MOC Developments by Specialty

Below is a chart published by the American Board of Medical Specialties on new developments in specialty board MOC requirements.  Many of the changes include pilot programs for new exam procedures, including allowing physicians to take recertification exams from the home or office rather than at testing facilities. Other boards are evaluating the effectiveness of testing more frequently but with fewer questions.  See what your board is considering and give them feedback; ensure your voice is heard.

ABMS Member Board Lifelong Learning and Self-Assessment- Part II Assessment of Knowledge, Judgment and Skills- Part III Improvement in Medical Practice- Part IV Other
American Board of Anesthesiology
  • Expanding Continuing Medical Education (CME) activities accepted for MOC credit *
  • Utilizing MOCA 2.0, a web-based platform to deliver on-demand content relevant to individual physicians’ medical practice*
  • With use of MOCA Minute learning tool, allow physicians to tailor and target learning opportunities relevant to practice. In a recent survey of diplomates, nearly 75% report that MOCA Minute serves them well as an assessment tool*
  • Adding and expanding multiple activities for diplomates to
    demonstrate that they are participating in evaluations of their clinical practice and are engaging in practice improvement. They may choose activities that are most relevant to their practice. *
American Board of Allergy and Immunology  
  • Developing a pilot to replace the 10-year exam with an open-book article based assessment; all diplomates will enter the process in 2018 ^
  • Redesigning activities directly related to practice including module for
    Physician Investigators and Academic Leaders and Clinical Supervision module*
  • Providing credit for participation in registries *
  • Providing credit for physicians who serve the specialty in research, administrative, and pharmaceutical positions *
  • Soliciting diplomate feedback via email, society meetings and surveys *
American Board of Colon and Rectal Surgery  
  • Developing a CertLink-based longitudinal assessment pilot to explore and evaluate assessment methods that provide immediate, personalized feedback ^
American Board of Dermatology
  • Partnering with specialty society to transfer CME credit directly to Board *
  • Awarding 60 American Medical Association (AMA) category 1 CME credits for passing MOC exam *
  • Providing remote proctoring to eliminate travel to a testing center *
  • Exam study guide provided at no cost *
  • Planning to implement CertLink-based longitudinal assessment platform as an alternative to 10-year exam ^
  • Providing diplomates with a library of simple, relevant, focused Practice Improvement models*
  • Offering a lower annual fee of $150 *
  • No additional cost for MOC exam *
  • Partnering with specialty society to transfer any MOC related credit directly to Board *
American Board of Emergency Medicine
  • Developing a pilot program to incorporate clinical registry +
  • Researching improved methods to assess and improve communication
    and professionalism ^
  • No longer require patient experience of care surveys based in response to diplomate feedback *
  • Providing MOC credit for improvements diplomates are already making in their practice setting*
American Board of Family Medicine
  • Launching Continuous Knowledge Assessment in January 2017*

  • Improving relevance of re-certification exam using national study of care content in family medicine practices*
  • Providing feedback to family medicine residents and practicing physicians about the “anatomy” of the exam and their particular knowledge gaps. Effort has resulted in significant improvement in passing rates and improved feedback regarding relevance.*
  • Investing $6 million to launch national primary care registry that reduces time and reporting requirements for clinician quality measurement ^
  • Collaborating with the American Academy of Family Physicians (AAFP) to award credit for performance improvement CME, meeting ABFM Standards as vetted by AAFP (third Quarter 2017)+
American Board of Internal Medicine
  • Exponentially broadening CME activities recognized for MOC credit (~8,000 activities; close to 76,000 physicians have reported participation)*
  • Developing seamless reporting systems for CME*
  • Engaging nearly 7,000 physicians to provide input on relevant clinical content *
  • Introducing grace period for physicians to re-try assessments for additional study and preparation if initially unsuccessful*
