History

Physicians are certified in their individual specialty by Specialty “Boards” (e.g., the American Board of Internal Medicine, the American Board of Pediatrics, the American Board of Family Medicine, etc.). To be Certified, physicians have to complete relevant residency training (and fellowship training for subspecialties) and pass an exam.

Historically, most boards provided one-time, “life-long” certification.

Concerns arose about the need for physicians to demonstrate their ongoing competence in order to remain certified. In 2000, the 24 Medical Specialty Boards agreed to move toward issuing time-limited Certification. To extend (or maintain) Certification, during their current Certification period, physicians now have to periodically meet requirements to recertify for an additional time period. Newly certified physicians automatically enter their specialty’s Maintenance of Certification (MOC) program. Some “lifetime” certified physicians are participating in the MOC program as well.

The MOC programs of all 24 Specialty Boards have the same four general requirements:

Part I. Professionalism and Professional Standing (including holding a valid, unrestricted medical license)
Part II. Lifelong Learning and Self-Assessment – educational activities, including self-assessment of knowledge
Part III. Assessment of Knowledge, Judgment, and Skills (primarily re-certification exam)
Part IV. Improvement in Medical Practice – participate in assessing and improving health care

Specific requirements of individual Specialty Medical Boards vary. Within this four-part framework each Specialty Board has developed its own specific requirements, options for meeting them, and timeframes in which they must be met.

ABMS maintains an overview of the Part IV (Improvement in Medical Practice) requirements of each member Board.

Individual boards continue to evolve their requirements. Therefore, physicians starting the recertification process in a specialty in one year may have specific requirements that differ from requirements applying to physicians starting the recertification process in earlier or subsequent years. Also, physicians starting a new recertification cycle are likely to find that their specialty board’s requirements have changed somewhat from the previous cycle. Physicians participating in a specialty board’s MOC program can check the requirements that currently apply to them by logging onto their personal account on the website of the specific Medical Board.

Several of the certifying boards sought to have the Part IV assessment and improvement of practice be more relevant to meaningful activities by physicians and to substantive improvements in care by:

• Defining requirements for quality improvement (QI) projects to meet Part IV requirements
• Approving qualifying institutions to award Part IV credit to physicians who participate in those projects

This approval allows the University of North Carolina at Chapel Hill MOC program to award Part IV credit to physicians for QI work that they are doing as part of their regular work. It is a “win-win” situation for the institution and for physicians:

• The institution and clinical leadership can identify and support improvement in priority areas
• Physicians meet their Part IV requirements for recertification through their work on important improvements
• The efforts are aligned, requiring little additional work beyond some documentation of the activity and participation

In December 2017, the American Board of Medical Specialties (ABMS) met with members of the Council of Medical Specialty Societies (CMSS), the Specialty Society CEO Consortium (S2C2) and state medical societies to discuss the Maintenance of Certification (MOC) programs of its Member Boards. The meeting focused on the critical issues and concerns that physicians have raised about MOC, what the ABMS Member Boards are doing to resolve these concerns, and how these organizations can work together to create a future continuing Board Certification program that is relevant and valuable to all of our stakeholders, especially to Board Certified physicians and the patients they serve. For more information, see NC MOC News.