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Verification of Certification and Board Status FAQ

29. What kind of patient surveys are planned for the fourth component of MOC, Evaluation of Performance in Practice?

At this point no survey instrument has been completely developed and tested. The ABMS is working to develop a valid instrument that may be used by all member boards. When that survey or other vehicle is available, the information will be available on the ABOS website and diplomates will be notified of how it will impact their MOC process.  The ABOS process of stringent Peer Review is also a strong measure of practice performance. It has been an integral part of the Board's recertification effort and will continue in its present form in the M.O.C. process.

30. Is the MOC program in final form?

No. Specific components have been developed and are being implemented to better evaluate the competence of all practicing physicians. Each individual specialty Board is defining a program to comply with the requirements of MOC. Changes to, and probably additional, requirements can be expected in the future as this is a dynamic program to evaluate physicians on an ongoing basis.

As the MOC process evolves, it is likely that the clinical and non-clinical orthopaedic surgeon may be afforded the opportunity to demonstrate competence in systems based practice in his/her particular professional activities.

31. What is "systems based practice"?

The core of Performance in Practice component of MOC is continuing quality improvement (CQI) for the physician personally and as part of the system in which he/she practices. Systems Based Practice (SBP) is a multidisciplinary approach to optimize patient care through teamwork to standardize health care delivery in hospital and clinical systems. SBP works to understand applicable research, improve outcomes, and ensure quality and safety. As applicable to health care, systems based practice requires that physicians understand how patient care relates to the healthcare delivery system as a whole and how the system can be used to improve patient outcomes.

Examples of SBP include the integration of different hospital departments to improve peri-operative antibiotic administration; coordinating implant purchasing agreements for economy; and pre-operative "sign-your-site" and "time-out" policies to minimize risk of wrong site surgery.

32. When will MOC be fully in effect?

Implementation will begin as measures are in place and sufficient time for notification has been allowed. All member boards of the ABMS must have a full MOC Program cycle in place by 2016. The MOC process will be implemented gradually starting with those diplomates whose certificates expire at the end of 2010. Diplomates whose certificates expire later will be able to participate in additional parts of MOC. Your preparation for MOC should begin now by becoming informed about how it will affect you and what you must do before your application for the cognitive exam.

33. If my certification will expire at the end of 2009, will I be required to participate in MOC?

No, provided that you renew your certificate before it expires.  The first MOC requirements will become mandatory for those diplomates whose certificates expire in 2010.

34. What parts of MOC will be implemented first for diplomates whose certificates expire at the end of 2010, 2011, and 2012?

The first additional required parts of the MOC process will be documentation of the CME and SAE, as well as submission of a three-month case list for the Computer-based examination pathway. The secure examination must be completed before the current certificate expires in order to maintain continuity of board certification. The earliest that a diplomate whose certificate expires in 2010 may take the secure examination is during 2008. The application for this exam will be available online January 1, 2007 and must be completed by May 1, 2007. In order to complete the application process for this examination, CME, SAE and the case list must be complete and on file when the application is due.

35. How will I know what I have to do to comply with MOC?

You will receive a letter from the ABOS notifying you of the rules for MOC for your year of expiration of your certification. You will also be able to keep track of your status and milestones on the ABOS website www.abos.org

It is your responsibility to be aware of the specific requirements to maintain your Board Certification.

36. Will the ABOS create specialty exams for MOC in areas currently not covered e.g., foot/ankle, oncology, trauma, etc.?

It is difficult to envision a written examination for some focused specialties. A minimum number of test-takers is needed in order to have valid statistics for the setting of passing standards and test equating procedures. Many diplomates feel that the Oral examination pathway most accurately evaluates their expertise.

37. What happens if a diplomate fails to complete all of the requirements for MOC to take the secure examination on time for his/her certification cycle? Does he/she have to start over?

All diplomates will be notified in sufficient time to complete the requirements. Failure to complete and/or document these requirements will delay the application process and testing and may result in lapse of certification. Information about additional requirements will be available to you directly from the ABOS but not from any other orthopaedic society or subspecialty society.

38. What will the ABOS do with my case list?

Evaluation of Performance in Practice is primarily to focus on quality improvement. The case list will provide a means for an individual orthopaedic surgeon to look at his/her own practice for "best practices" and to have a baseline for improvement during the next MOC cycle. These "best practices" will differ for individual practices and are likely to include personal compliance with practices such as "sign-your-site," perioperative antibiotics, and DVT prophylaxis. As more such "best practices" metrics are developed, the orthopaedic surgeon will have the opportunity to demonstrate to the ABOS as well as to other organizations and the public that he/she is practicing safe and competent orthopaedics.

The information that will be collected will be used to look at the nature of orthopaedic surgery in the United States and Canada. A three month snapshot for a cohort of board certified orthopaedic surgeons will give about a 2% picture of all of orthopaedic surgery each year. This will include cases that are not captured by Medicare statistics or other data collecting bodies.

The aggregate data on the practice performance issues will be provided back to the diplomates for comparison purposes.

Until such time that validated practice standards are established, the case list by itself will not be used to determine eligibility for or satisfactory completion of the MOC process. The case list, as well as all information about an applicant for MOC, is available to the Credentials Committee. The Credentials Committee has always had the authority to accept, defer or deny application for sitting for the examination, or to require a particular pathway for evaluation. This will not change.

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