Learning Objectives
- Demonstrate an increase in the learner’s knowledge of clinical medicine.
- Demonstrate an improvement in the learner’s ability to make decisions that provide safe and effective medical care.
- Recognize areas of personal strength and areas for growth in clinical knowledge.
Intended Audience
Physicians and residents who are seeking to maintain and augment their knowledge in clinical medicine and/or preparing for their initial board certification or recertification.
Accreditation
The Massachusetts Medical Society (MMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) and must ensure independence, balance, and scientific rigor in its accredited continuing education activities.
All individuals in control of the content for an MMS accredited continuing education activity must disclose all financial relationships with ineligible companies.
AMA Credit Designation Statement
The Massachusetts Medical Society designates this enduring material for a maximum of 347 AMA PRA Category 1 Credits™. Physicians should claim only credit commensurate with the extent of their participation in the activity.
AAPA Credit Designation Statement
AAPA accepts certificates of participation for educational activities certified for AMA PRA Category 1 Credit™ from organizations accredited by ACCME or a recognized state medical society. Physician assistants may receive a maximum of 347 hours of Category 1 credit for completing this program.
ABIM MOC Points
Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 347 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. Participants will earn MOC points equivalent to the amount of CME credits claimed for the activity. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.
Royal College of Physicians and Surgeons of Canada
Through an agreement between the Accreditation Council for Continuing Medical Education and the Royal College of Physicians and Surgeons of Canada, medical practitioners participating in the Royal College MOC Program may record completion of accredited activities registered under the ACCME’s “CME in Support of MOC” program in Section 3 of the Royal College’s MOC Program.
Method of Participation
You must answer questions correctly to receive CME credit and MOC points.
Six questions answered correctly are designated for 1 AMA PRA Category 1 Credit™.
Six questions answered correctly equal 1 MOC point.
Accreditation Term:
CME credit and MOC points are available for 3 years. Term begins January 27, 2020.
Original Release Date: January 27, 2014
Review dates: 2015, 2016, 2017, 2019
Termination Date: January 27, 2023
The Massachusetts Medical Society (MMS) is accredited by the Accreditation Council for Continuing Medical Education (ACCME) and must ensure independence, balance, and scientific rigor in its accredited continuing education activities.
All individuals in control of the content for an MMS accredited continuing education activity must disclose all financial relationships with ineligible companies.
Individual Disclosures
During their tenure with NEJM Knowledge+, the following planners, authors, and reviewers have disclosed the following relevant financial relationships with an ACCME defined ineligible company.
Vaneeta Bamba, MD
– Member of the Growth Advisory Board for Genetic Short Stature for Novo Nordisk
Thomas M. Best, MD, PhD
– Consultant for Abbot and ZetrOZ
Ethan G. Brown, MD
– Grant/contract research with Gateway Institute for Brain Research
– Consultant for Rune Labs
William Busse, MD
– Advisory board for Merck
– Consultant for Amgen, Novartis, GlaxoSmithKline, MedImmune, and Genentech
– Data monitoring boards for Genentech and Boston Scientific
– Study oversight committee for IC
Andrew T. Chan, MD
– Consultant for Bayer Healthcare, Pfizer, Pozen, and Millenium Pharmaceuticals
– Speakers bureau for Millienium Pharmaceuticals
Vincent W. Chiang, MD
– Financial interest in and advisory board member for AugMI Labs
Ezra M. Cohen, MD
– Consultant for Cornerstone Research Group
Jean M. Connors, MD
– Honoraria from Pfizer
– Consultant for Proteostasis Therapeutics
– Scientific advisory board for Portola Pharmaceuticals
Kelly M. Cordoro, MD
– Consultant for Anacor Pharmaceuticals
– Scientific steering committee for Celgene
Peter D. Friedmann, MD, MPH
– Legal expert consultant for Endo Pharmaceuticals
– In-kind research support from Alkermes
– Scientific advisory committee for Indivior
Rajesh T. Ghandi, MD
– Scientific advisory board for Gilead and Merck
