Articles tagged with: Maintenance of certification

Pediatric Part 2 QOW: Glitches Resolved

Written by Stuart Silverstein on Friday, 17 March 2017. Posted in Maintenance of Certification (MOC)

It seems that the American Board of Pediatrics resolved the glitch in their system. I now have 32 Part Points rather than 40.

My MOC transcript is now correct with the duplication removed:

 

Once again, QOW activities completed after January 2017 are eligible for CME credit which I received. This time, the credit was awarded for 2017 not back to the past in 1969.

 

Above: How the ABP fixes MOC glitches

MOCA Means MORE Questions

Written by Stuart Silverstein on Tuesday, 07 March 2017. Posted in Pediatrics Recertification

In our previous blog “Be a Beta MOCA” we informed you that the MOCA for earning Part 3 credit had arrived. In this blog we will review the details of this pilot and what you get out of enrolling in the program.

If you are due to take the Exam in December of 2017 and have not signed up for the MOCA group yet, you will have to take the actual exam, at a Prometric Center in 2017. The chance to sign up passed already in October.

Above: How I feel knowing I missed my chance to sign up and not have to take a secured exam

Whenever you opt into the MOCA Group during the year you are due to take the exam in December, the exam gets delayed by a year.

What is the MOCA process? You are sent 20 questions to answer every 3 months. These questions are based on 40 topics which are available on the ABP website.

The Months are Long but the Minutes are Short

The days are long but the years are short. Well here the months are long but the minutes are short. What does that mean? Well you have 3 months to answer the questions but you will be given 5 minutes to answer the question. That is 5 minutes to look it up, call your friends or just answer it. If you start the question and log off you get the question wrong.

You will need to get a majority of the questions correct just as you would on the Part 3 Electronic Prometric exam.

So what if you successfully get the majority of the questions answered correctly, are you done?

Of course not! For one thing this is just in the experimental stage. The only reward you get for now is a postponement of the Prometric® proctored examination.

Above: How I feel knowing the exam is just postponed using MOCA

Where is this Going?

The following year, you will have the same choice again. Take the proctored exam or take the 20 questions per quarter route. If you accept the latter, your due date for the proctored exam gets pushed up yet another year to 2019.

At one point, once this is all settled the ABP will determine if MOCA will replace the Electronic Secured Prometric exam

Once the prometric is phased out, instead of taking an exam once every 10 years you will have to answer the 20 questions a quarter. If you take out your calculator that means you are answering 80 questions a year, instead of 200 questions in one sitting, every 10 years.

Completion of QOW and Possible Glitches

Written by Stuart Silverstein on Wednesday, 22 February 2017. Posted in Maintenance of Certification (MOC), Pediatrics Recertification

As noted in the previous blog, I had 22 points toward my required 40 Part 2 points. Once I completed 20 more QOW’s I was to receive 10 more points, which would bring me to a total 32 Points as noted in the screenshot below:

 

 

 Once I completed the 20 questions,  and answered the required questionnaire, I received the following confirmation and words of congratulations:

 

 

 

Above: How I feel every time I get a congrats notice from the ABP

 

I next visited my portfolio dashboard, to verify that it was updated.  I expected to see either 32/40 complete or 30/40 complete. Much to my surprise my dashboard indicated that I had completed 40/40 or ALL of my 40 required Part 2 points.  Clearly this was an error and likely due to the new QOW changes being configured incorrectly.

 

 

 

 

Today I called the Board to let them know of this probable glitch since this is likely a system wide issue. 

I next checked my MOC transcript and clearly I received duplicate credit for questions completed on the same day.  Once the glitch in the system is fixed, this should be adjusted and I will update this blog. The screenshot of my transcript is below:

  

 

 

I next wanted to check if I received the CME credit and the link for that is “View Completed Activities“ which is noted in the screenshot below:

 

Once this Is clicked you are taken to the screenshot below. Activities for my current cycle are noted with a red asterisk. There you can see that only activities completed in 2017 are eligible for CME credit. I suspect that only 1 certificate will appear once the glitch is fixed.

 

Once I clicked on the CME certificate link I was taken to the screenshot below. The certificate confirmed that I completed the activity on December 31, 1969. Yes , December 1969.  

 

 

I was in the 4th grade. Just to put this in the right perspective that was 11 months after the New York Jets won the Super Bowl.

