ABSTRACT
BACKGROUND: Maintenance of certification (MOC) in Physical Medicine and Rehabilitation is a process of lifelong learning that begins after successfully completing an Accreditation Council for Graduate Medical Education (ACGME)-accredited residency and passing the American Board of Physical Medicine and Rehabilitation (ABPMR) Part I and Part II Examinations. We seek to identify factors predictive of successful MOC Examination performance. OBJECTIVE: To identify characteristics predictive of successful completion on the ABPMR MOC Examination. DESIGN: Retrospective review. SETTING: American Board of Physical Medicine and Rehabilitation database review. PARTICIPANTS: 4,545 diplomates who completed the MOC Examination between January 2006 and December 2017. METHODS: MOC Examination performance was the primary outcome variable. Performance on Part I and Part II Examinations were independent variables. Additional potential predictors evaluated included year of MOC cycle in which examination was taken, years of practice since residency completion, age, and subspecialty certification. MAIN OUTCOME MEASURES: Performance on MOC Examination. RESULTS: Age at time of MOC Examination was inversely correlated with examination score (r = -0.14, P < .001). Similarly, as time since completion of residency training increased, MOC scores declined. Passing the Part I Examination on first attempt predicted a 98% MOC pass rate, compared to 90% for those who failed initially. MOC performance was highly correlated with Part I performance (r = 0.59, P < .001) and Part II performance (r = 0.32, P < .001). Although MOC performance was similar for those taking the examination in years 7 - 10 of their cycle (97% pass rate), those taking the examination after more than 10 years of the cycle had a significantly lower performance (85% pass rate, P < .01). CONCLUSIONS: Better performance on the MOC Examination is associated with better performance on Part I and Part II Examinations, taking the examination earlier in the 10 year cycle, younger age, and less time since completion of training. Diplomates who are at higher risk for failing the examination may need to prepare differently for MOC Exam than those who are more likely to pass. LEVEL OF EVIDENCE: III.
Subject(s)
Certification , Clinical Competence , Internship and Residency , Physical and Rehabilitation Medicine/education , Adult , Female , Humans , Male , Middle Aged , Retrospective Studies , Specialty Boards , United StatesABSTRACT
UNLABELLED: This self-directed learning module highlights recent developments in the acute care of stroke patients, prediction of outcome after stroke, evaluation of risk factors, secondary prevention of stroke, and the evaluation of the young adult with stroke. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article contains sections on the acute evaluation and management of the stroke patient, prediction of functional outcome after stroke, and secondary prevention of stroke. Special emphasis is given to the evaluation of the young adult with stroke. OVERALL ARTICLE OBJECTIVES: (a) To summarize the acute evaluation and management of stroke, particularly in the young stroke patient; and (b) to review the risk factors for stroke and secondary prevention measures.
Subject(s)
Stroke/diagnosis , Stroke/therapy , Acute Disease , Humans , Recovery of Function , Risk Factors , Secondary Prevention , Stroke/etiologyABSTRACT
UNLABELLED: This self-directed learning module highlights diagnosis and treatment of comorbidities and complications encountered by patients with stroke. It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on cardiopulmonary complications and examines neurologic sequelae, risk factors for falls, and prevention strategies. It also discusses upper-limb pain, fatigue, and depression and highlights diagnosis and management of genitourinary complications. OVERALL ARTICLE OBJECTIVE: To summarize common comorbidities and complications encountered by patients after stroke.
Subject(s)
Stroke/complications , Accidental Falls , Depression/etiology , Humans , Pain/etiology , Pulmonary Embolism/etiology , Sleep Initiation and Maintenance Disorders/etiology , Urination Disorders/etiologyABSTRACT
UNLABELLED: This self-directed learning module highlights common rehabilitation issues in stroke survivors. Topics include spasticity, constraint-induced movement therapy, partial body weight-supported treadmill training, virtual reality training, vestibular retraining, aphasia treatment, and cognitive retraining. It is part of the study chapter on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. OVERALL ARTICLE OBJECTIVES: (a) To identify and review the treatment options for poststroke spasticity; (b) to review the use of body weight-supported treadmill training in stroke patients; (c) to describe virtual reality training as an adjunct in stroke rehabilitation; (d) to review vestibular rehabilitation; (e) to discuss advances in aphasia treatment; (f) to discuss cognitive retraining; and (g) to provide an update on treatment of neglect syndromes.
Subject(s)
Stroke Rehabilitation , Activities of Daily Living , Aphasia, Wernicke/etiology , Aphasia, Wernicke/therapy , Cognition Disorders/etiology , Cognition Disorders/therapy , Humans , Muscle Spasticity/etiology , Muscle Spasticity/therapy , Perceptual Disorders/etiology , Perceptual Disorders/therapy , Physical Therapy Modalities , Self-Help Devices , Stroke/complications , Vertigo/etiology , Vertigo/rehabilitationABSTRACT
UNLABELLED: This self-directed learning module highlights diagnosis, treatment, and rehabilitation issues in patients with neurodegenerative disorders, including multiple sclerosis (MS), Parkinson's disease, and amyotrophic lateral sclerosis (ALS). It is part of the study guide on stroke and neurodegenerative disorders in the Self-Directed Physiatric Education Program for practitioners and trainees in physical medicine and rehabilitation. This article specifically focuses on the differential diagnosis, diagnostic evaluation, medical management, and rehabilitation issues in MS. Similarly, the differential diagnosis treatment and rehabilitation in Parkinson's disease is discussed. Electrodiagnosis, pharmacologic treatment, and rehabilitation options for ALS are also discussed. OVERALL ARTICLE OBJECTIVES: To review the differential diagnosis, evaluation, medical treatment, and rehabilitation management of patients with MS, Parkinson's disease, and ALS.
Subject(s)
Amyotrophic Lateral Sclerosis/diagnosis , Amyotrophic Lateral Sclerosis/therapy , Multiple Sclerosis/diagnosis , Multiple Sclerosis/therapy , Parkinson Disease/diagnosis , Parkinson Disease/therapy , Amyotrophic Lateral Sclerosis/complications , Diagnosis, Differential , Humans , Multiple Sclerosis/complications , Parkinson Disease/complicationsABSTRACT
UNLABELLED: This self-directed learning module highlights several movement disorders. These include dystonia, chorea, tremors, and myoclonus. A description of the clinical presentation and associated disease processes is presented. Although the discussion on treatment focuses on pharmacologic intervention, surgical options are presented when appropriate. Other movement disorders (ie, parkinsonism) are discussed elsewhere in the Study Guide. OVERALL ARTICLE OBJECTIVES: (a) To define the various symptoms and etiologies of dystonia; (b) to define chorea and its treatment; (c) to define tremors, including associated neurologic disorders, plus pharmacologic and potential surgical interventions; and (d) to describe the symptoms, classification, and treatment of primary and secondary myoclonus.