  • Planning to introduce a more frequent, less burdensome assessment option that can be completed remotely in 2018^
  • Providing detailed assessment feedback to guide focused learning*
  • Increasing number of specialty specific improvement in practice activities recognized for MOC credit – activities that physicians are participating in within local practice and institutions*
  • Developing seamless reporting systems to reduce reporting burden
  • Freezing certification fees for the last 4 years*
  • Introducing Community engagement function to collect physician ideas/concerns to enhance program*
  • Removing requirement for maintaining underlying certificate for subspecialties, decreasing burden and cost*
  • Redesigning physician web portal, which has included extensive user feedback, to be introduced in 2018^
American Board of Medical Genetics and Genomics
  • Designing longitudinal assessment pilot project that encourages lifelong learning through ongoing question evaluation; if successful, will replace secure exam +
  • Developing opportunities to allow diplomates to use activities already completed at their workplace to fulfill certain MOC requirements ^
American Board of Neurological Surgery
  • Developing a pilot to replace the 10-year exam with an annual remote, open book knowledge assessment designed to test, teach, and re-test critical clinical concepts*
  • Providing credit for physicians who participate in monthly Morbidity and Mortality conferences*
  • Providing credit for documented participation in an institutional quality improvement project*
American Board
of Nuclear
  • Developing longitudinal assessment program to replace high-stakes secure exam+
  • Recognizing quality improvement activities physicians already do in their clinical practice*
  • Allowing physicians to attest they are meeting requirements without documentation requirement*
American Board of Obstetrics and Gynecology
  • Completing MOC requirements earns 25 hours CME from the American College of Obstetricians & Gynecologists*
  • Partnering with the American College of Obstetricians & Gynecologists provides CME without extra cost*
  • Allowing internal user authentication*
  • Partnering with the CDC on pertinent Zika articles*
  • Developing modular exams to allow diplomates to select relevant content to better meet their focus of practice*
  • Implementing a pilot program to allow physicians who read lifelong learning articles and demonstrate learning by high performance on the questions accompanying the article, to earn exemption from the MOC exam. Pilot will be proposed as a permanent part of the MOC program in 2018. If adopted, it will eliminate the MOC exam fee and reduce the financial and time commitment burden.
  • Recognizing work with quality improvement registries for credit*
  • Approving CDC Zika-related quality improvement projects
American Board of Ophthalmology
  • Replacing DOCK (high-stakes) exam with longitudinal assessment program. Program will provide key ophthalmic journal articles with questions focused on the application of knowledge to patient care.*
  • Allowing diplomates to take the DOCK exam remotely at home or office; exam to be phased out*
  • Replacing Practice Improvement Modules (PIMs) with a simpler tool to measure practice improvement; self-Directed PIMs will be optional for those who are interested.
  • Fees for MOC have not increased since 2012. Fees for the initial written and oral examinations have not increased since 2007.
American Board of Orthopaedic Surgery
  • Expanding period to satisfy CME and Self-Assessment Examination (SAE) requirements*
  • Expanding SAE activities that are acceptable to
    satisfy requirements*
  • Partnering with specialty and subspecialty societies to allow automatic transfer of CME and SAE credits to ABOS Diplomate Dashboard*
  • Offering additional Practice-Profiled Exams in the areas of Orthopaedic Trauma, Pediatrics, and Foot & Ankle to allow assessment in the Diplomate’s practice area (now offer 8 different Practice-Profiled Exams)^
  • Allowing Diplomates without subspecialty certifications to take Practice-Profiled Exams in Orthopaedic Sports Medicine and Surgery of the Hand*
  • Eliminating general orthopaedic questions from Practice-Profiled Exams so diplomates are only tested in areasrelevant to their practice*
  • Piloting a Virtual Practice Evaluation that will evaluate diplomates on their own cases without requiring travel.