Above: How I felt when realizing I was in the 3rd grade in 1969

 

I noted this to the Board when I called them, clearly there are a few glitches to work out and they appreciated that. I will update you when this is corrected in a future blog, which I suspect will occur before the Jets appear, let alone, win their 2nd Super Bowl

 

 

What you need to know:

 

In order to receive 10 Part 2 MOC points for the Question of the Week, you need to answer 20 questions correctly and complete an online questionnaire. In addition, you will also receive 10 hours of CME credits for your efforts. There seems to be a glitch in the system, possibly due to the new QOW credit system, which will likely be corrected by the American Board of Pediatrics now that they are aware of this issue.

   

CME for QOW

Written by Stuart Silverstein on Wednesday, 18 January 2017. Posted in Maintenance of Certification (MOC), Pediatric recertification

A MOC Earned is a CME Earned 

In our previous blog, we left you hanging regarding the timing and the amount of CME credit you could receive when you complete 20 QOWs and get 10 MOC Part 2 points.  

You get 1 CME hour for every MOC point you earn on the QOW module. Therefore, you get 10 hours CME credit for 10 MOC Part 2 points earned. That means, they expect you to spend 30 minutes on each question.

Apparently, the QOWs completed prior to January 4th will not count toward CME as noted in the screenshot below:

What happened to the 2 points I received way back in December 2016? 

Recall, that the letter I received from the ABP in December noted that I would get 2 MOC points (not eligible for CME). However, since I need to answer 20 questions to get my 10 points, what will these 2 points do for me? That is not clear since, like an ATM machine, the MOC points are dispensed in multiples of 10s and 20s. It might just be that I have 2 points floating around like a non functional skin tag.  

This is why the dashboard on my portfolio notes that I have 22/40 MOC Points instead of 20/40

However, I still have to answer 20 questions not 18 to get the 10 MOC points. This is noted in the screen shot below. What purpose these 2 extra points will serve remains a mystery. 

The screen shot of my dashboard outlines this clearly! So now it is time for me to begin answering the QOWs as I march toward the magic number of 20 for my MOC and CME double dipping adventure. See you at the completion of this trip.

 

What you need to Know

When you complete your 20 QOWs you get 10 Part 2 MOC credits and 10 CME hours. This only counts for QOWs answered after January 7th 2017.  It is not clear how Part 2 QOW points earned prior to January 7th will apply for MOC credit but we do know that they won’t count for CME credits. 

Questions about Questions of the Week 2017: QOW Equals MOC and CME

Written by Stuart Silverstein on Wednesday, 11 January 2017. Posted in Maintenance of Certification (MOC), Pediatric recertification

The year 2017 is barely more than a week old! Belated Happy New Year to everyone!

In case you missed it, 2017 promises to be full of exciting surprises, unusual Tweets and mercurial changes. In addition Donald J. Trump as president is bound to be interesting as well.

In a previous blog we discussed the Question of the Week as one of the easier ways to fulfill the Part 2 Pediatric MOC Credit.

Late December, I got the following email from the American Board of Pediatrics (ABP). 

This represents additional changes to a constantly shifting and confusing process.

Apparently the Question of the week is the ABP’s most popular Part 2 activity. Yay! Starting 2017 (the future is now here), there are several “enhancements”

While the enhancements were being configured, in early December, access to the QOW was disabled.  I have to admit I had no idea since I am not in a rush to complete this requirement.

After receiving this letter I learned the following:

Wow NOW CME MOC QOW[1]

Most of it is good news! When you complete the QOW, in addition to MOC credit you will also receive CME credit. Double dipping has never been better.

Less is More !

In the Pre -2017 era, you needed to successfully complete 25 Questions of the Week to get your 10 MOC credits. In the Post-2017, era you only need to complete 20 QOW to receive your 10 credits (and CME Credits as well)

More Underwhelming Changes

Additional information in this announcement included:

Medical Pearls: are available at the end of each questions

QOW Archiving: QOWs that have been on the shelf longer than 3 years will still be available. However you won’t be able to get MOC or CME credit for these oldies on the shelf.

References Hyperlinked: If a particular topic interests you, the references can be accessed through hyperlinks embedded in the QOW

These enhancements are interesting and nice but really not important for those of you looking for a quick and painless way to get your Part 2 credits.

Once you have fulfilled your Part 2 requirement this will, of course, be a useful resource and learn more about topics of interest and relevance to your practice.