– Grant support from Tibotec (Janssen Therapeutics), Abbott, ViiV Healthcare, Gilead, Merck, and Theratechnologies
– Consultant for Theratechnologies
James E. Gern, MD
– Consultant for Janssen Pharmaceutical Companies of Johnson & Johnson, GlaxoSmithKline, Boehringer Ingelheim, MedImmune AstraZeneca, and Merck
– Grant support from GlaxoSmithKline and Merck
Emily M. Godfrey, MD, MPH
– Speakers’ bureaus for Merck Pharmaceuticals and Bayer Women’s Health
– Consultant for Teva Women’s Health
Jason Robert Gotlib, MD
– Clinical trial research funding from Novartis, Promedior, Incyte, CTI Biopharma, Gilead, Seattle Genetics, and Pharmacyclics
– Study steering committee member, advisory board member, and receipt of honoraria from Novartis
– Advisory board member and receipt of honoraria from Incyte
Jonathan S. Hausmann, MD
– Consultant and advisory board member for Novartis
– Consultant for Pfizer and Biogen
Brian C. Healy, MD
– Grant support from Analysis Group, Celgene, Novartis, Merck Serono, Verily Life Sciences, Tiziana Life Sciences, and Genzyme
Ole-Petter Riksfjord Hamnvik, MB BCh BAO, MMSc
– Consultant for Fusion Pharmaceuticals
Elizabeth Harrison, MD
– Financial interest in Pfizer, Merck, and Express Scripts
Simon M. Helfgott, MD
– Consultant for AbbVie and Genentech
Mihir M. Kamdar, MD
– Scientific advisory board member and stockholder for Amorsa Therapeutics
– Expert advisory panel for Collegium Pharmaceuticals
– Consultant for Fern Health, Medtronic, and Vivtex
– Received fees from Medtronic and Fern Health
Amel Karaa, MD
– Consulting fees from Akros Pharma, Concert, Alexion, Lumleian, and MitoBridge
– Grant support, reimbursement for travel, and consulting payments from Stealth BioTherapeutics and Shire
– Grant support, consulting fees, reimbursement for travel, and honoraria from Sanofi Genzyme
– Grant support and reimbursement for travel from Reata Pharmaceuticals and Protalix Biotherapeutics
Ruslan Korets, MD
– Consultant for Boston Scientific
Jenna C. Lester, MD
– Consultant for Rodan + Fields
Eli Miloslavsky, MD
– Fellowship in 2012—2013 from Genentech
Paul A. Monach, MD
– Grant support from Genentech
Christopher J. Moran, MD
– Grant support from Allergan
Alan C. Moss, MD
– Consultant for Janssen Pharmaceutical Companies of Johnson & Johnson, Theravance Biopharma, Seres Therapeutics, Boehringer Ingelheim, Pfizer, Gilead, and Mallinckrodt Pharmaceuticals
– Grant research/support from Pfizer and Boehringer Ingelheim
Leigh C. Reardon, MD
– Consultant and speakers bureau for Actelion
– Speaker for Janssen Pharmaceutical Companies of Johnson & Johnson
– Participant in advisory board meeting for CareDx
Richa Chibbar, MD
– Consultant for Ferring Pharmaceuticals and AbbVie
Shari S. Rogal, MD, MPH
– Grant support from Gilead
Misha Rosenbach, MD
– Consultant for Celgene
Paul E. Sax, MD
– Consultant for Bristol-Myers Squibb, GlaxoSmithKline, Merck, Janssen Pharmaceutical Companies of Johnson & Johnson, and Gilead
– Grant support from Bristol-Myers Squibb, GlaxoSmithKline, Merck, and Gilead
Marvin I. Schwartz, MD
– Consultant for Boehringer Ingleheim, InterMune, and Merck
Bradford Shingleton, MD
– Consultant for Transcend Medical
– Grant Research/support from Alcon
John I. Takayama, MD, MPH
– Financial interest in Omnicell
Derrick J. Todd, MD, PhD
– Consultant for Kiniksa Pharmaceuticals, Genentech, Optum, and Regeneron
Avram Z. Traum, MD
– Consultant for Alexion Pharmaceuticals
Ruth Ann Vleugels, MD, MPH, MBA
– PI for a randomized controlled clinical trial funded by Pfizer
Andrew A. Wagner, MD
– Consultant for BK Ultrasound
Raymond Y. Wang, MD
– Advisory board member or consultant for Biomarin Pharmaceutical, Neurogene, RegenxBio, Takeda, Orphazyme, and Inventiva Pharma
– Equity ownership in Biomarin Pharmaceutical, RegenxBio, and Sarepta Therapeutics
– Speaking engagement for Biomarin Pharmaceutical
– Webinar participant for Ultragenyx Pharmaceutical
– Drug Monitoring Committee member for Denali Therapeutics
Sharmeel K. Wasan, MD
– Grant support from Pfizer
Melissa B. Weimer, DO, MCR
– Advisory role with Alkermes
James L. Zehnder, MD
– Grant research/support from Novartis
All relevant financial relationships have been mitigated prior to the beginning of this activity in accordance with ACCME and MMS policies. All other individuals in control of the content have reported no relevant financial relationships with ineligible companies for this activity. The complete list of contributors can be found here.
