New NCCPA Recert Pathway - Discuss.....

[Reality Check 2]

Breaking news from NCCPA.

I did Pathway II eons ago and liked it.

What are the thoughts now? Discuss......

From NCCPA:

NCCPA is pleased to announce that beginning in 2023, PAs will have two options for their recertification assessment. The traditional PANRE that is administered at Pearson VUE test centers will remain as one option, and NCCPA will also launch an official alternative longitudinal, take-at-home process....

The application period will open later this year for PAs who are due to recertify in 2024, 2025, and 2026 and want to participate in this new process. The registration period will close December 15, 2022, and the first block of exam questions will be available in January 2023.

 

So, what does the new PANRE-LA look like?  Here’s an overview:

• Each quarter, 25 questions will be administered in an online format that PAs can take anywhere, anytime, and on any compatible device. Each question will have a five-minute time limit, and PAs may use online or printed references to help inform their answer selection.
• Before opening an exam question, PAs will be provided information on the content category that will be assessed and can decide to move forward with opening the question or defer it until later in the quarter. This way PAs know in advance what content area will be coming up in case they want to review the exam blueprint topics or reference materials before opening the question.
• Immediate feedback will be provided to PAs to let them know if the answer they submitted was correct, and they will be provided a rationale and references that can be accessed for additional information. The content of questions that have been completed and the rationales will be available throughout the process so PAs can review it anytime, at their convenience.
• PAs will have three years to complete the new process. During the 12 available quarters, PAs will be required to complete eight quarters and may skip up to four quarters. This allows PAs more flexibility to participate in quarters that fit best with their schedules.
• There are benefits for getting started right away and working straight through. PAs who complete the first eight quarters may be able to finish the process in two years, if they reach the passing standard. PAs who have not met the passing standard may continue in the program, and scores will be recalculated at the end of each subsequent quarter, using the best eight quarters.  This provides PAs an opportunity to improve their performance before the end of the 12-quarter process.
• PAs will apply for the PANRE-LA process in the year six of their certification maintenance cycle and the exam questions are administered in years 7-9. As previously noted, one of the foundational principles of the PANRE-LA process is to help PAs identify and close core medical knowledge gaps, and NCCPA anticipates that only a very small percent of PAs will not reach the passing standard after completing the PANRE-LA. However, another benefit of this process is that PAs will still have up to three opportunities to take and pass PANRE in the tenth year of their recertification cycle before their certification expires.

[MediMike]

Love the idea. Think it's the best way to assess medical knowledge and one's ability to utilize resources when the information is not directly known.

[iconic]

As long as they keep getting their money from us; why should it matter to them

[DelusionalEnthusiasm]

Where is the option to get rid of NCCPA

[wilso2ar]

If I'm reading this right, then those of us where our tenth year is 2024 would only be able to complete 8 quarters before our certification expires.  We wouldn't have 12 quarters. Then if I did fail, I would have only a couple of months to take the traditional PANRE?

I think this is a much better option and actually gets closer to what the test should prove.  The ability to apply knowledge, reference and learn.  I would like to do this, but this time around I may do the traditional way.  It worked fine for me last time. 

[ohiovolffemtp]

While I'm not in favor of either having to recertify at all since physicians don't have to or of the NCCPA in general, it does sound like they learned from the PANRE Pilot and developed a reasonable alternative pathway.

Another thing I would prefer is for the PA specialty organizations own and deliver the specialty certifications rather than the NCCPA giving CAQ's.  That way there would be accountability for the testing process to PA's actually practicing in those areas.

[MediMike]

1 hour ago, ohiovolffemtp said:

While I'm not in favor of either having to recertify at all since physicians don't have to or of the NCCPA in general, it does sound like they learned from the PANRE Pilot and developed a reasonable alternative pathway.

Another thing I would prefer is for the PA specialty organizations own and deliver the specialty certifications rather than the NCCPA giving CAQ's.  That way there would be accountability for the testing process to PA's actually practicing in those areas.

To my knowledge board certified physicians are required to recertify q10 years, along with maintenance of certification CME. They are offered a longitudinal assessment option as well, unless I'm reading this wrong below.

https://www.abim.org/maintenance-of-certification/assessment-information/assessment-options

I fully agree with specialty organizations doing the CAQs, the ridiculousness of the current exams is out of this world. 

[ohiovolffemtp]

The key difference is that physicians are not required to maintain board certification to keep their licenses.  Many of the EM doc's I've worked with over the years have dropped their board certifications after 2 recerts.  So, docs can continue to practice and get paid without further testing, depending upon where they work.  It's only if employers, or hospitals, or payers, require the certification.  States don't for licensure.

[iconic]

15 minutes ago, ohiovolffemtp said:

The key difference is that physicians are not required to maintain board certification to keep their licenses.  Many of the EM doc's I've worked with over the years have dropped their board certifications after 2 recerts.  So, docs can continue to practice and get paid without further testing, depending upon where they work.  It's only if employers, or hospitals, or payers, require the certification.  States don't for licensure.

I mean it’s kind of state dependent for PAs; last I looked many states do not require continuing certification by NCCPA 

[Reality Check 2]

I think I am in the window to start this for my 10 yr recert. This Pathway II type thing is very appealing. 

Might even learn something.

Regardless of the functionality, I have my "C" and plan to keep it - as trying to get it back would be painful and costly.