More Questions were raised by the QOW Enhancements:

How many hours of CME credit will I receive for each set of 20  questions answered successfully? 

The letter also stated that I will receive 2 points for the QOW’s I already answered in 2016. 

Will I received CME credit for these 2 points earned in 2016?

Here is a snapshot of my current profile. I currently have 22 points toward my Part 2 requirement of 40 Points.

Once I continue this process, I will have the answers to this question and will be sharing this in a future blog! 

 

 

 

 

 

 



[1] Yes this is a play on the How Now Brown Cow elocution teaching exercise from the days of yore.

Be a Beta MOCA

Written by Stuart Silverstein on Friday, 16 December 2016. Posted in Maintenance of Certification (MOC), Pediatric recertification

The opportunity to enroll in the Pediatric MOCA program is here.  So what does that mean?

As we have noted in our blogs, the American Board of Pediatrics has agreed to test the MOCA alternative to the Prometric secured exam to test your “Cognitive Expertise” in Pediatrics. Most of would agree that anything is better than taking another exam!

However, not taking the exam may or may not be the case and this is the reason that the ABP is allowing you to enroll in the new MOCA program. By enrolling in the MOCA program you will essentially be serving as a “beta tester” the rest of us. 

Who Can MOCA?

Enrollment in the program is limited to those of you who are due to take your Prometric exam at the end of the year. For those of you who must fulfill your Part 3 requirement by December 2017 you would have needed to enroll this past October. If you opted in, then you are among the chosen. If you did not opt-in you are among the frozen. That is the frozen who must still take the exam before the December deadline.  For the chosen few, who opted in here are your options:

 

If you have elected to enroll in the MOCA program, your exam requirement is postponed until December 2018. What do you have to do to deserve this reprieve?  You have to actually go through the program during the calendar year of 2017. In our next blog we will go over what this entails and where it gets you in your MOC cycle.

Above: When MOC Part 3 is postponed

Light a Fire

Written by Stuart Silverstein on Friday, 24 June 2016. Posted in Maintenance of Certification (MOC), Pediatrics Recertification

Light a fire if you're among the lucky ones who have registered for and are planning on taking the Part 3 Cognitive Expertise Secure Exam before the summer break. You are in the home stretch. It's down to the wire and it’s time to light a fire to your studying.

Earlier this month we pre-released 100 copies of the 5th and newest edition of our popular Surfing Your Way to Pediatric Recertification and the MOC Process. For those of you unable to get a copy we have some good news. We now have the book available in stock and ready for shipment. For those of you in the home stretch and wish to use our book in our promo code lightafireonMOC to receive 10% off. 

For those of you who have not signed up for the exam, there may (or may not) still be time to sign up. There is only one way to find out by checking into this link.

MOC pediatrics

The QOW Experience

Written by Stuart Silverstein on Tuesday, 01 March 2016. Posted in Maintenance of Certification (MOC), Pediatrics MOC , Pediatric recertification, Pediatric Maintenance of Certification

In my previous blog last week, I noted that the ABP QOW was a great way to get MOC Part 2 credit.  Each year, the ABP has been releasing 50 questions a year, one week at a time.  They have been doing so since December 2013 which means folks like me who are entering their MOC cycle can catch up if they would like.  For every 25 questions you answer correctly you get awarded 10 Part 2 MOC points out of the 40 required points.

Above GIF: How I feel when answering a QOW correctly

In the last blog, I had 11 out of the required 25 questions answered correctly. I also got 4 questions wrong.  This is the key, you must answer them correctly for it to count.   Since I am working on 2014 and 2015, there are 100 questions with a potential for 40 points available.  In that context it is very easy to get sloppy and answer the questions incorrectly.  And I have been guilty of this. However, since I am in year one of a 5-year cycle, this won’t be too costly since there are other Part 2 MOC modules available.  Even if I decide to get all of my MOC Part 2 points through the QOW, I have future years to continue the process.

Above GIF: My reaction when answering a QOW question incorrectly

Once you answer the question there is a forum for each question you can post comments to.

One reader even noted that he answered the question correctly on the Pre-Test but got it wrong after reading the abstract and discussion.  This reader’s advice was to not read the answers before reading the abstract.  This is personal taste.   The bottom line is: if you need these points this year, then you have to go through the abstract and discussion with emphasis on the conclusion and the parts of the discussion that focuses on the key points in the question.

