Maintenance of Certification (MOC) is the process through which Diplomates of the American Board of Orthopaedic Surgery can maintain their primary Certificate in Orthopaedic Surgery. MOC is lifelong certification process that promotes continuous learning to improve patient care. The American Board of Medical Specialties (ABMS), the governing organization for all 24 medical specialty certifying boards, has mandated that a Diplomate participate in an MOC process to maintain their Board Certification. The ABOS believes in physician self-regulation and supports a program that ensures the safe, ethical, and effective practice of orthopaedic surgery to serve our patients, our profession, and the public.
Initial Board Certification is acquired through the completion of Part I and Part II application and examination processes. MOC is the process of life-long learning during each 10-year certification period and includes the earning and submitting of continuing medical education (CME) and self-assessment examination (SAE) credits, maintaining state medical licensure, undergoing periodic knowledge assessment, and participating in practice improvement.
Lifetime Certificates will always be honored. Holders of these can still volunteer to participate in the MOC process but are not required to participate to maintain their Board Certification status.
Failure to complete and/or document requirements will delay the application process and testing and may result in lapse of Board Certification. Failure to complete and pass a knowledge assessment in the 10 year MOC time period counts as failure to complete MOC requirements. A lapse in Board Certification or a loss of Board Certification results in a Diplomate being subject to the requirement of taking and passing an Oral Examination to regain Board Certification.
When you apply for Recertification, you must submit a Case List that contains a minimum of 35 consecutive surgical cases over a 12-month period. There are orthopaedic surgeons who may not perform 35 surgical cases over a one-year time period. The ABOS allows these surgeons to apply for Recertification through a Non-Operative Pathway and these individuals are listed on the ABOS website as being “Certified through a Non-Operative Pathway.” For more information, talk to your Certification Specialist.
Loss of or restrictions to a Diplomate’s state medical license is reportable to the ABOS. Licensure limitation or revocation may constitute grounds for revocation of Board Certification and will result in a review by the ABOS Credentials Committee.
Newly certified Diplomates may begin to earn CME/SAE for MOC after passing the ABOS Part II Examination. Diplomates who have just passed an ABOS Recertification Examination may begin to earn CME/SAE for MOC beginning on the effective date of their Recertification. This date will always be January 1st of the first year in the 10 year MOC cycle.
Category 1 CME that is topically related to the practice of orthopaedic surgery or an orthopaedic subspecialty is acceptable to meet the MOC requirements. For a list of examples of acceptable and unacceptable CME activities, click here. CME credits must be earned during the current 10-year MOC cycle. The ABOS does NOT accept CME that the AMA may have granted pertaining to ABOS Certification or Recertification as those credits are earned during a previous 10 year cycle.
The CME provider provides verification of participation to attendees after the completion of a CME activity.
All CME and SAE activities that have been claimed through the American Academy of Orthopaedic Surgeons (AAOS) Online Learning Portfolio are automatically transferred to the ABOS daily. You can also upload credits through your ABOS Dashboard. In both cases, you need to have a certificate for verification of completion of the activity. ABOS staff review each activity and approve all that are relevant to the field of orthopaedic surgery.
If you notice that credits have not transferred from the AAOS Learning Portfolio, the first step is to confirm with the AAOS that credit for the activity has been recorded and that you have claimed those credits. The next step is to check with the ABOS to make sure that your AAOS membership number is correct in ABOS files.
In order to maintain your designation on the American Board of Orthopaedic Surgery’s (ABOS) website as “Participating in MOC: Yes,” a minimum of 120 orthopaedic-related Category 1 Continuing Medical Education (CME) credits, of which at least 20 credits are from Self-Assessment Examinations (SAE) or ABOS-approved practice improvement activities, must be submitted by the end of the third year of your 10-year Maintenance of Certification (MOC) cycle.
Prior to submitting an ABOS Recertification Application, you will need a total of 240 CME credits, 40 of which are SAE credits or ABOS-approved practice improvement activities. This includes the 120/20 needed to participate in MOC. Your Certificate will still be active for the entire 10-year period, even if you choose not to participate in MOC.
Self-Assessment Examinations (SAE) and Practice Improvement are produced by organizations other than the ABOS, then approved for MOC credit by the ABOS. In order for a project to be approved for SAE, it must be orthopaedic related, similar to CME credits. There are several different ways to earn SAE credits including Scored and Recorded Examinations, Portfolio Program, Practice Improvement Modules (PIMs), Registries, and Physician Scorecards. More information can be found here.
There are several ways that a Diplomate can satisfy this portion (Cognitive Expertise – Knowledge Assessment) of the ABOS MOC program:
1. Computer-Based Recertification Examinations
a. General Orthopaedic Examination
b. Practice-Profiled Examination
i. Adult Reconstruction
iii. Orthopaedic Sports Medicine
iv. Surgery of the Hand
v. Orthopaedic Trauma
vi. Pediatric Orthopaedics
vii. Foot and Ankle
viii. Shoulder and Elbow
2. Case-Based Oral Examination
3. ABOS Web-Based Longitudinal Assessment
The ABOS Web-Based Longitudinal Assessment (ABOS WLA) is a new program and there is a separate Q&A devoted to that program. That Q&A can be found here.
Diplomates who have met the requirements for MOC are eligible to apply to take a Recertification Examination in years eight, nine, or ten of the 10-year MOC cycle. This does not result in a change in the end date of the 10-year MOC cycle.
All applications are online at their ABOS Dashboard. The CME/SAE and Case List are separate from the actual Application to sit for a Recertification Examination and must be completed prior to finalizing an Application. Upon receipt of the MOC Application, the ABOS will begin a formal credentialing process. Following the successful completion of the credentialing process, the applicant will be notified by email of admission to take the Examination.
Examinees will be at a Prometric Testing Center for 3 1/2 hours which includes test taking, break, and tutorial time. There are 150 total items. To view a breakdown of the examination, click here.
Four sessions of 25 minutes each with five-minute breaks in between the sessions make up the Examination. There are also required Briefing and Debriefing sessions that take place before and after the actual examination. These each last approximately 45 minutes.
The Case List is reviewed by the ABOS Credentials Committee. This provides a reference for the competency level of the Diplomate in providing quality surgical and patient care management in the practice setting. The Credentials Committee, upon review of the Case List, may accept, defer, or deny a Diplomate’s application to take a Recertification Examination based on their findings. They may also require an Oral Recertification Examination to evaluate performance in practice. The case list will also provide a means for a Diplomate to review their own performance.
Email is the connection between ABOS and the Diplomate. Keep your contact information updated. You can update your information by logging in to your ABOS Dashboard. You will receive an email when your Application has been received and also after it has been processed.
A current updated email address with ABOS is required. The Diplomate will click on “I forgot username” and/or “I forgot password” and the system will email information to the email address within the Diplomate’s profile. Login information is not communicated by phone for security purposes.