The word “deadline” sounds serious—the first half of it, anyway. Although the repercussions for missing deadlines related to the American Board of Orthopaedic Surgery (ABOS) Maintenance of Certification (MOC) program are certainly less severe than this ominous-sounding word might imply, diplomates should do everything possible to meet MOC due dates.


Published 7/1/2013
Shepard R. Hurwitz, MD

Stay One Step Ahead of MOC Deadlines

Shepard R. Hurwitz, MD

In this column, I will provide a rundown on some of the requirements and deadlines, as well as some tips for staying ahead of the curve when it comes to MOC.

Deadline basics
First of all, it’s important to know that application deadlines apply to all ABOS certifying and recertifying exams, including the following:

  • Part I written examination and Part II oral examination for initial board certification
  • MOC exam (choice of written or oral examination)
  • Subspecialty certificate in surgery of the hand
  • Subspecialty certificate in orthopaedic sports medicine
  • Combined recertification for surgery of the hand and sports medicine
  • Recertification for surgery of the hand and sports medicine

Drilling down to MOC
Diplomates must meet additional deadlines for MOC that go beyond just applying for recertification. As part of the 10-year MOC process, diplomates must submit evidence of obtaining 120 AMA PRA Category 1 CME Credits™ in two consecutive 3-year cycles. In each of the 3-year cycles, 20 credits must come from scored-and-recorded self-assessment examinations (SAE).

How exactly does this whole process work? Suppose a diplomate whose board certification will expire in 2014 takes and passes the recertifying examination that year, thereby extending certification through 2024. The diplomate would need to accrue 120 CME credits, including 20 SAE credits, during the first 3-year cycle (2015–2017), and 120 more CME credits, including 20 SAE credits, during the second 3-year cycle (2018–2020) (Fig. 1).

Then, in 2021, the diplomate would apply to take the recertification examination in 2022, 2023, or 2024. (Only after submitting evidence of having earned the required amount of CME and SAE in two consecutive 3-year cycles can diplomates apply for the examination.)

To apply, the diplomate would visit and complete an application by May 1 of the year before the year in which he or she wishes to take the examination. For example, if the diplomate wants to take the examination in 2022, the deadline for applying for the examination would be May 1, 2021. The application deadline for taking the exam in 2023 would be May 1, 2022, and for 2024, it would be May 1, 2023.

Is there a late application deadline?
Diplomates who miss the May 1 deadline can take advantage of the late deadline of May 15, but would be required to pay a late fee of $350.

After May 15, no applications will be accepted by the ABOS website and there is no appeal process. The diplomate must wait until the next year to apply again. That’s one reason the ABOS provides three opportunities to recertify.

What happens next?
Once the ABOS receives the diplomate’s application and fee for the MOC recertification exam, it verifies that the diplomate has a valid medical license and holds hospital and surgical center privileges. The diplomate’s office address, email address, and practice location(s) are also verified.

Next, the ABOS sends questionnaires to different professionals and orthopaedists in the diplomate’s practice area. The ABOS must receive at least five replies from orthopaedic surgeons and two replies from other professionals to proceed with the vetting process. This sending and gathering of questionnaires is part of what the ABOS calls the “peer-review process,” which is considered one of the main elements of Part IV of MOC: Evidence of Performance in Practice.

The other large element of Part IV is the case list submitted with the application. Diplomates who opt for the computer examination pathway must submit a 3-month case list (at least 14 cases, but no more than 75 cases), while those who choose the oral examination pathway must submit a 6-month case list (at least 35 cases).

Results of the peer review and the various background checks (licensing, hospital privileges) are reviewed by ABOS staff and the ABOS Credentials Committee. If information is missing, the Credentials Committee will not approve the application. If the reporting cycles are incomplete or an application fee or case list was not submitted, the diplomate must wait and apply again the following year.

Don’t let this happen to you
The worst case scenario is to miss the final MOC reporting and application deadlines the year before your certification expires. If that final deadline is missed, your certification would expire the following Dec. 31.

Orthopaedists who still perform surgery would then need to take an oral exam to regain certification. So, for surgeons who are required by their employers to remain board-certified, the ABOS strongly suggests that all required information for MOC be submitted on time and that application for the recertifying exam be made as early as possible.

Above all, check with the ABOS
My advice is to check your MOC deadlines and requirements online by logging into the ABOS website at and clicking on the MOC tab. There you will find the deadlines and requirements that apply to you, based on the year your board certification will expire.

If you have questions, please call the ABOS at 919-929-7103 and ask to speak with one of the coordinators familiar with MOC requirements and deadlines. You will get the most accurate answers to your questions and concerns if you go straight to the ABOS, rather than relying on any other source.

Shepard R. Hurwitz, MD, is the executive director of the ABOS. He can be reached at