If you have already gone through all of the archived questions then you will have to wait an entire week to move on to the next question since the QOW is question of the week!

When you answer the question correctly you must “claim your pearl “ by clicking the appropriate button illustrated in the screen shot below. Below that is the "post" button and "comment section". This is where you post your comments that other readers can read or just ignore.

ABP_recertification_screenshot1

Once you answered 25 questions correctly and claimed all 25 pearls, you get a nice little sticker that says the following:  

screenshot_ABP_recertification

Your stats on that set of questions gets reset, thus I was unable to go back and get a screen shot for this blog.

I then went to my dashboard which is in the screen shot below. As you can see I now have 10 out of 40 required Part 2 MOC Lifelong Learning and Self Assessment Points needed by December 17th 2020.  

MOC_ABP_screenshot3

Of note you do not get CME Credit for completing the QOW. I will review the other modules that we recommend for Part 2 MOC Credit in future blogs some of which do provide an opportunity for free CME credit. The nice thing is you can get all of your credit through QOW and still take advantage of the other modules, which helps you to prepare for the Part 3 secured exam AND provides CME credit.

I am currently going through my next set of questions and have 10 out of the required 25 questions completed. As I move along in the cycle I will provide updates on my experience with advise on avoiding the pitfalls I encounter. 

easy_recertification_moc_pediatrics

Pediatric MOC QOW and the Slow and Steady / Binge Option

Written by Stuart Silverstein on Sunday, 14 February 2016. Posted in Maintenance of Certification (MOC), Pediatrics Recertification

One of the options for obtaining MOC Part 2 credits is the ABP Question of the week or QOW[1] as they like to call it. The ABP releases 1 question per week, with a break for Christmas and New Year.  This totals 50 questions per year. Once you sign up up, the QOW is inconveniently sent to your already cluttered email box.  You can of course just log into your portfolio to access the question and send this email to the trash if you would like.

For every 25 questions you answer correctly you get 10 Part 2 MOC points.

Each QOW consists of:

1) A case study
2) Pre test Question: Before reading the abstract and discussion you take a guess at the correct answer.
3) A thrilling abstract filled with breathtaking stats and equations

4) A stimulating discussion about the abstract with even more exciting stats. They then, finally give you relevant information to your practice
5) Post test Question

Another chance to answer the same question. Since you have now gone through the abstract and exciting discussion you are now expected to answer the question correctly.

You only get one shot at the post test. If you get it right you get your pellet and are 1/25th closer to the 10 Points of Part 2 Credit you are seeking.

Slow and Steady Wins the Race Method

This is an opportunity to slowly but relatively painlessly chip away at the Part 2 MOC payload.

Since you need to answer an entire set of 25 questions to get the 10 points, there is absolutely no margin of error if you want to get the 20 points offered each year.

Slow and steady of course won’t work if you have left this to the last minute.

BINGE – QOW Method

If you are in the beginning of your MOC cycle you have the luxury of time

These questions are all there for the taking since they have been sending out and archiving the QOW since December 2013. As a result, you can, “ binge QOW “[2] your way to earning points, by going through all of the QOWs published and available since the beginning.

BINGE and SLOW Method

If you are early in your cycle as I am then you can binge QOW and go slow and steady as well.

Warning, they expect you to spend 20 minutes with each question, so keep this in mind if you choose to “binge QOW” your way to points. Theoretically, you can get through this in less than 20 minutes, but you are attesting to having taken the full 20 minutes when you submit each QOW for MOC credit.  

Sharpen your pencils and you will see that they have archived a full 50 questions for 2014 and 2015 waiting for you to binge on.  This means that there are 40 points available to you before you even start answering one question per week.

Recall that we recommend earning 60 of your combined Part 2 / Part 4 100 point requirement through Part 2 activities.

This means that if you answered all of the archived QOWs correctly to earn 40 points and then slowly earn 20 more through the slow and steady method, you have earned your 60 Part 2 credits exclusively through QOW.

I just started my next 5-year MOC cycle and it seems that I might be able to knock this requirement within my first year of this current cycle.

 

Fulfilling your Entire Part Quota with QOW?

As we note in our Down to the Wire Guide to Completing the Pediatric MOC PDF you will see that there are advantages to earning MOC credit through the Knowledge Self Assessment and the Decision Skills Self Assessment modules. As I go through the process I will research whether one can still go through these modules without needing the credit.

