Initial Certification in Hospice and Palliative Medicine

History and Statement of Principles
The Hospice and Palliative Medicine Program, developed by the American Board of Internal Medicine (ABIM), the American Board of Anesthesiology (ABA), the American Board of Emergency Medicine (ABEM), the American Board of Family Medicine (ABFM), the American Board of Obstetrics and Gynecology (ABOG), the American Board of Pediatrics (ABP), the American Board of Physical Medicine and Rehabilitation (ABPMR), the American Board of Psychiatry and Neurology (ABPN), the American Board of Radiology (ABR), and the American Board of Surgery (ABS), is designed to recognize excellence among physicians who are specialists in the care of seriously ill and dying patients with life-limiting illness. The field of hospice and palliative medicine is based on expanding scientific knowledge about symptom control when cure is not possible and appropriate care during the last months of life. The major competencies of subspecialist-level hospice and palliative medicine fall under the broad, patient-centered goals of:

• relieving suffering and improving the quality of life for patients and families living with life-threatening illness,

• helping patients and families cope well with loss and engage in effective grieving,

• managing and coordinating the array of challenging problems associated with end-of-life care, including the management of the immediately dying patient, and

• promoting closure and the possibility of growth at the end of life.

The examination will be administered to candidates from the ABIM, ABA, ABFM, ABOG, ABP, ABPMR, ABPN, ABR, and ABS at the same time in the same testing centers. Participation in the certification program is voluntary. Certification is not required of practitioners in this field, and the certificate does not confer privileges to practice.

Specific Training Requirements
Please Note: This is a brief summary of training requirements and not intended to be all inclusive. Read the current Information for Applicants publication for all requirements for Initial Certification in the Subspecialty of Hospice and Palliative medicine.

To achieve certification in hospice and palliative medicine, candidates from the ABPN must hold a valid certificate in psychiatry, neurology, or neurology with special qualification in child neurology and fulfill all of the following requirements:

• Attestation of requisite experience or documentation of successful completion of formal training requirements, as specified in the description of the practice and training pathways.

• Have met all training requirements (if applying through training pathway) by July 31 of the year of the examination.

• Must meet the ABPN’s licensure requirements.

• Be certified by the Board in psychiatry, neurology or child neurology by December 31 of the year prior to the examination administration.

• Successful performance on the hospice and palliative medicine examination.

NOTE: Candidates from other Boards should contact those Board for information regarding certification requirements.

Practice Pathway (Specific Requirements During the "grandfathering period" 2008 through 2012)
During the “grandfathering period”: the first five years and the first three examinations (2008, 2010, and 2012), as an alternative to one year of ACGME-accredited fellowship training in hospice and palliative medicine, applicants may qualify by submitting documentation of one of the following sets of temporary criteria:
• Documentation of completion of one year of fellowship training in hospice and palliative medicine. Hospice and palliative medicine fellowship training taken prior to July 1, 2010 must be conducted within a program affiliated with an ACGME-accredited residency or fellowship program
OR
• Attestation of at least two years of subspecialty-level practice in hospice and palliative medicine during the past five years prior to application for examination (averaging at least 20 percent of time) including:
• At least two years and 100 hours of participation has been spent with a hospice and palliative care team*
AND
• Participation in the active care of at least 50 terminally ill patients
OR
• Documentation of current certification by the American Board of Hospice and Palliative Medicine

* To qualify, interdisciplinary hospice or palliative care teams must have all of the following characteristics:
(a) provide active clinical care;
(b) hold regular meetings;
(c) have regular membership of a physician, nurse, and at least one other professional from a psychosocial discipline; and
(d) operate in a context in which a substantial number of the teams' patients are near the end of life. It is expected that multidisciplinary team members will be appropriately trained and ultimately certified in Hospice and Palliative Medicine.
The Board reserves the right to audit this information.

Training Pathway (Specific Training Requirements after 2012)
Applicants seeking certification in Hospice and Palliative Medicine must be certified by the Board in psychiatry, neurology, or child neurology or other specialty (other than ABIM, ABA, ABEM, ABFM, ABOG, ABP, ABPMR, ABR, and ABS) by December 31 of the year prior to the examination. After the 2012 examination, all applicants, other than those initially approved during the “grandfathering period,” are required to submit documentation of successful completion of one year of ACGME-accredited fellowship training. Hospice and palliative training undertaken July 1, 2010 and after must be accredited by the ACGME.
The Board will require a certificate of successful completion of the fellowship or a letter from the training program director documenting successful completion of one year of ACGME-accredited fellowship training in hospice and palliative medicine. The exposure to hospice and palliative medicine given to psychiatry, neurology, or child neurology residents as part of the basic training in psychiatry, neurology, or child neurology does not count toward the one year of training. All licensing and training requirements must be met no later than July 31 of the year of the examination.
The required one year of specialized training in hospice and palliative medicine may be completed on a part-time basis, as long as it is not less than half-time; credit is not given for periods of training lasting less than one year, except under special circumstances that must be approved by the ABPN Credential Committee. In such cases, it is the responsibility of the applicant to provide detailed documentation from the respective training directors that outlines training content, duties, and responsibilities. Each case is considered on an individual basis.
Hospice and palliative medicine that was credited toward the training requirements for admission to another ABPN examination may not be used to fulfill the training requirements for admission to the Hospice and Palliative Medicine examination.

E. Examination Content
The hospice and palliative medicine examination will be a comprehensive, one-day, computer-based examination of multiple choice questions in the single-best answer format. The examination will assess the candidate's knowledge and clinical judgment in aspects of hospice and palliative medicine required to perform at a high level of competence.

American Board of Psychiatry and Neurology, Inc.
2150 E. Lake Cook Road, Suite 900, Buffalo Grove, IL 60089
Phone: 847.229.6500 Fax: 847.229.6600

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