Maintenance of Certification, or MOC, is a process by which physicians maintain certification through the American Board of Medical Specialties or the American Osteopathic Association. The process of implementing MOC began in 2000, when the ABMS determined that such a system would help to keep physicians up-to-date on the rapidly-evolving information and issues within their respective specialties. This system has been around for some years, but many physicians are still unclear on MOC's requirements and benefits.
Understanding the MOC Process
Before MOC, board certification for the majority of specialties was limited to a single board exam. After passing this exam, the clinician was considered board-certified for his or her life. However, if these clinicians were not committed to continuing their education on their own, they would often fall behind on the latest developments within their fields. With MOC, board certifications are time-limited and exist on a 10-year cycle. In order to maintain certification, physicians must fulfill four MOC program components.
MOC Program Components
The four MOC program components are as follows:
- Professional Standing - Physicians must hold an active and unrestricted U.S.-based license to practice medicine.
- Self-Assessment and CME - Physicians must participate in at least two approved self-assessment activities. Physicians must also complete a minimum number of acceptable credit hours in continuing education.
- Cognitive Expertise - Physicians must pass a cognitive examination.
- Performance in Practice (PIP) - Physicians must complete at least 3 PIP units, including at least one external review and one chart review.
In addition to the program components listed above, physicians must also demonstrate six competencies identified by the Accreditation Council for Graduate Medical Education. These competencies include:
- Medical knowledge
- Practice-based learning and improvement
- Patient care and procedural skills
- Interpersonal and communication skills
- Systems-based practice
MOC is surrounded by controversy, with proponents touting the program's ability to encourage continuing education. Those who oppose MOC believe the requirements are cumbersome and that the program does not actually improve the quality of patient care. In fact, many physicians are now lobbying to limit MOC requirements.
According to surveys of current clinicians, approximately 65 percent of physicians believe that the MOC certification process adds no clinical value to their practice of medicine. In addition, 81 percent of doctors surveyed said they need to use their own free time in order to study for MOC requirements, while 74 percent report that studying takes away from time spent with family. To complicate matters further, while 77 percent of clinicians are currently practicing in states that require MOC, 64 percent of clinicians surveyed are unaware that their state has these requirements.
How VISTA Can Help
The future of MOC is unclear. In fact, seven states have already passed laws that prevent insurance companies, licensing boards, hospitals and healthcare systems from penalizing doctors who fail to complete MOC requirements. Locum tenens physicians who travel from state to state for assignment should check MOC requirements in the states they are interested in working, as the specific requirements can differ from one state to another.
MOC is mandatory for doctors in many states, and the requirements can be difficult to understand and meet. If you are working as a locum tenens physician, you’ll want to follow how the requirements continue to evolve.