Published 3/1/2008
Jennie McKee

Get up to MOC speed

Read on if your certification expires in 2010, 2011, or 2012

By now, you’ve heard of Maintenance of Certification™ (MOC), the process the American Board of Orthopaedic Surgery (ABOS) uses to evaluate orthopaedic surgeons with time-limited certificates. If your certification expires in 2010, 2011, or 2012, you’re one of the first diplomates to participate in the MOC process.

Because hectic schedules can make it challenging to stay informed about MOC requirements and deadlines, here’s a quick refresher to help you stay on track.

General MOC requirements
Using MOC, the ABOS evaluates applicants on the following four components:

  • Evidence of professional standing
  • Evidence of life-long learning and self-assessment
  • Evidence of cognitive expertise
  • Evidence of performance in practice

A description of the requirements of each component follows. Refer to Fig. 1 for more details about the requirements and due dates if your certificate expires in 2010, 2011, or 2012 and you wish to take the 2010 examination.

Evidence of professional standing
Under this component, if you are in practice when you apply for the MOC examination, you must have a full and unrestricted license to practice medicine in the United States or Canada. For each hospital/surgical center where you have admitting privileges, you must submit an original, signed, and notarized letter documenting those privileges to the ABOS office.

Commitment to life-long learning and self-assessment
To satisfy this component, diplomates must have acquired a minimum of 120 AMA PRA Category 1 CME Credits™, including 20 credits for completing one or two scored and recorded self-assessment examinations (SAEs) during the 3-year period immediately prior to demonstrating evidence of cognitive expertise. Scored and recorded examinations require that your answers are scored—electronically or in hard copy—by the organization that published the examination.

You must complete the requisite CME and self-assessment activities before you apply to take the recertification examination. Note: Self-scored examinations that offer CME credit are helpful in fulfilling the 120 Category I CME credit requirement, but do not count toward the self-assessment examination requirement.

The Academy has an online, password-protected CME transcript service (http://www.aaos.org/transcript) for documenting your participation in and completion of CME programs. You may upload CME credits awarded by AAOS or other CME providers to your personalized transcript. The site enables you to print or download your transcript for submission to the ABOS. It is your responsibility—not the CME provider’s—to submit the documentation to the ABOS. Visit the ABOS Web site (http://www.abos.org) for detailed information on submission deadlines and procedures.

The AAOS transcript Web site helps you track your CME; however, documentation of completion of CME must come from the provider of the CME. If the CME provider is not the AAOS, you must obtain documentation of completion and the original transcript from the CME provider and send them to the ABOS.

Evidence of cognitive expertise
This MOC component requires completion of a secure computer-administered examination or oral examination. A secure computer examination is administered at an accredited testing site; proof of identify is required. Exam questions focus on core orthopaedic knowledge, including ethics and patient communication.

If you choose to take an oral exam, you must submit a 6-month case list. The ABOS selects 12 cases, and you may choose 10 of the 12 for the examination. Three 35-minute sessions are conducted and independently graded by two examiners during each session. The practice-based oral examination is available only if you are engaged in the surgical care of patients. Passing the practice-based oral examination also meets the requirements for the fourth MOC component, evidence of performance in practice.

If you are a nonoperating orthopaedist, you will be required to participate in the MOC process to maintain board certification. You must undergo the same credentialing process, document CME and SAE, take a secure examination, participate in patient surveys when these are available, and submit a case list of 30 consecutive new patients evaluated and treated in your practice.

Evidence of performance in practice
Before applying for the computer-administered recertification examination, orthopaedic surgeons who provide operative care must submit all surgical cases for a consecutive 3-month period or a maximum of 75 consecutive surgical cases. Candidates who choose to take the oral examination must submit a 6-month case list. Submit the case list using the ABOS “MOC case list” template. (Nonoperating orthopaedists must submit a case list of 30 nonsurgical new patients evaluated and treated in their practice.)

Evaluating performance in practice puts the focus on quality improvement. The case list provides a way for you to identify your own “best practices” and to establish a baseline for improvement during the next MOC cycle. “Best practices” will differ for individual orthopaedic surgeons and are likely to include personal compliance with practice guidelines such as “sign-your-site,” perioperative antibiotics, and deep venous thrombosis prophylaxis. As more “best practice” metrics are developed, you will be able to demonstrate that you are practicing safe, effective care.

Your case list and other information is available to the ABOS Credentials Committee, which can accept, defer, or deny application for sitting for the examination or require a particular pathway for evaluation.

Upon receipt of your completed electronic application, the ABOS conducts a peer review of your professional standing. Individuals within your practice community will be sent evaluation forms, based on the following six general competencies as defined by the Accreditation Council for Graduate Medical Education and the American Board of Medical Specialties:

  • medical knowledge
  • patient care
  • interpersonal and communication skills
  • professionalism
  • practice-based learning and improvement
  • systems-based practice

The ABOS Credentials Committee reviews all completed and returned forms. Information obtained through the peer-review process—including responses from the orthopaedists, administrators, and staff—is part of this MOC component.

Applying for and taking the examination
Visit the ABOS Web site to apply for the recertification examination. When the ABOS receives your MOC Recertification Examination application, it will begin a formal credentialing process. When you have successfully completed the credentialing process and have completed the life-long learning requirement, you will be admitted to take an examination.

Contact the ABOS at (919) 929-7103 or visit http://www.abos.org for specific information about MOC requirements and deadlines. MOC timelines for diplomates whose certificates expire in 2010 through 2017 are available on the ABOS Web site by clicking on the “Diplomates” tab and selecting the year your certificate will expire.

Jennie McKee is a staff writer for AAOS Now. She can be reached at mckee@aaos.org

Does your certificate expire in 2009? Don’t miss the May 1, 2008, deadline
The last of the “old-fashioned” recertification examinations for those whose certificates expire in 2009 will be given in 2009. Completed applications are due in the ABOS office on May 1, 2008. If your certificate expires in 2009 and you do not recertify on time, your certification will lapse and you will be required to participate in MOC; CME, SAE, case list, and all other requirements and deadlines will apply.

Taking the 2010 examination?
Here’s an important reminder

If your certification expires in 2010 and you plan on taking the 2010 examination, pay particular attention to two dates: Dec. 15, 2008, and May 1, 2009.

Dec. 15, 2008, is the deadline for obtaining and submitting documentation of 120 AMA PRA Category 1 Credits™, including 20 credits from one or two scored and recorded self-assessment examinations. It’s also the deadline for submitting a 3-month list of your surgical cases, or a maximum of 75 consecutive cases.

May 1, 2009, is the deadline for submitting a completed application and marks the beginning of the peer-review process.