FAQs for Permanent Certificate Holders

Based on the new Maintenance of Certification (MOC) requirements, will my certification status change?

No. The American Board of Pediatrics (ABP) awarded certificates without an expiration date in good faith, and those certificates will not change.

What are time-limited certificates?

Time-limited certificates are those that expire based on certain requirements.

Beginning May 1, 1988 (with the exception of the subspecialties of Pediatric Critical Care Medicine and Pediatric Pulmonology, which began with time-limited certification as new subspecialties in the mid-1980s) ABP certificates had to be renewed every seven years. This recertification process was accomplished by passing an open-book, at-home examination. In 2003, this policy was changed to include a secure examination administered at testing sites every seven years. The recertification process has now evolved into the Maintenance of Certification (MOC) program, only one part of which is a secure examination.

What is Maintenance of Certification (MOC)?

The MOC program is a four-part process that assures the public of your competency in the field of pediatrics. Your professionalism is demonstrated by:

• your unrestricted license to practice medicine (Part 1)
• your medical knowledge is current because you engage in self-assessment and learning activities (Part 2),
• passing a secure examination (Part 3),
• your active involvement in measuring and improving the quality of patient care (Part 4).

Why is the new MOC program necessary?

The 1990s were the beginning of a conscious and concerted effort by those both inside and outside the medical profession to begin to systematically evaluate the quality of delivered medical care. It also became necessary, to codify the reasons for inadequate care and medical error, and to make recommendations for system-wide improvement. Health service researchers began to document widespread unexplained variation in care delivered, even by board-certified physicians. In addition, the Institute of Medicine (IOM) published the summaries of phase 2 of their Quality Initiative project. The publication of To Err is Human: Building a Safer Health System (1999) and Crossing the Quality Chasm: A New Health System for the 21st Century (2001) received widespread and immediate public attention. The IOM also made specific recommendations for change, including the goals that care should be safe, effective, efficient, equitable, patient-centered, and timely. These two reports accelerated calls for change in medical education, how care is delivered, and how certified physicians are evaluated throughout their careers.

During this same period, the Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Medical Specialties (ABMS) jointly identified the areas in which a physician must be competent to practice quality medicine. Six core general competencies were eventually defined. These measurable competencies (patient care, medical knowledge, professionalism, systems-based practice, practice-based learning and improvement, and interpersonal and communication skills) were adopted in 1999/2000. The implementation, measurement, and mastery of these competencies have been endorsed by all of organized medicine and now define a competent physician. The four parts of the ABP MOC program measure these competencies and allow the ABP to assure the public, licensing boards, payers, and others that Diplomates meet these new standards. Because maintaining certification is a commitment to quality and influences better care, the ABP is committed to making MOC a benchmark standard that fulfills multiple requirements for licensing, accreditation, and hospital credentialing.

How does MOC affect initial certification and subsequent recertification?

It affects the concept of certification and recertification in a very important way. Beginning in 2010, with the introduction of the fully developed MOC program, the concept of recertification as previously structured will cease to exist. The more continuous evaluation process is known as Maintenance of Certification (MOC). Certification beginning in 2010 is contingent upon pediatricians fulfilling the requirements of the four-part MOC program. Parts 1, 2, and 4 requirements are completed every five years. Part 3, the secure examination, is required every ten years. If these MOC requirements are not met, ABP certification will end. In 2010, the ABP will recognize two categories of pediatricians: those who have permanent certificates; and those who are certified and have met the current requirements of the MOC.

Do other Boards have similar MOC programs?

Yes. The American Board of Medical Specialties (ABMS) boards have MOC programs based on the same four part model.

Why should I be involved in MOC when I remain certified by the ABP?

Groups outside the ABP are less likely to accept a credential awarded 10, 20, or more years ago as evidence of your current ability to provide quality medical care. For example, state licensing boards are considering requiring physicians to participate in Maintenance of Licensure (MOL), a program that will include a secure examination. The Joint Commission has strongly encouraged hospitals to show evidence that they are measuring the six core competencies of their medical staff every two years as part of the credentialing process. In addition, payers are beginning to require similar evaluations. There are also pay-for-performance models that require evidence of continuous participation in an ongoing evaluation of professional competence for inclusion in their process.

How will participation in MOC help me fulfill requirements related to hospital credentialing and insurance company requirements?

The American Board of Medical Specialties (ABMS) and the ABP are working hard to ensure that outside groups, organizations or other regulatory agencies that need to measure a physician's competence can successfully utilize the MOC program as the gold standard within the medical industry. For specific examples, see How MOC is Recognized.

If I choose to participate in the MOC program, will I be "recertified"?