Below is a screen shot of my status at this point. I currently have 11 out of the necessary 25 points to get my 10 Part Credits.  I will post my next blog once I have successfully answered my 25 questions and received my first 10 Part 2 points for this cycle. Notice I answered 11 out of 15 questions correctly. I will make suggestions on avoiding this pitfall in my next blog post.

For those of you who prefer video, click this link to the ABP video blog that explains the QOW option for Part 2 MOC credit. 



[1] Pronounced COW

[2] hmm I may have coined a new term

If at First you Don’t succeed Try Try ….Something New ( Part 3 )

Written by Stuart Silverstein on Wednesday, 06 March 2013. Posted in failed pediatrics board exam, pediatrics board review, pediatric board certification review, Pediatric Maintenance of Certification

Of Course a Course?

Even if you are an auditory learner, attending a pediatric board review course is often not enough.  Live board review courses are primarily a good way to preview what you should be studying and/or serve as a review to reinforce the material you have already studied in board review books and questions. Even within a board review course one will find wide variation in the lectures. Some lecturers are very good at providing high yield pearls and focus their lecture on the board exam. Other lecturers just give their standard lecture on their area that includes clinical information and research that is not helpful to those of us who are only interested in passing the exam at this point in your career. 

Less is More

Often out of desperation, after failing the boards there is a tendency to buy every book written and attend every course you “ heard” was good.  It is better to focus in on a limited number or resources and really work with them than to surround yourself with a forest of books and material. 20% of the material out there will give you 80% of the results. Focus on the 20% that will work for you. There is nothing wrong with using the same resources as before or updated editions, as long as you take a new approach.

Pediatric Studying

Content Specifications

The American Academy of Pediatrics publishes the Content Specifications of topics you need to focus on in preparing for the pediatric board exam, which is similar to the content specifications for the Pediatric Maintenance of Certification/ Recertification exam published by the American Board of Pediatrics. It can be found here

 

Included in the content specifications are important images and illustrations you must be familiar with. Therefore you will need a good access and/or material that will help you distinguish between similar looking illustrations, tables and photos.

 

There is very little variation from year to year regarding the topics emphasized in the content specifications. The core material needed to pass the boards is fairly static.

Reinforce with Review

Remember to review the material you studied the previous study session. With each progressive week the sections you have reviewed more than 3 times will become less and less time consuming. At the end you will be studying the areas you were stronger in to begin with.

In fact each study session you should begin my answering board review questions from the material you studied the previous week to gauge how well you actually mastered the material and to identify any gaps.

Missed it by That Much

Of course most pediatricians who failed the exam tell us they failed by only a few points. In the past the curve has been set up so that everyone who fails the exam misses it by a small margin, which often comes down to 10-15 questions. We have heard that the grading system has changed somewhat and that instead of a curve, passing is based on answering a minimum number or percentage of questions correctly.  This will be the subject of a future blog.  In the meantime we still suspect that passing and failing will still come down to 10 -15 questions making the difference between passing and failing the boards.

We have outlined some important steps you can take that will help you answer the 10-15 that make the difference between failing and passing the boards successfully.

We have heard from some of you who are taking the exam again and wish to hear from more of you. This will enable us to help share, anonymously of course, the experience of others. This pooled information can further help repeat board takers finally get it done.

Finally, we know you may feel like this now:

You may feel like this

But once you outline a study schedule and strategy you should and need to feel like this:

You need to feel like this 

 

Zen and the Art of Pediatric MOCcycle

Written by Stuart Silverstein on Tuesday, 15 January 2013. Posted in Pediatric recertification, Pediatric Maintenance of Certification

I recently heard about a pediatrician, who procrastinated as long as he could to put his toe into the uncertain waters of the “MOC” process until the deadline for “enrolling” in the MOC process was less than a month away. That pediatrician was me!  

 I not only had to  put together the book used by so many of our colleagues, but I also have to go through the process myself.  I can tell you the latter is much more difficult.  It is much easier to teach and preach than to perform.

I invite those of you who are and/or will be going through the MOC process in the coming weeks to join me on what I hope will be a humor-laden description of this confusing process which will cover more than merely preparing for an exam.  That isn’t to say that preparing for and taking a proctored exam is an easy task for us working stiffs who spend all day helping patients and then answering to the needs of a family when we get home. Many of us have not taken an exam since Bill Clinton was actually the president, and not a hired gun giving speeches at the DNC.  

