American Board of Medical Microbiology



American Board of Medical Microbiology1752 N Street, NWWashington, DC 20036tel: 202-942-9281E-mail: certification@Self-Record Application for RecertificationTo maintain active status, Diplomates must participate in continuing education, which is measured in contact hours. Contact hours are the actual number of hours a professional participates in continuing education. Diplomates must accumulate 150 contact hours every three years to maintain active status.The recertification period is three years. All continuing education must be obtained during the three-year period of January 1 of year 1 through December 31 of year 3. Recertification applications must be submitted by January 31 of year 4. Recertification fees: The recertification fee per specialty is $400 for ASM contributing and premium ASM members and $475 for ASM supporting members and non-members. Completed forms can be submitted by mail or email. For applications not postmarked by January 31 of year 4, a late fee will apply―$400 for contributing and premium ASM members and $475 for ASM supporting members and non-members. Refunds will not be issued for denied recertifications. Do not submit Continuing Education documentation! Approximately 20% of the recertification applications will be audited. Documentation supporting continuing education credits earned will be required only of persons whose names are selected for the audit. Auditing will occur by March 15 of year 4. Please retain your documentation until that date so that if you are chosen for an audit, you can submit the materials within one month of notification. A recertification fee refund will not be issued for failed audits. If you fail the audit and reapply for recertification, a resubmission fee is required―$400 for contributing and premium ASM members and $475 for ASM supporting members and non-members.Biographical Data: Name (First M.I. Last): Daytime phone number: Mailing address: Fax number: E-mail address: If you are an ASM member, please write your member number here: Who is paying your recertification fee? ?I am ? My employer is Emeritus Status: Effective 1 January 2014, Diplomates holding active status may make a formal request to the Board for Emeritus status if they have ten or more years of active standing through certification/recertification, are no longer employed full-time, and do not require ABMM certification for their employment.?The Board reserves the right to rescind Emeritus status if a Diplomate does not meet the employment guidelines set forth above. (Those requesting Emeritus status do not need to submit payment or record their continuing education hours.) ? ________________________________________________ I hereby request Emeritus status (please sign and date above).Mail or email completed and signed application and payment to ABMM Recertification at the address or email address printed above.CONTINUING EDUCATION (CE)Record the total number of continuing education hours you earned in the table below.Acceptable documentation for each activity is provided below. Please retain the appropriate documentation for each activity, so that if you are selected for an audit, you can provide it within one month of your selection. The acceptable documentation listed only needs to be provided if you are selected for an audit.Continuing Education ActivitiesLIMITEach limit is based on the entire three-year period.Total Hrs/Units EarnedCategory #1: Continuing education activities with accredited/approved sponsorship. All activities which have approval by P.A.C.E., the Accreditation Council for Continuing Medical Education (ACCME) and the American Medical Association (AMA) for Category 1 credit are approved. These may include continuing education activities like attending a conference, participating in an online seminar or taking an assessment after reading an accredited journal article (see for lists of approved organizations). If an activity is approved for Category 1 credit, it will be printed on the certificate of attendance or certificate of completion. In addition, continuing education activities accredited by Advances in Clinical Chemistry Education and New Technology (ACCENT), the Accreditation Council for Pharmacy Education (ACPE), the California Department of Health, Canadian College of Microbiologists, Dubai Health Authority, European Union of Medical Specialties, Florida Board of Clinical Laboratory Personnel, Health Authority of Abu Dhabi, International Association for Continuing Education and Training (IACET), the Qatar Council for Healthcare Practitioners (QCHP), Royal College of Pathologists (UK), Royal College of Pathologists of Australasia , Royal College of Physicians (UK), Royal College of Physicians and Surgeons (Canada) are acceptable as Category 1 credits. Certificates are required to document all of the above-mentioned activities.If you participated in continuing education outside of the U.S. and would like the ABMM to review the sponsoring agency’s credentials, email their accreditation guidelines to certification@. Authoring any full-length paper, short report, note, or case study published in a peer-reviewed journal/periodical indexed or abstracted in PubMed, Medline, Current Contents, Biological Abstracts, Chemical Abstracts, Microbiology/Immunology Abstracts, Excerpta Medica Database (EMBASE), Science Citation Index, or Ovid (Letters to the editor are not acceptable.): 10 contact hours for each publication, maximum of 3 publications per recertification period. Documentation: A copy of the first page of the article showing the title, the authors’ names, and the date/year of publication.A maximum of 10 contact hours may be claimed for each unique chapter of a book catalogued by the Library of Congress, with a maximum of 30 contact hours per recertification period. Documentation: A copy of the first page of the chapter, or a copy of the table of contents page, showing the title and the authors’ names; a copy of the publication/copyright page is also required.Preparing and presenting a lecture designated for AMA PRA category 1 credit, ACPE or PACE credit: 3 contact hours for each hour of lecture, maximum of 30 contact hours per recertification period. Credit may be claimed only once for each unique lecture per recertification period. If the lecture is acceptable for Category 1/ACPE/PACE credit, the corresponding symbol will appear next to the lecture in the program. Documentation: A copy of the program page showing the lecture topic, presenter’s name, the date/year it was presented, and the symbol showing the lecture was accredited.Achieving another doctoral-level, specialty board certification (The certification must be approved by