1) How long has CPEP had a reentry program and what led to the start of the program?
The CPEP Clinical Practice Reentry Program was launched in 2003 to meet the needs of physicians returning to practice after a voluntary absence. In the early 2000s, an increasing number of medical boards began implementing rules requiring physicians who had not provided direct patient care for extended time periods to demonstrate competence before being granted a license. We created the program in response to our observations that these reentry physicians were going through CPEP’s competence assessment program to meet licensing requirements. We felt that the reentry professionals had unique needs; therefore, we developed a program tailored to their circumstances. Through the Reentry Program, professionals can demonstrate competence, identify their educational needs, and receive educational support as they achieve their goal of returning to practice. The program focuses on the individual participant, with their specialty and proposed scope of practice in mind. As a result, participants receive the personalized support they need to resume their career in medicine.
2) How many reentry candidates have completed your program to date?
By the end of 2012, 122 participants had completed the one-‐day evaluation process (clinical skills analysis), and 45 of these professionals had participated (or are currently participating) in the Reentry Education process. Participants are from a variety of specialties ranging from primary care to surgical specialties, such as spine surgery. Our participants have come from 26 different states. They have been out of practice for as few as two years to more than twenty years – with the average time out of practice being about 8 years.
3) Do you offer reentry programs only to physicians or to other medical professions as well?
CPEP offers this program to physician assistants, podiatrists, and advance practice nurses in addition to physicians (M.D. and D.O.).
4) What types of reentry services do you provide?
The Reentry Program has two components – each component is personalized to the professional’s specialty and proposed scope of practice. The first component is the Clinical Skills Analysis. This is a one-‐day evaluation which provides an objective evaluation of the participant’s clinical competence and educational needs. Specifically, we evaluate medical knowledge, clinical judgment, communication skills, and patient care documentation skills. CPEP provides a detailed report of the evaluation findings along with a Reentry Education Plan to guide the participant as he/she transitions into clinical practice.
The second component is the Reentry Plan implementation. CPEP’s Reentry Plans are practice-‐based learning programs that generally take place in the participant’s home community. Plans utilize a variety of educational activities including: supervised clinical experiences to update technical skills; preceptorships; CME courses, online education and self-‐study resources; training in use of contemporary medical information resources, and guidance in contemporary documentation practices, including the use of EMRs. CPEP provides educational expertise and oversight as the participant completes the Reentry Plan, as well as regular reports and tracking of progress and completion. The length of time to complete the Reentry Plan varies; most plans are completed in approximately 3 to 6 months.
5) Do you have to come to Colorado to complete a reentry program?
The one day Clinical Skills Analysis must be done in person. Currently, this is conducted only in Denver, CO. The Reentry Plan is designed to be completed while the professional resumes practice in his/her home community; the physician does not have to relocate to Denver to complete the Reentry Plan activities. CPEP oversees the Reentry Plan implementation through regularly scheduled calls and email communication with the participant, preceptor and others involved in the educational process.
6) How is it determined that a physician would be a good candidate for the program?
The participant must have left practice voluntarily and be returning to a field in which s/he has been trained and/or practiced. Reentering physicians who are switching specialty areas or who have had prior disciplinary action would qualify for CPEP’s more comprehensive assessment/education process.
7) What do you know about the success of physicians who have completed your program?
Of those professionals who enrolled with CPEP for Reentry Plan implementation, approximately 80% successfully completed the program and resumed patient care responsibilities. Please refer to CPEP’s research study for more detailed information related to participant success (Grace ES, Korinek EJ, Weitzel LB, and Wentz DK. Physicians Reentering Clinical Practice: Characteristics and Clinical Abilities. J Contin Educ Health Prof. 2011; 31(1):49-‐55). We do not have data on professionals who come for the Clinical Skills Analysis and do not continue working with us to complete their reentry education.
8) What are the average costs?
The cost for the clinical skills assessment, including the Reentry Plan development, ranges from $7,750 to $10,950 depending on the specialty to be evaluated. The Reentry Plan implementation and educational costs are highly individualized, and depend on the intensity of the Plan activities. Physicians who do well on the evaluation would not incur further educational expenses. The average cost for the Reentry Plan implementation can run from $2,500 -‐ $5,000. The physician generally resumes direct patient care early in the course of the Reentry Plan and may be able receive compensation for patient care services during the training period.
9) Any words of advice for someone thinking about leaving clinical practice to make reentry easier when they decide to return?
If it is feasible for you to do so, maintain your license and board certification. Keep up with continuing medical education activities. If there are opportunities to stay involved in practice in a limited context, take advantage of those opportunities and maintain some, albeit limited, level of practice. Lastly, think ahead when considering a return to practice. The process can take a lot longer than you might expect. Take advantage of formal reentry programs. Having objective feedback and ongoing support while you resume practice is invaluable. The assistance provided by the programs can help ensure a safe return to practice and boost confidence.
For more information about the Clinical Practice Reentry Program, go to www.cpepdoc.org.