APPLICATION
REQUIREMENTS
BOS
CONJOINT COMMITTEE CERTIFYING EXAMINATION IN HOSPICE AND PALLIATIVE MEDICINE (HPM)
All
applicants must submit the following:
1.
Completed application (clearly printed applications only will be
accepted)
2.
Completed Board Registration Form
3.
Copy of current state medical license for the principal location of
clinical practice
4.
Copy of current AOA membership card or letter from AOA verifying active
membership
5.
$1200 application/examination fee
Applicants
with one year of AOA-approved training in HPM completed after July 2008 must
also submit the following:
1.
Copy of HPM fellowship certificate
2.
Letter of recommendation from Program Director in the HPM program
3.
If in an allopathic (ACGME) program, a copy of letter from ACOI
verifying registration of the training
program with the AOA
4.
If in an allopathic (ACGME) program, a copy of the letter from the AOA
granting approval of the
training in HPM and that the “Training is Complete.”
(This may be submitted after the exam but
must be received prior to the Board submitting your certification to
the AOA Bureau of Osteopathic Specialists.)
Applicants
applying by means of the Clinical Practice Pathway must also submit the
following:
1.
Verification of 30 hours of CME in HPM over the preceding twenty-four
(24) months prior to
application for examination
2.
Completion of the attestation of HPM Clinical Practice form
3.
Completion of the two supervising peer report forms (one must be from
the CEO or Medical Director
of the Hospice Unit where privileges are granted and Medical
Director at hospital or equivalent if
practice is solely outpatient)
INFORMATION
FOR THE BOS 2009
CONJOINT
EXAMINATION FOR CERTIFICATION OF
ADDED
QUALIFICATIONS IN HOSPICE AND PALLIATIVE MEDICINE
Introduction
The Hospice and Palliative Medicine(HPM) program for
Certification of Added Qualifications is developed by a conjoint effort of the
American Osteopathic Boards of Family Medicine, Internal Medicine, Neurology
and Psychiatry, and Rehabilitation Medicine.
This program is designed to recognize excellence among physicians who
are specialists in HPM.
This information booklet has been prepared by the AOA/BOS
Boards participating in the conjoint examination for its Diplomates who are
applying for examination in HPM. The program will have two components:
A. Satisfactory
completion of training
B.
Successful performance on a comprehensive, one-day examination.
Requirement for Licensure
A valid, unrestricted license to practice medicine in a state
of the United States is required of all candidates.
A photocopy of the medical license in the state of the current practice
must be submitted with the application. Candidates
with restricted, suspended or revoked license in any jurisdiction at the time
of application, will not be admitted to the examination or be certified.
Substantiation of Clinical Competence
The application must contain substantiation of the
Diplomate's satisfactory clinical competence in HPM. This substantiation must be provided by the program director
in the HPM fellowship or by two references in a supervisory role over the
applicant if applying via the Clinical Practice Pathway.
One of the references must be by the CEO or Director of the Hospice
Unit where the applicant has privileges.
Prerequisites
A. Training Requirement
Candidates must possess a valid certification certificate by
their primary AOA Board and have completed a 12 month AOA approved fellowship
in HPM which was completed after July 1, 2009.
B. Clincial Practice Pathway
If applying via means of the Clincial Practice Pathway the
applicant must meet the following prerequisites:
1.
30 hours of CME in HPM over the preceding 24 months prior to
application for examination;
2.
Clinical practice for a minimum of two years and be able to demonstrate
that a minimum of 25% of practice is in the care of the terminally ill;
3.
Have directly participated in the active care of at lease 50 terminally
ill patients in the preceding three years for whom palliative medicine was the
predominant goal of care;
4.
Have worked as a physician member of an interdisciplinary clinical care
team for at least two years which included a minimum of 100 hours of active
participation in team meetings that complied with the Clinical Practice
Guidelines for Quality Palliative Care;
5.
Verification by two palliative care medicine authorities that the
applicant is an established palliative care provider physician and meets the
critieria above(one of the authorities must be the CEO or Director of the
Hospice Unit where the physician has privileges); and
6.
In lieu of number 5, the applicant must have served as a hospice
Medical Director in a palliative care practice for one or more years.
7.
Applicants who have met requirements 1-6 above, are certified by the
ABHPM, and have provided a minimum of 15% of the items for the first exam
administration will be granted certification for the period of time remaining
on their current certificate but not to exceed five years.
Recertification will be required thereafter to maintain certification.
Dates
The date of the HPM Examination is November 1, 2009.
A letter requesting to sit for the Examination must be submitted to the
applicant’s primary certifying Board during the registration period, which
will begin May 15, 2009 and end August 1, 2009.
The completed application must be submitted in
toto no later than August 1, 2009.
Any applications postmarked after August 1, 2009, will be assessed a
two hundred dollar ($200) late registration fee.
No applications will be accepted after September 1, 2009.
All candidates who have submitted their application prior to the
deadline date will be notified whether or not they have been admitted to the
examination prior to September 1, 2009.
Fees
The application/examination fee will be $1200, which must be
submitted no later than August 1, 2009. There
is a nonrefundable fee of $100 for withdrawals prior to June 1 and $250 for
withdrawals between June 1, 2009 and July 1, 2009.
No refund is granted for any withdrawal postmarked after August 1,
2009.
Address Changes
Registered candidates must notify their Board office, in
writing, of any change in address prior to or after the Certifying
Examination. Candidates will be
responsible for the cost of payment of a duplicate certificate which has been
lost and not returned to the Board, in which the mailing address was not the
current updated address of the candidate.