the ACGME or CLIA; other certifications may be submitted for approval by the ABMM Board; CCM certification obtained by reciprocity with the ABMM does not qualify): 25 contact hours. Documentation: A copy of the certificate showing the date the certification was awarded.Successfully recertifying by exam for the American Board of Pathology in Medical Microbiology or the American Board of Internal Medicine in Infectious Disease. Only one recertification by examination can be claimed per recertification period: 10 contact hours. Documentation: A letter of from the board confirming successful recertification by exam. Earning a medically related degree such as an M.P.H.: 25 contact hours. Documentation: A copy of the transcript showing when the degree was awarded.CAP or?NY State Inspection: Serving as an inspector. Documentation from the accreditor stating date of inspection and institution visited.? Maximum 8 hours per year and 16 hours per 3-year recertification period.Writing Evidence-based Practice Guidelines: Documentation: Copy of the first page of the guideline that states authors’ names, title of guideline, name of publication and publication date. Maximum 10 hours.Data Extraction for Evidence-based Practice Guidelines: Documentation: A letter from the sponsoring organization stating the name of the guideline, number of publications reviewed by the Diplomate, and the anticipated publication date. Maximum 10 hours.A minimum of 75 contact hrs. must be earned. There is NO LIMIT to Category 1 total hours. Category #2: Continuing education activities without accredited/approved sponsorship (activities which do not satisfy the requirements for Category 1, as described above). Examples include:Preparing and presenting a poster at a scientific meeting (including those offered by ASM): 5 contact hours per presentation, maximum of 6 presentations (30 hours) per recertification period. Credit may be claimed only once for each unique poster per recertification period. Documentation: A copy of the program page showing the poster topic, presenter’s name, and the date/year it was presented.If you publish more than the maximum number of papers or book chapters allowed under Category 1, you may claim up to 10 contact hours for additional papers and book chapters under Category 2 as indicated below. Whether claimed for Category 1 or Category 2, credit for the scientific information presented in a paper or book may be claimed only once per recertification period.Papers. Hours spent preparing a paper which has been published during the current recertification period in a recognized (peer-reviewed and indexed) journal or presented before a professional audience.Books. Hours spent preparing a chapter of a microbiology/immunology or related book.Documentation: Same as the documentation required for each of these activities when claimed under Category 1.Study Section or NIH Grant Review Process – 25 hours maximum. Documentation: A letter from the Chair indicating the dates you served in this capacity.Writing a Federal Grant: Must be the Principal Investigator. Documentation: Acknowledgment from the agency of submission. Maximum of 10 hours.Service on Editorial Boards, including ad hoc reviews, - 1 contact hour is awarded for each manuscript reviewed. Documentation: A print-out of the reviewing history in your account for web-based reviews. A thank you note from an editor for non-web-based reviews.There is NO LIMIT to Category 2 total hours. Category #3: Teaching. Actual hours teaching or lecturing about microbiology/immunology and/or career-related subjects (examples include university courses, review courses, and monthly didactic lectures). One contact hour may be claimed for each hour of lecture. The same course or lecture can be claimed only once per recertification period. Documentation: A letter from the department chair or course coordinator indicating the course title, number of hours taught, and the date(s) it was taught.30 contact hrs. LIMIT Category #4: Non-supervised CE, such as those described below (One contact hour may be claimed for each hour spent engaged in the following activities): Self-instruction materials: Any audiovisual materials, open or closed circuit TV, radio broadcasts, programmed educational materials, or study of current publications in clinical microbiology/immunology. Documentation: A written description of the self-instruction materials and date it was delivered. Maximum of 15 hours.Consultant: Education received by a consultant. Documentation: A statement of the education provided by the consultant and the date it was delivered. Maximum of 5 hours. Self-assessment: Credit may be claimed for the time spent taking self-assessment exams not claimed under Category 1. Exams must be scored and the results made known to the examinee who took the exam. Documentation: A copy of the exam results or certificate of exam completion; the topic of the exam and date of completion must be included. Maximum of 15 hours.Filing a Patent: Credit may be claimed for time spent filing a clinical microbiology patent. Documentation: Acknowledgment from the U.S. Patent Office of submission. Maximum of 10 hours.Service on scientific advisory board: Documentation: A letter from the board acknowledging service, including position served, length, and description of how this activity is continuing education (e.g. review of IRBs). Maximum of 5 hours.Earning a relevant non-medical degree such as a M.B.A.: Maximum of 10 contact hours. Documentation: A copy of the transcript showing when the degree was awarded.30 contact hrs. LIMIT TOTAL: 150 contact hrs. MINIMUM FOR RECERTIFICATION I attest that I have completed the required hours of continuing education as noted above. I understand that I maybe selected for an audit and if so, I agree to submit documentation of my continuing education. By typing my name here, I verify all above information is correct.DateEmployer NotificationUpon request, the ABMM will notify your employer of your recertification. If you would like the ABMM to do this, please complete the information in the box to the right. This service is optional. Employer’s Name & Title: __________________________________Employer’s Address:__________________________________________________________________________The recertification fee of $400 (for contributing and premium ASM members) or $475 (ASM supporting members and non-members) may be paid by check or credit card. To pay by credit card, please fill in the box below:? Visa Credit card number: expiration:? MasterCard ? American ExpressName as it appears on credit card:MonthYear Today's Date: / / Type or sign signature: ................
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