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Maintenance of Certification
What You Need to Know

What is Maintenance of Certification?

Maintenance of Certification (MOC) is a program of continuous professional development initiated in 2000 by the American Board of Medical Specialties (ABMS) and its 24 member boards. The ABMS statement regarding its commitment to Maintenance of Certification is:   ” Board certification granted by an ABMS Member Board provides assurance of a physician’s expertise in a particular specialty and/or subspecialty of medical practice. The ABMS MOC program is an ongoing process of education and assessment for certified physicians to improve practice performance.”   

Maintenance of Certification

Once Board Certified, physicians maintain their medical specialty expertise by participating in a robust continuous professional development program called the ABMS Program for MOC. The MOC program provides physicians a structured approach for enhancing patient care and improving patient outcomes through focused assessment and improvement activities.

The ABMS Program for MOC involves ongoing measurement of six core competencies defined by ABMS and ACGME:

  • Practice-based Learning and Improvement
  • Patient Care and Procedural Skills
  • Systems-based Practice
  • Medical Knowledge
  • Interpersonal and Communication Skills
  • Professionalism

These competencies, which are the same ones used in the ACGME’s Next Accreditation System, are measured in the ABMS Program for MOC within a four-part framework:

All Programs for MOC implemented by the Member Boards measure the same six competencies within the same four-part framework. While these elements are consistent across all Member Boards, what may vary, according to the specialty, are the specific activities the Member Boards use to measure these competencies. Despite some variation in the activities, they are all built upon evidence-based guidelines, national clinical and quality standards, and specialty best practices.

Professional Standards

ABMS and the Member Boards evolve the educational and professional standards for certification and medical specialty practice to support advancements in medicine, science, and technology as they relate to the environments in which board certified physicians practice. An updated set of standards, which became effective in 2015, place greater emphasis on:

  • Professionalism – how physicians carry out their responsibilities safely and ethically
  • Patient safety – how physicians use patient safety knowledge to reduce harm and complications
  • Performance improvement – how physicians use the best evidence and practices compared with peers and national benchmarks to treat patients
  • Incorporating judgment into examinations – assessing not just what the physicians know but what they do with that knowledge

Click here for more information on the American Board of Medical Specialties Website regarding initial certification  and MOC.    ABMS MOC

This process is designed to document that physician specialists certified by the ABMS boards are maintaining the skills and knowledge necessary to provide quality patient care in their specialty. The program gives diplomates the opportunity to demonstrate to peers, patients, and the general public a commitment to lifelong learning and improvement in their chosen field of practice.

MOC is the new “gold standard” of specialty board certification. It acknowledges that diplomates have already demonstrated a commitment to excellence by becoming certified and builds upon this experience. MOC incorporates six core physician competencies, as defined by the ABMS and the Accreditation Council for Graduate Medical Education (ACGME), into an evaluation process by which practicing surgeons can document their ongoing commitment to excellent patient care—the heart of the certification process.

Perhaps most importantly, MOC represents an opportunity for physicians to take a leadership position in the national movement to improve health care quality and patient safety, through performance assessments founded on objective clinical standards and measurable outcomes.

How does it work?

Effective January 1, 2010, all American Board of Colon and Rectal Surgery (ABCRS) diplomats certified in 1990 or later will be enrolled in the MOC process. Current rules state that diplomates with unlimited certification are not required to participate in the MOC process but are encouraged to do so. MOC requirements progress in three-year cycles. At the end of each cycle, diplomates must report their MOC activities to ABCRS. Also see (Requirements for MOC) for more information.

Why do we need this now?

MOC represents an evolution from existing recertification and was developed in response to growing public concerns regarding the quality of health care. Given the current health care environment, it has become critical that a commitment to quality health care delivery is documented on a continuing basis and not just at a ten-year recertification. If physician organizations do not recognize the level of public dissatisfaction with perceived health care quality and take clear and effective steps to improve it, it is quite likely that external regulation by the federal government or other organizations, which would be far more onerous and less focused on important clinical issues, will be forthcoming. The ABMS is working to see that the federal government, third party payers, and state licensing boards recognize MOC and use it to replace current and future requirements.

What does MOC specifically entail?

The ABMS, in conjunction with the ACGME, has defined six general competencies as the foundation for physicians’ training and practice characteristics during their professional life-time. These six competencies are:

  1. 1. Medical knowledge about established and evolving biomedical, clinical and cognate sciences, and the application of this knowledge to patient care;

  2. Patient care that is compassionate, appropriate, and effective for the treatment of health problems and promotion of health;

  3. Interpersonal and communication skills that result in effective information exchange and teaming with patients, their families and other health professionals;

  4. Professionalism as demonstrated by a commitment to professional responsibilities, adherence to ethical principles, and sensitivity to a diverse patient population;

  5. Practice-based learning and improvement that involves investigation and evaluation of one’s own patient care, appraisal and assimilation of scientific evidence, patient care;

  6. Systems-based practice, as demonstrated by an awareness of and responsiveness to the entire systems of health care, and the ability to effectively call on system resources to provide optimal care.

ABCRS MOC Required Components

Using the framework of the general competencies, the MOC program will consist of four key components that will measure these competencies on a continual basis:

  1. Professional Standing (every 3 years)
    • Documentation of full-licensure in the state in which you practice
    • Documentation of privileges for colon and rectal surgery at your hospital
    • Letter of recommendation from the chief of staff at your hospital
  2. Life-long learning and self-assessment (every 3 years)
    • 90 hours of Category 1 CME credits (which can include CARSEP or SESAP)
    • Completion of  a self-assessment activity (50) cmes
  3. Cognitive expertise (every 10 years)
    • MOC cognitive exam
  4. Evaluation of performance in practice (every 3 years)
    • Communications and interpersonal skills
    • Clinical practice data – Ongoing participation in a national, regional or local outcomes database or quality assessment program.