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