  • Diplomates submit medical records on 12 selected cases similar to an oral examination with the examination performed in a virtual platform*
  • Producing more detailed blueprints for all examinations in order to provide additional information for candidates to prepare for and successfully complete the MOC Examinations*
  • Standardizing Case List submission to include a maximum of 75 cases for all Case Lists, with the same requirements for all recertification pathways*
  • Expanding the case collection period,making it easier for surgeons to obtain the necessary 35 minimum surgical cases*
  • Streamlining the Case List entry process, making it easier to enter cases and classify complications 
  • Streamlining the application entry process *
  • Eliminating MOC fees*
  • Improving communication to diplomates, including a new website and dashboard that tracks diplomate progress*
  • Assigning each diplomate an ABOS Certification Specialist throughout their career from whom they receive personalized, focused email communication*
  • Streamlining the ABOS Peer Review process, utilizing zip codes to obtain adequate peer review*
American Board of Otolaryngology
  • Developing a pilot to explore the use of a CertLink-based platform for self-assessments^
  • Developing a CertLink-based longitudinal assessment pilot to explore and evaluate assessment methods that provide immediate, personalized feedback as an alternative to the exam^
  • Partnering with the American Academy of Otolaryngology in their development of a QCDR (Reg-ent). Selected data will be extracted from Reg-ent for use in Practice Improvement Modules that diplomates can use to meet the Improvement in Medical Practice requirements.*
American Board of Pathology
  • Partnering with societies to facilitate electronic submission of CME activities*
  • Partnering with Accreditation Council for Continuing Medical Education (ACCME) to provide automatic reports of completed CME activities^
  • Allowing diplomates to choose from over 90 modules, covering numerous practice areas for a practice relevant assessment*
  • Providing remote, secure testing, so diplomates do not have the burden of cost and time away from practice and family to travel to ABP exam center*
  • Implementing a new assessment pilot that will allow diplomates and the Board to assess knowledge and judgment in an ongoing, more frequent manner, with educational feedback, rather than a single, point-in-time high-stakes examination+
  • Continuing to add Improvement in Medical Practice activities that can receive MOC credit, for example implementing a Choosing Wisely recommendation*
  • Monthly meetings of the MOC Advisory Committee to offer suggestions for continuous improvement*
  • Making significant upgrades to ABP website and MOC tracking portal^
American Board of Pediatrics
  • Expanding CME activities that count for MOC credit*
  • Partnering with Accreditation Council for Continuing Medical Education (ACCME) to provide automatic reports of completed CME activities*
  • Question of the Week activity now provides CME as well as MOC credit*
  • Potential to earn MOC credit for continuing to answer MOCA-Peds questions after assessment requirements have been met^
  • Replacing 4+ hours long exam with Exam pilot (MOCA-Peds) to deliver 20 questions electronically each quarter.
  • Pediatricians learn immediately whether they have answered correctly, then receive additional information supporting the answer.*
  • If successful, MOCA-Peds will roll out to all certified pediatricians in subsequent years. Those who want to continue taking the exam once every five years in a secure testing facility will still be able to do so. 
  • Enabling new pathways for pediatricians to claim MOC quality improvement credit for work they are already doing. These pathways are available to physicians who are engaged in quality improvement
  • Allowing Residents and Fellows to “bank” MOC credit for qualifying quality improvement activities in which they participate. The pediatricians supervising these trainees also may claim MOC credit for qualifying projects. 
  • Providing an Annual Payment Option beginning in 2018 will provide diplomates the option to pay an MOC fee ($275) annually rather than as a lump sum every 5 years^
  • No increase in MOC fees since 2015, or in initial certification fees since 2014*
  • Improving access to ABP information and resources, including an upgraded Diplomate Portal and a new Customer Relations Management Tool 
American Board of Physical Medicine and Rehabilitation
  • Partnering with specialty society to transfer CME credit directly to Board*

  • Pilot project may lead to replacing 10-year high-stakes exam with a quarterly assessment that tracks progress and facilitates learning^
  • Releasing MOC100, a set of free practice questions pulled directly from the ABPMR exam question banks, to help physicians prepare for the exam*
  • Working with specialty society to produce clinical updates that will integrate with longitudinal assessment tool^
  • Introducing several free tools to complete an improvement in medical practice project, including: simplified and flexible template to document small improvements and educational videos, infographic, and enhanced web pages*
  • Approving specialty society registry based quality improvement activities for MOC Improvement in Medical Practice credit+
  • Working with specialty society to develop relevant registry-based quality improvement activities^
  • Approving National Committee for Quality Assurance Patient-Centered Specialty Practice Recognition for MOC Improvement in Medical Practice credit 
  • Increasing options to maintain certification; physicians with a subspecialty can drop primary certification, maintaining their subspecialty only*