Location and Time of Examination
The examination will be held on November 1, 2009 at the
Hilton New Orleans Riverside Hotel, 2
Poydras Street, New Orleans. The
examination session will begin at 8:00 a.m. and conclude at 1:00 p.m.
All candidates must report to the examination room no later than 7:30
a.m.
Hotel Accommodations
The examination is being held in conjunction with the Annual
AOA Convention. To reserve a
hotel room you must register through the AOA hotel reservation process.
You will receive hotel reservation materials through the AOA convention
registration packets which AOA members will be receiving.
Instructions for Completing the Application Packet
Please read all of the following information carefully before
completing the application form. All
of the items on the application forms must be filled out completely or your
application will not be accepted. The
application form must be printed or typewritten.
All supporting documents to be submitted with the application are
clearly delineated on the enclosed instruction sheet for all applicants.
Acknowledgment of Acceptance
All candidates whose applications have been accepted will be
notified by September 1, 2009. Each
accepted candidate will be issued an examination admission card which is to be
retained and submitted to the proctor at the time of the examination.
Copyrighted Materials
The HPM examination is confidential and copyrighted under the
Federal Copyright Act. Candidates
agree not to copy, reproduce, reconstruct by dictation or other means, or
disclose examination content in any manner.
Scoring and Results
Your final score is determined by the number of questions
answered correctly. There is no
penalty for guessing. The minimum
passing score reflects an absolute standard developed by the AOA Boards
participating in this conjoint examination.
After the exam is given, it will be psychometrically analyzed and
evaluated to ensure the reliability of individual results.
Your results will be released and a score report will be mailed to you
within 90 days of the date of the exam. Scores
are provided through the mail only. Copies
of your score report will be maintained for one year from the date they were
released. During that period you
may obtain a duplicate copy of your score report upon written request and a
fee of $25. Questions regarding
exam results and any appeals of the examination must be submitted in writing
within 30 days of the date results were released.
THE EXAMINATION:
General Description
This examination will be a proctored 5-hour examination
consisting of multiple-choice questions of the "one best answer"
type. There will be a total of
200 items on the examination. The
HPM Examination will cover the broad aspects of HPM that specialists
practicing in the field are expected to know.
The examination will assess the candidates knowledge and clinical
judgment in aspects of HPM required to perform at a high level of competence. The examination will include but will not be restricted to:
Approach to care including relief of symptoms,
bereavement care, treating the family and the patient as a unit of care,
standards of delivery of care, medical director’s role, hospice Medicare
benefit, other reimbursement mechanisms and approach to specific populations
such as children, elderly, substance abusers; cultural, spiritual,
socio-economic and psychiatric considerations of the patient and the family;
grief and bereavement including normal grief, abnormal grief, risk factors and
therapeutic interventions; all aspects of the management of impending death
including the physiological changes and complications; medical management of
pain including assessment of pain, fundamentals and principles of analgesics,
radiation, nerve block, acupuncture, hypnosis, barriers to pain relief, and
pain management of special populations; non-pain
symptom management including spinal cord compression, cachexia, dry mouth,
diarrhea, dysphagia, pruritus, skin breakdown, agitated delirium, acute airway
obstruction, palliative sedation, and discontinuation of technologic support,
etc; communication and teamwork including family-centered approach, effective
communication with co-workers, patients and families, physician leadership,
and interdisciplinary care; ethical and legal decision-making including
ethical principles, decision-making principles, patient rights, ethics of
physician/patient relationship, professionalism, burnout, coma and
controversies in terminal care; prognostication and the natural history of
serious illness including reasonable patient prognostication, amyotrophic
lateral sclerosis, cardiovascular complications, cancer, dementia, frailty,
multi-organ dysfunction syndrome, pediatric medical issues, pediatric
neurological conditions, perinatal and infant death, pulmonary disease, renal
failure, stroke and unintentional injury and trauma.
The content areas covered and their relative
proportions on the exam are as follows:
|
Medical Content Category |
Relative
Percentage |
|
Approach to care |
9.5% |
|
Psychosocial and spiritual considerations |
10% |
|
Impending death |
8% |
|
Grief and bereavement |
6% |
|
Medical management |
44% |
|
Communication and teamwork |
6.5% |
|
Ethical and legal decision making |
8% |
|
Prognostication and natural history of serious illness |
8% |
Certificates
Those who passed the examination will receive a Certificate
of Added Qualifications in Hospice and Palliative Medicine by their primary
Board. All certificates will be
time-limited and will be valid for ten (10) years from the date of
certification. The diplomate must
maintain a valid certification certificate in their primary specialty or
subspecialty in order for the certificate of Added Qualifications in HPM to
remain valid. The HPM Certificate
will become invalid the date that the diplomate's primary or subspecialty
certificate becomes invalid. The
certificate of Added Qualifications in HPM will be awarded after the AOA
Bureau of Osteopathic Specialists gives final approval of the examination
process for each candidate. This
approval process will take approximately six months following the notification
of successful completion of the examination.
On written request and payment of a fee of $200, candidates may
obtain rescoring of the examination within a year of receiving the results. The answer sheets of candidates will be destroyed thirty-six
months after administration of the examination.
Preparation
The Board can make no specific recommendation about study
methods, review courses, etc., to prepare for the examination; however,
extensive self study of HPM in texts and journals and participation in continuing
medical education programs and review courses in HPM should be useful.
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