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 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.
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To be eligible for entry into ABIM's Focused Practice in Hospital Medicine Maintenance of Certification (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).
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
- 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 Hospital Medicine 10 year MOC exam or Knowledge Check-In after having been approved to enter the program.
- 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. 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 Maintenance of Certification (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 Hospital Medicine 10 year MOC exam or the Hospital Medicine Knowledge Check-In (once it launches in 2020) satisfies the assessment requirement for the FPHM MOC program.
- If you withdraw from the FPHM program after successfully passing the Hospital Medicine MOC exam or Knowledge Check-In, your FPHM certification status and assessment due date will be assigned to your Internal Medicine certification. 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 or, if eligible, the Knowledge Check-In.
- If you take the Internal Medicine MOC exam or Knowledge Check-In while in the FPHM MOC program, these assessments and any valid MOC points will be applied to the Internal Medicine certification upon withdrawal from the FPHM program.
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 or Knowledge Check-In (once it launches in 2020) and maintaining an unrestricted medical license, participants must earn 100 MOC in the past five years or be participating in the MOC reciprocity program.
If you have previously participated in MOC, your MOC points may 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 and tell you how many remaining points you may need to earn.
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
- Earn a total of 100 MOC points every five years or be participating in the MOC reciprocity program.
- Meet your assessment requirement through either the traditional MOC exam pathway or the Knowledge Check-In pathway
- 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
If you have passed an assessment in Internal Medicine since passing the Hospital Medicine exam, you can make the change from FPHM to Internal Medicine on your Physician Portal. Sign in and under My Assessments and Certifications, slide the indicator to not show you the requirements for Hospital Medicine. You will be asked if you want to withdraw from the program. After you confirm, the FPHM section will be removed from the page. Please make sure Internal Medicine displays with your next assessment due date.
If you have not passed an assessment in Internal Medicine since passing the Hospital Medicine exam, 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.
To withdraw from the Focused Practice in Hospital Medicine (FPHM) MOC program, sign in to your Physician Portal. Under My Assessments and Certifications slide the indicator to not show you the requirements for maintaining the Hospital Medicine certificate.
You will be asked to confirm that you want to withdraw from the program. If you withdraw from the program, you will need to select to show requirements for either your Internal Medicine certificate or a subspecialty certificate (if you have one). Please note, if you are registered for a Hospital Medicine MOC exam, your registration will be cancelled.
If you are interested in reinstating a lapsed Internal Medicine certificate, see above section “Transition from FPHM to Internal Medicine certificate”. Points earned toward maintaining your Hospital Medicine certificate may be applied to other certificates you choose to maintain.