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 357 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 357 hours of Category 1 credit for completing this program.

ABIM MOC Points

ABIM CME MOCSuccessful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 357 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.

Read the ABIM Policy here.

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, 2020, 2021, 2022
Termination Date: January 27, 2024

MMS Disclosure Policy

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

Below are all relevant financial relationships reported by NEJM Knowledge+ contributors during the past 3 years.

Vaneeta Bamba, MD

2021Novo Nordisk, Growth Advisory Board for Genetic Short Stature, discontinued Nov 2020
2022Nothing disclosed
2023Nothing disclosed

Ethan Brown, MD

2021Rune Labs, consultant, discontinued Apr 2019
2022Rune Labs, consultant
2023Nothing disclosed

Steven Chen, MD

2022Pfizer, advisory board member, discontinued May 2021
Novartis, advisory board member, discontinued Dec 2021

Ezra M. Cohen, MD

2021Cornerstone Research Group, consultant
2022Nothing disclosed
2023Presidio, scientific board member

Nathan Connell, MD

2021Nothing disclosed
2022Takeda Pharmaceutical, consultant
2023Takeda Pharmaceutical, consultant
Octapharma, honoraria
Genentech, advisory board member
Doximity, equity

Areeg H. El-Gharbawy, MD

2021Ultragenyx, principal investigator for a clinical trial
Ultragenyx, advisory board member
Amicus, advisory board member

Rajesh T. Gandhi, MD

2021Merck, scientific advisory board
2022Nothing disclosed
2023Nothing disclosed

Glenn J. Hanna, MD

2022

Actuate Therapeutics, grant/funding

Bicara, consultant/advisory board

Bicara, grant/funding

Boxer Capital, consultant

Bristol Myers Squibb, grant/funding

Bristol Myers Squibb, consultant

Coherus, consultant

Elevar, consultant/advisory board

Exicure, grant/funding, discontinued Jan 2022

Exicure, consultant/advisory board

Gateway for Cancer Research, grant/funding

Genentech, grant/funding

General Catalyst, consultant

GlaxoSmithKline, grant/funding

ImmunityBio, grant/funding

Kartos Therapeutics, grant/funding

Kite Pharma, grant/funding, discontinued Jun 2022

KSQ Therapeutics, consultant

KSQ Therapeutics, grant/funding

Kura Oncology, consultant/advisory board

Kura Oncology, grant/funding

Merck, consultant/advisory board

Naveris, consultant/advisory board

Prelude, consultant/advisory board

Rain Therapeutics, consultant, discontinued Nov 2021

Regeneron, consultant/advisory board

Regeneron, grant/funding

Remix Therapeutics, consultant/advisory board

Repertoire, grant/funding

Sanofi Genzyme, advisory board, discontinued Nov 2021

Sanofi Genzyme, grant/funding

Secura Bio, grant/funding

V Foundation, grant/funding, discontinued Jun 2022

Jonathan S. Hausmann, MD

2021

Pfizer, consultant, discontinued Dec 2020

Biogen, consultant, discontinued Dec 2020

Novartis, consultant

2022

Pfizer, consultant, discontinued Dec 2020

Biogen, consultant, discontinued Dec 2020

Novartis, consultant

2023Fresenius Kabi, consultant
Novartis, consultant

Brian C. Healy, MD

2021

Analysis Group, grant support
Celgene (Bristol Myers Squibb), grant support
Verily, grant support
Novartis, grant support
Merck Serono, grant support
Genzyme, grant support

2022

Analysis Group, research support to institution, discontinued Nov 2020
Celgene (Bristol Myers Squibb), research support to institution, discontinued Nov 2020
Novartis, research support

2023

Novartis, research support

Koyal Jain, MD, MPH

2022

PI for Kaneka study and Visterra study

Mihir M. Kamdar, MD

2021Amorsa Therapeutics, scientific advisory board, stockholder
Medtronic, consultant, fees
Fern Health, consultant, fees
2022Nothing disclosed
2023Elevate, cofounder and chief medical officer
Fern Health, medical advisor

Ruslan Korets, MD

2021Boston Scientific, consultant
2022Boston Scientific, consultant
2023Boston Scientific, consultant

Lekha M. Rao, MD

2023Epigenyx Therapeutics, consultant
UCB, principal investigator for a clinical trial
Eisai, principal investigator for a clinical trial

Leigh C. Reardon, MD

2021

Janssen, speaker
CareDx, participant in advisory board discussion, discontinued Dec 2020

2022Janssen, advisory committee
2023Janssen, consultant

Eric Roeland, MD

2023Napo Pharmaceuticals, scientific advisory board
Actimed Therapeutics, scientific advisory board
Meter Health, scientific advisory board
Veloxis Pharmaceuticals, consultant
Aileron Therapeutics, consultant
BYOMass, consultant
Takeda, advisory board
Enzychem Lifesciences Pharmaceutical Company, data safety monitoring board

Deborah R. Stein, MD

2021Nothing disclosed
2022Nothing disclosed
2023Horizon, consultant
Alexion, consultant

Taher S. Valika, MD

2021Save My Scope Inc, chief medical officer

Ruth Ann Vleugels, MD, MPH, MBA

2021Pfizer, principal investigator for a clinical trial

Raymond Y. Wang, MD

2021

Biomarin Pharmaceutical, speaking engagement, discontinued Jul 2019

Biomarin Pharmaceutical, advisory committee, discontinued Sep 2019

RegenxBio, advisory committee, discontinued May 2020

Takeda Pharmaceutical, advisory committee, discontinued Aug 2020

Ultragenyx Pharmaceutical, webinar, discontinued Nov 2020

Inventiva Pharmaceutical, advisory committee, discontinued Dec 2020

Neurogene, advisory committee, discontinued Nov 2020

Denali Therapeutics, drug monitoring committee

2022

Biomarin, ad hoc advisory board, discontinued Oct 2021

Orphazyme, ad hoc FDA advisory meeting, discontinued Oct 2021

Sio Gene Therapies, consultant, discontinued Nov 2021

Sio Gene Therapies, ad hoc advisory board, discontinued Aug 2021

Inventiva Pharmaceutical, ad hoc advisory board, discontinued Jul 2021

Takeda Pharmaceutical, ad hoc advisory board, discontinued Mar 2021

Ultragenyx, speaker, discontinued Nov 2020

Neurogene, ad hoc advisory board, discontinued Oct 2020

Regenxbio, ad hoc advisory board, discontinued Apr 2020

2023RegenxBio, consultant
Takeda Pharmaceutical, advisory committee, discontinued 2022
Denali, drug safety monitoring board

Sharmeel K. Wasan, MD

2021Pfizer, grant support
2022Nothing disclosed
2023Nothing disclosed

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.

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