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MOC Frequently Asked Questions

Do you need to recertify for your medical specialty board soon?

Here are some frequently asked questions about the process.

Why is Recertification now called Maintenance of Certification (MOC)?

The American Board of Medical Specialties (ABMS) chose the term “Maintenance of Certification” (also called “Continuous Certification”) to reflect their focus on a continuous process of professional development that spans the entire certification period. Traditional recertification requires a diplomate (a physician who has received initial board certification) to apply for recertification near the end of the specified certification period and pass a secure recertification examination. MOC goes beyond this requirement to include continuing education and assessment activities throughout the recertification cycle.

What is the evidence that participating in MOC improves the quality of care delivered by physicians?

Currently, studies are underway to help answer the question of whether or not this type of continuous quality improvement as applied to professional development will translate into better outcomes for patients. To date, this information is not yet available. However, the ABMS is leading the transition to a physician-driven process that will be credible to the many outside stakeholders interested in quality clinical care, including patients, insurers, businesses and government. The ABMS is working with its Member Boards to ensure that physicians and the medical profession, as opposed to outside regulators, develop the process by which physician performance is assessed and reported.

Why do the MOC requirements differ depending on the year of initial certification?

Whether or not a physician holds a time-limited or time-unlimited certification depends on their specialty and when they were initially certified. Those physicians who hold time-unlimited certification may have no requirements for recertification. The transition to full MOC compliance varies according to how many years diplomates have left on their current certificates at the 2007 initialization of MOC. Those with fewer years remaining on their certificates have fewer requirements to fulfill since requirements are proportioned based on time remaining. Once all the diplomates have entered a new cycle, the requirements will be the same for everyone.

Is the MOC program in its final form for all the Member Boards?

Specific components have been developed and are being implemented to better evaluate the competence of all practicing physicians. Each individual Member Board is defining its own program to comply with the requirements of MOC. Changes to, and probably additional, requirements can be expected in the future. Some Member Boards have implemented their Part II and Part IV requirements already while others are finalizing the development of theirs.

Why should I participate in MOC and what will happen if I choose not to?

In addition to the personal benefits of demonstrating one’s professional development in medical knowledge, life-long learning and quality improvement for the provision of good clinical care, there are several other potential reasons why a diplomate may want to participate in MOC:

  • ABMS and Member Board provide information to patients and other public stakeholders who seek documentation that their physician is practicing the highest quality care. Physicians who choose not to participate will be listed as not participating in MOC in Member Board and ABMS databases.
  • Some insurers are using participation in MOC as a measure of quality and participation may be tied to performance-based reimbursement strategies in the future.
  • State licensure boards are actively looking at Maintenance of Licensure (MOL) programs, and the ABMS and its Member Boards are working with the Federation of State Medical Boards to assure that participation in MOC will qualify for MOL.
  • In certain states, malpractice carriers have already started to give discounted premium rates to physicians participating in MOC.
  • The Healthcare Reform Act of 2010 contained language specifically acknowledging the ABMS MOC process. It is expected that after 2015, participation in MOC will be a requirement for full participation in Medicare and Medicaid billing and payments.

If I have a time-unlimited certification do I need to participate in MOC?

MOC is a voluntary process for time-unlimited certificate holders. Currently held certification will not be revoked. Diplomates will be reported in ABMS and many individual Member Board databases as “Not participating in MOC.” There are other reasons for participating in MOC, however, even on a volunteer basis. Please see “Why should I participate in MOC and what will happen if I choose not to?”

If I hold a subspecialty certification (e.g., Cardiology) do I need to participate in MOC for general board certification?

If diplomates entered MOC upon certifying or recertifying in a general specialty such as Internal Medicine, they must be current in fulfilling those MOC requirements to be eligible to certify or recertify in another specialty. However, once that is achieved, they are not required to take the recertification exam in general Internal Medicine if they do not wish to maintain this general certificate.

Can I participate in MOC if I am no longer clinically active?

Diplomates who are no longer in active practice and do not treat patients in any capacity may have different requirements for MOC. Some Member Boards require only the completion of Parts I, II and III. Other Member Boards have designed Part IV activities specifically for diplomates with little or no patient care responsibilities such as those involved in research or administration. Some Member Boards require the diplomate to attest that he or she is no longer actively participating in any direct patient management.

How and when should I get started in MOC?

The first step is to visit the website of your individual Member Board click on the MOC link (called Continuous Certification by some Member Boards). You may be required to log in and create an account if you do not already have one.

Most Member Boards suggest starting MOC activities at the beginning of your certification period given the emphasis on continuous improvement. Different MOC activities have variable time requirements for completion. Some Member Boards require that activities be completed at specified intervals throughout this period.

If my time-limited certification has lapsed, can I still pursue MOC?

If your certification has lapsed, it may be possible to regain certification. Many Member Boards provide specific information on their websites to those wishing to re-establish their board certification.

What is the cost of MOC?

Participating in MOC is typically associated with additional costs that cover the 4-part process. Some Member Boards charge an overall fee that includes the MOC examination and educational materials while others have separate fees for each item as well as an MOC enrollment fee. Check the specific Member Board website for details regarding fees.

What are the requirements for the MOC process?

Individual Member Boards have requirements which are grouped into four categories as outlined by ABMS:

  • Part I – Licensure and Professional Standing: Medical specialists must hold a valid, unrestricted medical license in at least one state or jurisdiction in the United States, its territories or Canada.
  • Part II – Lifelong Learning and Self-Assessment: Physicians participate in educational and self-assessment programs that meet specialty-specific standards that are set by their member board.
  • Part III – Cognitive Expertise: Physicians demonstrate, through standardized examination, that they have the fundamental, practice-related and practice environment-related knowledge to provide quality care in their specialty.
  • Part IV – Practice Performance Assessment: Medical specialists are evaluated in their clinical practice according to specialty-specific standards for patient care. They are asked to demonstrate that they can assess the quality of care they provide compared to peers and national benchmarks and then apply the best evidence or consensus recommendations to improve that care using follow-up assessments.

How can IU CME support my MOC Efforts?

MOC is analogous to the AMA's PRA Category 1 Credit system used in CME, in that MOC recommends the same kinds of desirable physician attributes that certified CME has had since the ACCME revamped its accreditation criteria in 2006 to focus on changes in competence, performance and patient outcomes. This allows physicians to demonstrate that they’re participating in programs and educational activities that are linked to competency and tagged to their scope of practice.

Most Member Boards require proof of CME activities for Part II of MOC. IUSM CME can help satisfy this requirement in several ways:

  • IUSM CME can help you track CME credit information and provide you with data. If you’ve participated in CME-certified activities either in live conferences or self-study formats through Indiana University, visit our transcripts page to acquire a credit summary or transcript of your involvement. Certificates of participation can be printed from here.
  • Busy clinicians can take advantage of Point of Care CME that allows you to claim credit for literature searches that you are doing already to find the answers to clinical questions. All you have to do is document your clinical question and references to claim CME credit.
  • If you choose to do a small quality improvement project in your clinic or hospital, you can earn up to 20 CME credits through our Performance Improvement CME program. By providing some basic documentation about your quality improvement project, you can earn credit for the work you did. Additionally, some Member Boards allow Part IV MOC credit for a self-designed improvement project. Read more about Part IV and visit your Member Board website to determine if your project satisfies Part IV MOC requirements.

IUSM CME provides this information as an introduction about the MOC process. For information particular to your specialty, visit the Overview of Member Board Requirements. Still have questions? Contact IUSM CME at cme@iupui.edu and we can link you with someone in your specialty who can help answer your questions about MOC.