No. The term "recertified" will no longer be used by the ABP except to document the prior history of a specific pediatrician. Effective January 1, 2010, the ABP will recognize two categories of diplomates: those who have permanent certificates; and those who are certified and have met the current requirements of MOC.

If I choose not to participate in MOC, how will I be designated?

You will never lose the designation of an ABP Certified Diplomate. Your name will not, however, be listed as "meeting the requirements of the MOC program" on the ABP Website and will not be used when written confirmation of such participation is requested.

How do I get started in MOC if I have not recertified?

The first requirement is that you take the secure Part 3 examination (either the general pediatrics examination or the examination in your subspecialty). You will then be eligible to enroll and participate in the MOC program and may choose to fulfill the other parts of the MOC program in the next five years. A successful examination is valid for ten years.

What is the Part 3 examination like?

The examination measures pediatric clinical expertise and the knowledge that a pediatrician in practice (general or subspecialty) possesses without the use of reference materials. The examination is designed and developed by your peers and is independent of the initial certification examination. The subject areas being tested are shared with the American Academy of Pediatrics (AAP) and are used by the AAP PREP Committee in designing educational materials. Also, the general pediatrics self-assessment module available on the ABP Website is an example of what the examination is like and its degree of difficulty.

What if I don't pass the test? Will I lose my certification status?

No. Your certification status will not be affected if you fail the examination. Failure will remain confidential and you can retake the examination an unlimited number of times within one year of your application.

What happens if I pass the MOC examination and then decide not to do the other parts of MOC?

Your examination will still be valid for ten years and your certification will not be affected by your decision. You will not, however, be designated as "meeting the current requirements" unless you are enrolled in MOC. You may enter the MOC program at any time during the next ten years by fulfilling the re-entry MOC requirements.

Why should I begin the program in 2011?

Permanent certificate holders will have a unique opportunity to enter the MOC program before the program is fully implemented in 2010. If you pass the Part 3 examination in 2011, your examination fee includes access to the ABP MOC activities at no additional charge. Your name will be listed as "meeting the requirements of MOC" on the ABP Website and in response to inquiries made to the ABP by hospitals, payers, state licensing boards, and the public through 2014.

What happens if I choose to start in 2011, but then do not fulfill the other requirements of the MOC program by December 31, 2014?

Your permanent certificate will not be affected. However, beginning in 2015, you will lose the designation of "meeting the current requirements of MOC" until you re-enter the full MOC program. Your successful Part 3 examination will be valid until 2019. Remember, the activities you need to continue the program can be completed at no additional cost to you for the first five-year MOC cycle.

What happens if I decide to enroll in MOC after 2010?

If you enroll in MOC in 2010 or later, you have 2 years to pass the examination. In addition, you'll need to submit valid licensure, complete 100 points in Parts 2 and 4, and one patient survey during the same 2 year time period. Your designation as an active participant will begin as soon as you meet all requirements. This requirement is the same as those who have let their certification lapse and want to become certified again.

I have taken a recertification examination in the past. Will I have to take another if I want to enter the MOC program?

If you have passed the examination within the past ten years, you will not have to re-take an examination to enter the MOC program. Your recertification examination will be valid for ten years from the date of the examination. If you have passed the recertification examination within five years, there will be no additional charge for entering MOC in 2011.

What does my 2011 examination fee include?

Your fee includes access to the examination and once you pass it, the designation that you have "met the current requirements of MOC" until the end of 2014. At that time, you'll re-enroll in MOC and pay a fee. That fee will include access to your next Part 3 examination in 2019 at no additional charge. In 2015, your new MOC cycle begins.

What is the fee to enroll in MOC?

In 2011, the fee will be $990. Fees are adjusted annually. If you have paid for an examination in the past five years, there will be no additional charge to enroll in MOC.

How much time will all this take?

That depends on the individual. If ABP activities are used, it is estimated to take about 15 hours a year. If you are involved in an ABP-approved collaborative quality improvement project as a Part 4 activity, you are already participating (without getting credit) in an MOC activity. If you routinely use PREP, you have already participated in a Part 2 activity. The secure examination is one half day.

Will I receive Continuing Medical Education (CME) credit for participation in MOC?

Many of the MOC activities are approved for CME credit. The American Medical Association (AMA) grants CME credit for completion of the secure examination.

Are the requirements for MOC likely to change significantly over time?

While the ABP acknowledges your permanent certification status, it cannot assure you that the MOC requirements will not change. MOC will evolve yet the ABP has a place in the process that continuously assesses the competencies of our diplomates. The ABP will continue to make its MOC program the standard by which others can, and will, measure our certified pediatricians. We will continue to improve the process with the help of our members and diplomates.