  • Streamlining physician dashboard to track progress in the program, including automatic email reminders with tools and links to complete requirements 
American Board of Preventive Medicine
  • Offering MOC exam at computer testing locations throughout the country ^
  • Partnering with specialty societies to design quality and performance improvement activities for diplomates with population-based clinical focus (i.e. Public Health) *
  • Providing MOC credit for completion of an Improvement in Medical Practice activity accepted by any other ABMS Member Board *
  • Approved a new subspecialty in Addiction Medicine to help address the enormous medical and public health burden presented by substance use and addiction, which constitute America’s largest preventable health problem *
  • MOC fees frozen since 2001 *
American Board of Psychiatry and Neurology
  • Working with professional organizations to provide low cost or free MOC products*
  • Developing MOC examinations with committees of clinically active diplomates to ensure relevance to practice*
  • Enabling diplomates with multiple certificates to take all of their MOC examinations at once and for a reduced fee*
  • Providing “grace period” so that diplomates who fail the MOC exam will have the opportunity to retake the examination before losing their certification*
  • Allowing MOC credit for improvement in practice and patient safety activities diplomates complete in their own institutions and professional societies*

  • Enabling diplomates with multiple certificates to fulfill requirements without having to duplicate their self assessment, CME, or improvement in practice requirements*
  • Reducing MOC fees by 34%*
  • Enabling diplomates to attest completion of MOC requirements*
American Board of Plastic Surgery
  • Instituting online longitudinal learning program that will assess the physician’s knowledge, provide immediate feedback and reinforce areas of knowledge deficiency throughout the five year cycle^
  • Working with vendor to deliver MOC exam online rather than at a testing center, reducing costs and time away from practice^
  • Ensuring relevance to practice with a modular MOC examination format*
  • Producing a study guide that includes all the information needed to successfully pass MOC exam*
  • Providing feedback on diplomate data across five index procedures in four subspecialty areas. Diplomates are asked to input data from 10 cases from any single index procedure every three years.*
  • Eliminated a six-month case log required prior to taking the MOC examination*
  • Minimizing tracers to reduce data points required*
  • Allowing MOC credit for improvement in practice activities that a diplomate is engaged in through their hospital or institution*
  • Providing credit for registry participation*
  • Reducing fees associated with MOC in the past three years and plan additional 15% reduction in 2019*

American Board of Radiology
  • Expanding CME options to allow more online options for self-assessment*
  • Moving to an online assessment, eliminating the need for travel to an exam center
  • Expanding options to include numerous common clinical activities *
  • Automating data feeds from verified sources to minimize physician data reporting *
  • Making available to diplomates with solo or group projects, a template and education about quality improvement*
  • Simplifying online attestation process, allowing physicians to easily report MOC participation*
  • Creating dedicated customer service support team for expedited response to physician inquiries*
American Board of Surgery
  • Requirement for self-assessment CME credits reduced by 50%, to allow diplomates more choice in selecting CME programs that best reflect their area of practice*
  • Developing a pilot for modular examinations +
  • Transparent exam content, with outlines posted on ABS website and regularly updated *
  • Coordinating with American College of Surgeons and other organizations to ensure available study materials align with examination content*
  • Constructing an alternative assessment program that focuses on ongoing, high value, practice-relevant learning ^
  • Allowing multiple options for registry participation, including individualized registries, to meet Improvement in Practice requirements. There are no ABS fees for this component. 
  • Reporting cycle changed from every 3 years to every 5 to reduce burden on diplomates 
American Board of Thoracic Surgery  
  • Developing a specialty specific modular MOC Exam *
  • Ability to take exam in the physician’s office or home *
American Board of Urology
  • Communicating with the American Urological
    Association (AUA) and others regarding the development of educational materials that are MOC Compliant*
  • Distributing AUA Updates (CME self-study guides) including MOC relevant content+
  • Emphasizing clinical management on the exam. Questions are derived from AUA Self-Assessment Study Program (SASP) booklets from the past 5 years (30%), AUA Guidelines (15%), and AUA Updates. ABU allows diplomates to select one of four content specific modules. *
  • Offering a modular exam in 2017+
  • Providing MOC credit for participation in the AUA AQUA registry and the Michigan Urologic Surgery Improvement Collaborative (MUSIC) *
  • Participating in ABMS Portfolio Program, a program that works with all types of health care organizations to recognize the work physicians are already doing to improve their practices and the care of their patients*
  • In 2009 implemented a $200 Annual Certificate Fee to streamline and replace all Recertification and MOC fees*
  • Implementing a web portal to facilitate all aspects of Continuing Certification information and participation
 * Currently Doing
+ Scheduled Implementation in 2017
^ Scheduled Implementation in 2018 and Beyond