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Verification of Certification and Board Status FAQ

1. What is MOC?

Maintenance of Certification (MOC) is the process through which diplomates of the American Board of Orthopaedic Surgery can maintain their primary certificate in Orthopaedic Surgery.

2. Why must we change from recertification to MOC?

MOC has been developed in response to external regulatory forces and public demand. The American Board of Medical Specialties (ABMS) has defined the general "competencies" of a competent physician. These include Medical Knowledge, Patient Care, Interpersonal and Communication Skills, Professionalism, Practice-based Learning and Improvement, and Systems-based Practice. Each member Board must develop methods to systematically assess these competencies on a periodic basis as part of the maintenance of certification process.

The ABOS MOC program will address these general competencies using the four components specified by the ABMS.

    These Components are:
  1. Evidence of Professional Standing
  2. Evidence of Life-long Learning and Self-Assessment
  3. Evidence of Cognitive Expertise and
  4. Evidence of Performance in Practice

Please refer to additional information at www.abms.org for a detailed description of the deliberations that have led to the development of MOC.

3. What will be different about MOC?

The current recertification process includes evaluation of professional standing, a minimum of 120 Category 1 Continuing Medical Education credits, and a secure examination to test cognitive knowledge. In addition, ongoing learning and continuing efforts to improve practice are part of the description of the competent physician. All Member Boards of the ABMS are developing programs by which diplomates will demonstrate continuing participation in these areas.

4. How will MOC address the Four Components?

    The ABOS will evaluate a competent physician through the MOC program using the four components as follows:
  1. Evidence of Professional Standing will require that the diplomate maintain a full and unrestricted license to practice medicine in the United States or Canada.
  2. Evidence of Life-Long Learning and Self-Assessment will be addressed through on-going three-year cycles of 120 credits of Category 1 Orthopaedic or relevant Continuing Medical Education (CME) that include a minimum of 20 CME credits of Self-Assessment Examinations (SAE).
  3. Evidence of Cognitive Expertise will occur through a secure examination, as is currently in place for recertification.
  4. Evaluation of Performance in Practice will include a stringent peer review process and a few performance indicators: sign your site, preoperative antibiotics, informed consent and postoperative anti-coagulation.

The Credentials Committee currently collects peer review data on recertification candidates. This process will be expanded to include patient questionnaires that address doctor-patient communication skills as well as patient satisfaction. The ABMS is currently developing these questionnaires for use by all ABMS Member Boards.

In addition, the diplomate applying for a computer-based test will submit a three-month case list, and the diplomate applying to take the oral examination will submit a six-month case list to the Credentials Committee. This information will also be used to develop a database about the practice of Orthopaedic Surgery in this country. Aggregate data will be provided to the diplomates for comparison with their own practices.

The QI(Quality Improvement) focus of the 4th component of MOC will begin to look at diplomates’ participation in programs and practices to deliver better and safer patient care.

5. What is involved in evaluation of Professional Standing?

A diplomate must hold a full and unrestricted license to practice in all states and jurisdictions where he/she holds a license.

6. What is involved in life-long learning and self assessment?

Ongoing continuing medical education is a part of every diplomate professional life. Documentation of a minimum of 120 credits of category 1 CME is required during the three years prior to application for the MOC credentialing and testing. In addition, documentation of a second three-year period of CME/SAE will be required when the full 10 year MOC cycle is in place, starting with the Diplomates of 2017.

7. What kind of CME is acceptable?

Although there are different forms of continuing medical education, only Category 1 CME is acceptable to meet the MOC requirements. For MOC purposes, CME must be topically related to Orthopaedics or Orthopaedic subspecialties. These topics are broadly defined to include topics such as infection, medical management of orthopaedic complications, risk management and others. In addition, the ABMS has specified that Ethics, Professionalism, and Patient Communication, and Cultural Competency are areas that must be addressed. Credit will also be allowed for CME required by individual state Medical Licensing Boards.

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