of the program identifies physicians 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 meet the requirements of the Maintenance of Certification (MOC) Program.
To be eligible for entry into ABIM's Focused Practice in Hospital Medicine MOC program, you must:
- Have completed your residency training at least three years ago and have been certified in Internal Medicine, and
- Hold a valid, unrestricted medical license and confirmation of good standing in the local practice community.
The FPHM MOC program is not intended for subspecialists practicing in an inpatient setting. If you are a subspecialist who also practices as a general internal medicine hospitalist, you may apply to enter the FPHM program but you must be able to meet the patient encounter thresholds outlined below. Subspecialty encounters cannot count toward the patient encounter requirement.
If you are eligible to apply to enter the program, a feature will appear on your ABIM home page to guide you through the entry process. Sign in to your Physician Portal 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 inpatient care 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 an inpatient setting (see chart below).
Once you submit your self-attestation, the system will automatically trigger a secondary attestation for the Senior Hospital Officer (SHO) to complete. Attestation by a 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
- 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 inpatient encounters (limited to one encounter per patient day) per year for three years, or 3,000 over three years.||Requires a minimum of 250 inpatient 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 inpatient care.|
- The inpatient encounter volume thresholds must be fulfilled in the three years immediately prior to application for entry into the program.
- Inpatient encounters include patients seen in hospitals, skilled nursing facilities, rehabilitation facilities or other facilities to which a patient is admitted for care.
- 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 inpatient 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 five years or be participating in the MOC reciprocity program.
- Pass the traditional, 10-year MOC exam in Hospital Medicine after having been approved to enter the program.
- Self-attest to meeting patient encounters within the past three years (senior attestation also required).
You do not need to complete requirements in any particular order. However, if you do not complete the requirements within three years of entering the program, you will be prompted to resubmit the initial attestation to update your practice information. Your Physician Portal will show your outstanding requirements for earning the certificate.
The FPHM certificate issued is contingent upon participating in MOC. Once earned, the certificate will remain valid as long as you continue to meet the MOC program requirements.
You are eligible to take a Hospital Medicine MOC assessment upon being approved to enter the program.
- The traditional, 10-year MOC exam in Hospital Medicine satisfies the assessment requirement for the FPHM MOC program.
- If you withdraw from the FPHM program after successfully passing the Hospital Medicine MOC Exam, your FPHM certification status and assessment due date may be assigned to your Internal Medicine certification upon request. This means you will not need to pass an internal medicine assessment any earlier than is currently required for your FPHM designation.
- While you are in the FPHM MOC program, you can also take the Internal Medicine MOC Exam
- If you take the Internal Medicine MOC exam while in the FPHM MOC program, these assessments and any valid MOC points may be applied to the Internal Medicine certification upon withdrawal from the FPHM program at your request.
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 MOC points in the past five years or be participating in the MOC reciprocity program.
If you have previously participated in MOC, your MOC points will automatically be applied toward the requirements for the FPHM MOC program.
Your Physician Portal will track points earned toward the new FPHM MOC program requirements.
View your options for earning MOC points.
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 some MOC points every two years to be reported as "Participating in MOC"
- Earn a total of 100 MOC points every five years or be participating in the MOC reciprocity program
- Meet your assessment requirement by passing the traditional, 10-year MOC exam in Hospital Medicine
- Attest every five years that you continue to meet inpatient encounter thresholds (senior attestation also required):
- Full-time hospital practice inpatient encounters must be at least 2,000 in the past two years
- Part-time hospital practice inpatient encounters must be at least 500 in the past two years
Transition from FPHM to Internal Medicine Certificate
You can send a request to have ABIM re-instate your Internal Medicine certificate with the assessment due date currently assigned to your Hospital Medicine exam. You will be withdrawn from the FPHM program. The display under My Assessments and Certifications will be updated. You will not need to pass an Internal Medicine MOC exam any earlier than the date currently required to maintain your FPHM designation.
Points earned toward maintaining your Hospital Medicine certificate may be applied to other certificates you choose to maintain.
You can send a request to have ABIM withdraw you from the Focused Practice in Hospital Medicine (FPHM) MOC program and re-instate your Internal Medicine certification with the assessment due date currently assigned to Hospital Medicine. You will be withdrawn from the FPHM program and the display under My Assessments and Certifications will be updated. You will not need to pass an Internal Medicine MOC assessment any earlier than the date currently required to maintain your FPHM designation. Learn how to reinstate a lapsed Internal Medicine certification.