So, I keep it. Hate paying an organization that doesn't really support us - but - it is a choice to keep my "C".

If I am counting correctly and hell doesn't freeze over, I should only have to recert one more time before potential retirement................

Deep sigh

[MediMike]

2 hours ago, ohiovolffemtp said:

The key difference is that physicians are not required to maintain board certification to keep their licenses.  Many of the EM doc's I've worked with over the years have dropped their board certifications after 2 recerts.  So, docs can continue to practice and get paid without further testing, depending upon where they work.  It's only if employers, or hospitals, or payers, require the certification.  States don't for licensure.

I gotcha. Must be FP docs who had an EM board you work with? Can't imagine an EM boarded physician could let their cert drop, same with any other specialty...I'm actually kind of confused about this. There are places where a physician does not need to be board certified to work? 

I understand the difference between certification and licensing, but am pretty shocked that anyone can get reimbursed by an insurance company without some type of board certification. Seems like the loss of one would effectively result in the loss of both. Guess I've never looked that deeply into it!

[EMEDPA]

Works for me. I am next up 2024 , so will get on this. 

[ohiovolffemtp]

No, it was docs who had their EM boards who had done EM residencies, but after 1 or 2 recerts weren't required by the hospital to maintain their board certifications, so they didn't.  They didn't want the hassle and expense of taking the board exams.  Yes, there are places (this was a level 3 trauma center) who don't require certification after several recerts.  Reimbursement wasn't an issue.  We had docs with current EM boards, docs with lapsed EM boards, EM board eligible docs, IM and FP docs who had EM experience but were boarded in IM or FP.  The CMG's we worked for: a large regional that was bought by 1 of the big 3 never fussed about getting paid no matter what type of doc saw the patient.  The community hospitals I've worked at were similar.

[EMEDPA]

The last trauma ctr I worked at also did not require currently boarded em docs to keep current on acls/atls/pals. The few remaining FP docs did have to keep them up to date, and of course all the PAs did too. 

[MediMike]

1 hour ago, ohiovolffemtp said:

No, it was docs who had their EM boards who had done EM residencies, but after 1 or 2 recerts weren't required by the hospital to maintain their board certifications, so they didn't.  They didn't want the hassle and expense of taking the board exams.  Yes, there are places (this was a level 3 trauma center) who don't require certification after several recerts.  Reimbursement wasn't an issue.  We had docs with current EM boards, docs with lapsed EM boards, EM board eligible docs, IM and FP docs who had EM experience but were boarded in IM or FP.  The CMG's we worked for: a large regional that was bought by 1 of the big 3 never fussed about getting paid no matter what type of doc saw the patient.  The community hospitals I've worked at were similar.

Thanks for the information! I was way off.  Have seen quite a few of the poor bastards in my group studying for weeks on end and flying off for board review courses.  Always assumed it was the standard but look what assuming ended up doing to me

[sas5814]

its a big improvement but it fails the single most important criteria. It is still high stakes testing. Fail it and you'll likely lose your job. It should have had simple remediation for "failures". You need 10 hours of <insert here> to maintain your certification based on your test scores. You have 6 months to complete this requirement and submit proof."

Problem solved. Nobody is losing their ability to earn over a test that has not been proven to improve patient outcomes or make us better providers.

[rev ronin]

11 hours ago, sas5814 said:

its a big improvement but it fails the single most important criteria. It is still high stakes testing. Fail it and you'll likely lose your job.

It sounds like it's actually... not... if you start the whole thing on time. You can fail what would have been the PANCE pilot (8 quarters) and have another year to remediate in place before that counts as a fail.

The pilot PANCE exam was reasonable, except for one question that expected that we would give benzos to a teen with stable VS who was complaining of anxiety. There were other wrongly coded questions, but only 1 of 200 was egregiously and premeditatedly wrong.

[ohiovolffemtp]

Or the question that wanted an eye shield put over a long foreign body impaled in the eye.

[rev ronin]

11 hours ago, ohiovolffemtp said:

Or the question that wanted an eye shield put over a long foreign body impaled in the eye.

Either I missed that or didn't get that question.

True story: EMT inservice training on impaled long object in eye (pencil, I believe it was), the setup had a penlight out on the table, along with cup, gauze, etc. all ready for the EMT to use. None of my students picked the light up, let alone shone it in the uninjured eye. Made me a happy instructor/evaluator.

[Reality Check 2]

I still hate the questions about what to do FIRST, as though you are alone in a room out in the woods with no help and a table containing a fish hook, a ball of yarn and a bottle of aspirin and someone has chest pain.

Those are loaded questions - assuming no prehospital care, no triage and no nurses, techs, etc simultaneously working the patient.

My first response was always - check your own pulse then check the patients and say HI and ask what is going on….

I guess I am dumb though to think of common sense.

[rev ronin]

38 minutes ago, Reality Check 2 said:

I still hate the questions about what to do FIRST, as though you are alone in a room out in the woods with no help and a table containing a fish hook, a ball of yarn and a bottle of aspirin and someone has chest pain.

Those are loaded questions - assuming no prehospital care, no triage and no nurses, techs, etc simultaneously working the patient.

My first response was always - check your own pulse then check the patients and say HI and ask what is going on….

I guess I am dumb though to think of common sense.

I roasted them a number of times for giving me lab values without adequate PE done.  Really?  The lab is THAT fast, huh?