Disclosure of Commercial Support
No commercial support was received for this activity.
Medium or Combination of Media Used
This is an adaptive self-assessment tool designed to adjust to the learner’s strengths and areas for growth, and can be accessed from a desktop, laptop, tablet, or smartphone. Learners choose the subspecialty area and are presented with a sequence of questions. After each question is answered, the user is provided with the key learning point, detailed feedback that discusses the correct answer as well as each of the wrong answers, and citations to relevant articles.
Estimated Time to Complete the Educational Activity
One hour for every 6 questions answered correctly.
Bibliography
Each clinical vignette includes citations and references.
Hardware/Software Requirements
Windows
- Google Chrome 30+, Safari 5.0+, Internet Explorer 11.0+, Mozilla Firefox 10.0+, Microsoft Edge
Recommended: Google Chrome 39+, Safari 7+, Internet Explorer 11, or Firefox 32+ - Windows 7 (32-bit and 64-bit), Windows 8+. Windows 7+ is recommended.
- Minimum 1 GB of RAM but 2 GB or greater is recommended
- 2.33 GHz or faster x86-compatible processor, or Intel® Atom™ 1.6 GHz or faster processor for netbooks
- Display resolution: 1024 × 768 or better
Mac OS
- Google Chrome 14+, Safari 5.0+, Mozilla Firefox 12.0+
Recommended: Google Chrome 39+, Safari 7+, or Firefox 32+ - Mac OS X v10.6+
- Minimum 1 GB of RAM but 2 GB or greater is recommended
- Intel Core™ Duo 1.33GHz or faster processor
- Display resolution: 1024 × 768 or better
Mobile/Tablet
NEJM Knowledge+ apps are available for iOS and Android smartphones and tablets; Android phones may access NEJM Knowledge+ through our mobile-optimized browser version.
- iOS devices running OS 7+(includes iPhone and iPad devices). iOS version 8+ is recommended.
- Android version 4+ (includes smartphones and tablets). Android version 5+ is recommended. Note: Android phones will also support the browser version of each product (Chrome recommended).
Contact Information
For all questions and comments, please contact NEJM Knowledge+ by email at knowledgeplussupport@nejm.org or call toll-free (within the USA and Canada) or +1-781-434-7998.
Policy on Privacy and Confidentiality
Read our Privacy Policy.
Copyright
Copyright information can be found in the NEJM Group Terms of Use.
ABIM Policy
Participant data is governed by ABIM’s Confidentiality Policy and submitted to the ABIM using the ACCME PARS system. Identifiable patient data shall not be provided to ACCME or ABIM by any organization or participant.
Public Information About Providers of MOC Activities
The following information, provided to ACCME by the provider, is considered public information, and therefore may be released by ABIM and/or ACCME.
- Activity title
- Activity type
- Accredited provider name
- Accredited provider contact information (including phone number and website address)
- Joint provider name (if applicable)
- Activity date (start date, in the case of a multi-day live activity or enduring material activity)
- Specialty(ies) activity addresses
- Maximum allowable MOC points and patient safety credit awarded
The following information will be made available in physicians’ MOC history reports located in the secure physician login area of ABIM’s website:
- Activity title
- MOC point value, including patient safety credit, if applicable
- Activity completion date