The APA's Performance in Practice modules are guided practice improvement programs created for psychiatrists, designed to meet Part 4 MOC requirements for clinical modules. Modules follow a three-stage Performance Improvement CME structure that takes place within a 24 month period. By 2017, when ABPN MOC requirements are fully in place, MOC participants will be required to complete three PIP units, each consisting of both a clinical module (chart review) and a feedback module (patient/peer survey). In STAGE A - Chart Review, the physician compares his or her current practice (through a review of chart documentation) to guidelines and measures provided for the topic area (5 credits). In STAGE B – Improvement, based upon the results of chart review, the physician then selects an area where improvement is needed and documents his or her strategy for improvement. This improvement plan is for the personal use of the physician (5 credits). In Stage C – Second Chart Review, the physician reassesses his or her performance with review of 5 patient charts, and determines the results of his or her performance improvement effort (10 credits). Clinical Module for the Care of Patients with Major Depressive Disorder is approved by ABPN for MOC Part 4.