• Requirements for Externally Developed IMP Activities

    Criteria for Approving Externally Developed Improvement in Medical Practice (IMP) Activities


    • Activities must involve clinical content that is contained within the EM Model. Click here to view the EM Model.
    • The tenets of patient care practice improvement require that the activity incorporate the four steps of: measure; compare to benchmarks; implement an  improvement plan; and re-measure.
    • The activity should provide the participant with comparisons of his/her performance with evidence-based practice guidelines, other benchmarks, and/or explicit expert consensus.
    • Preferably, the activity will incorporate a learning opportunity designed to help the physician improve performance with respect to the clinical issue on   which the activity is focused, with a CME option for at least 10 hours of AMA PRA Category 1 Credits.

    Availability to ABEM Diplomates

    • Physician participation in any externally developed activity must be voluntary. ABEM will not mandate participation in an external proprietary activity. (An  exception could be made if the American Board of Medical Specialties (ABMS) requires an activity, such as a patient safety module).
    • Ideally, externally developed APP activities should be free or have minimal cost to the physician. The organization could charge the physician for an associated CME activity.


    • Funding provided by pharmaceutical or medical equipment companies must not be used to develop the activity.
    • Expert review and revision of the activity should occur at least once every three years.
    • The activity should be designed to engage at least 50 physicians per year.
    • The product must be in a form that enables ABEM reviewers to audit the activity, although there is no requirement that the activity be available for a specific period of time prior to ABEM approving it.
    • Simulation activities must occur at approved or accredited sites.  This would include ABEM-accepted accreditation at EM-oriented sites and at ABMS member board-approved sties.


    The organization should be stable, able to maintain the activity for at least three years, and able to provide ABEM with data verifying individual physician completion of the activity according to ABEM requirements.  Current ABEM data requirements are below.

    Additional Requirements for Simulation Modules

    In addition to the general criteria in use for reviewing applications to ABEM to count externally developed Part IV activities as meeting diplomates’ Part IV requirements, the following are the criteria ABEM will use to review and approve externally developed simulation activities to meet ABEM MOC Part IV requirements:  

    • Any simulation center at which a Part IV activity is held must be approved by an authoritative agency that meets the approval of the ABEM MOC Committee.   
    • There must be at least 8 hours of total course instruction.
    • There must be at least 2 hours of didactic instruction.
    • There must be active, hands-on participation in simulation encounters.
    • Scenarios must include some exposure to critically ill and/or injured patient encounters.
    • There must be post-scenario peer debriefing.
    • The session must include focused instruction on team management and coordinated communication.
    • The diplomate must be the lead participant, including having the primary responsibility for medical decision making and providing direction in at least one scenario.
    • At least one instructor must be an ABEM diplomate.
    • There should be no more than five learners for each instructor.  

    Data Requirements

    A list of ABEM diplomates verified to have participated in a pre-approved externally developed APP activity should be sent in Excel format to ABEM at least monthly. Send files to MOC@abem.org. The title of the file should include the organization and file date. The following data elements should be included:

    • Participant Last Name
    • Participant First Name
    • Participant’s individual 10-digit National Provider Identifier
    • Participant’s Date of Birth
    • Name of pre-approved module or activity
    • Date on which participant completed the activity
    • Was CME credit awarded (y/n)
    • If yes, the number of credits awarded
    • Name of individual verifying participation


    External Organization Application Approval Process and Instructions

    Externally Developed IMP Activities: FAQ  (PDF)

    Externally Developed IMP Activities: Application Form  (Word)

    If you have a question, please send an email to moc@abem.org or call 517.332.4800 ext. 329.