 

For most of you, this process will begin with a good news/bad news letter.  The good news is you have been given 2 more years to prepare for the proctored exam.

The bad news is you will have to enroll in the MOC process, and go through MOC cycles” to maintain your certification.  The proctored exam is just one part of the on the MOC–cycle trip.  The MOC process is not a cheap one and proportionately higher for us pediatricians who cannot compete with our more fortunate procedure reimbursed colleagues. We will cover that in future blogs.

 

Circling the Cycle:

Part 1: Professional Standing – Also known as having a valid medical license.

Part 2: Knowledge Assessment:  Differentiated into 2 subcategories[1]

  • Knowledge Self Assessment- 200 online questions, which you don’t even have to pass to get credit.
  • Decision Self Assessment – 50 multiple choice questions based on patient cases , this time you have to get a passing grade

Part 3:  Cognitive Expertise:  Also known as the proctored exam, or the big test, the one you had to take every 7 years and now have to take every 10 years while MOC cycling.

Part 4: Performance in Practice:  This is the part that had and still has me as confused as an octogenarian staring at iPod®.   As of this writing I am still not clear on what the heck we are expected to do.  This is not a simple matter of answering questions online or even preparing for and taking an exam. This involves something along the lines or doing a quality improvement study in your practice. 

I began reading this, and flies began landing on my eyes without my noticing while I reviewed the 2 choices for fulfilling this requirement which were:

  • Established Quality Improvement Projects:  Where you collaborate with other groups and practices.  Lots and lots of moving wheels.
  • Web Based Improvement Activities: These seem to be off the shelf activities conducted within your practice and presumes you will want to do this with in conjunction with the other physicians in your practice.

 

The other day I tried to make sense of this part of the MOC process.  I stared and read it over and over until my mind went blank.  The next thing I remember was sitting at Brazilian Steakhouse  and some guy named Raul was serving me sliced Turkey from a cutting  board at my table.  I guess I was so traumatized that I must have suffered retrograde amnesia. [2]  Therefore I will have to cover this in greater detail when I return to this part of the MOC requirement as I tackle it myself.

 

Coming Attractions

 

In the future, patient surveys will be added to the mix. Yes!  Patient surveys handed out to parents who will provide their opinion of communication style and availability.  It is not yet clear if you will have to hand this out randomly, or cherry pick your favorite patients for their input.  As if there aren’t enough challenges, practicing medicine will become American Idol where you will have to perform for a panel of judges. What’s next?  Patients commenting on your doctoring skills on your Facebook® wall and hitting “Like” buttons?

 

We will keep you posted when and if you will have to face such a tribunal!

 

For me the process began with what seemed like a bombardment of some 300 email and snail mail letters that I ignored until I realized those ignored letters is not good for my professional standing with the board.  I was also thankful that the ABP has not discovered Facebook® or Twitter® where I would sure to face the electronic equivalent of being placed in the public stocks.

 

Qualify to Enroll

 

I had until December last year to “qualify” to enroll in the MOC process, s I finally took the first steps to “qualify” for the enrollment process.  Up until that moment, as the author of “Surfing your Way to Recertification”, I have been receiving calls, emails and, yes, Facebook messages from friends asking about the process.  Much to my shock, when replying to my friends, I found myself stammering and changing the topic to the weather or local traffic reports. Until then I couldn’t give first hand advice and guidance.

 

In order to qualify I had to get through Parts 2 and 4.  Part 1, providing proof that I had a medical license which was easy enough.  Then again, if you don’t have a medical license why would you be going through all of this torture?

 

Over the coming weeks, we will muck through the MOC process together.  Unlike the ABP, we actually are familiar with Facebook ® and Twitter®, and I invite you to “like” us on Facebook and “follow our Tweets” on Twitter®.  We also want to note that this blog and our materials will help you get through and demystify the process.[3]



[1] Which makes this all even more convoluted and confusing, since they are 2 activities why not just assign them each an independent number. ?

[2] Folks, this was inserted the sake of humor,  it didn’t really happen so please do not write us to let us know that you had the same experience, as you might be better served seeking psychiatric assistance if that is the case.  

[3] We are not here to provide inside information on questions asked on the exam, answers to the questions, or otherwise reveal any other part of the MOC process, or the exact areas of knowledge that will be tested. We do welcome general feedback and shared experiences going through the process, but are not looking for nor will we be accepting such exam specific information.