What is Maintenance of Certification?
In an effort to improve the quality of patient care, the American Board of Medical Specialties (ABMS) developed the Maintenance of Certification (MOC) program that aims to ensure certified physicians remain current in advancing medical knowledge and competent in their specialty.
Officially adopted by all 24 medical specialty boards in 2006, the MOC process is founded on six core competencies for quality patient care. These core competencies were first adopted by the Accreditation Council for Graduate Medical Education (ACGME) and later the ABMS in 1999.
The American Academy of Physical Medicine and Rehabilitation (AAPM&R) and the American Board of Physical Medicine and Rehabilitation (ABPMR) are dedicated to upholding these competencies and fostering life-long learning in support of the MOC program requirements.
The ABPMR and the American Academy of PM&R are not related and the Academy has no role in setting MOC standards or guidelines. The Academy seeks only to provide products and services to help physicians meet the requirements set forth by the ABPMR.
Core Competencies (as defined by the ABPMR):
Patient Care
Improve performance skills, including medical interviews and physical examinations; incorporate a synthesis of clinical data.
Medical Knowledge
Know and critically evaluate current general and practice-specific medical information; understand and incorporate evidence-based decision-making.
Interpersonal and Communication Skills
Communicate effectively with patients and families, other professionals, and team members; maintain comprehensive, legible medical records.
Professionalism
Demonstrate self-awareness and knowledge of limits, high standards of ethical and moral behavior, reliability and responsibility, respect for patient dignity, and autonomy.
Systems-based Practice
Promote patient safety within the system; provide value for patients through cost-effective care; promote health and prevention of disease and injury; demonstrate effective practice management.
Practice-based Learning and Improvement
Engage in ongoing learning to improve knowledge and skills; analyze one’s practice to recognize strengths and deficiencies; seek input to improve practice and quality care.
For more detailed information regarding Maintenance of Certification, please visit the following links:
American Board of Medical Specialties (ABMS)
American Board of Physical Medicine and Rehabilitation (ABPMR)
ABPMR Requirements for MOC:
All ABPMR diplomates with 10-year, time-limited primary or subspecialty certificates that expire in 2010 and beyond are required to participate in the MOC program if they wish to remain certified in PM&R. Diplomates with a lifetime certificate (issued before 1993) are also strongly encouraged to participate in the MOC program, but will maintain their certificates regardless of participation and/or performance in the program.
The MOC program is divided into four parts, or components, that are designed to measure the six core competencies in order to maintain certification:
Part I: Professional Standing (Licensure)
Physicians must hold a valid, unrestricted medical license in at least one state or jurisdiction in the United States, its territories or Canada. For more information, click here.
Part II: Lifelong Learning and Self-Assessment
Physicians must participate in educational and self-assessment programs that meet specialty-specific standards set forth by the ABPMR.
What you need (within the 10-year MOC cycle):
- Complete a minimum of 500 hours of continuing medical education (CME) credits
- 50% of these 500 credit hours must pertain to PM&R
- 300 credits must be Category 1
- 200 credits may be either Category 1 or 2
- CME credits must be endorsed by either the ACCME or AOA
- For more information from the ABPMR, click here.
- Complete four (4) self-assessments (such as the SAE-P)
Part III: Cognitive Expertise (Examinations)
Physicians must demonstrate, through formalized examination, that they have the fundamental, practice-related and practice environment-related knowledge to provide quality care in PM&R.
What this means:
- You must take and pass the primary ABPMR MOC Examination once during the 10-year cycle.
- Subspecialty recertification also requires passing a MOC Examination for that subspecialty.
- For more information, click here.
Part IV: Practice Performance Assessment
Physicians are evaluated in their clinical practice according to specialty-specific standards for patient care. They are asked to demonstrate that they can assess the quality of care they provide compared to peers and national benchmarks and then apply the best evidence or consensus recommendations to improve that care using follow-up assessments.
What this means:
- You must complete one approved Practice Performance Assessment during the 10-year cycle.
- Practice Performance Assessments are often referred to as PIPs, Practice Improvement Projects, or Performance Improvement Projects.
- Completion of a Practice Performance Assessment is not required for diplomates whose certificates expire in 2008 and 2009 to allow for phasing in of the MOC program; however, Parts I-III are still required for recertification. Diplomates with certificates expiring in 2010 and beyond are required to complete all MOC components (Parts I-IV).
MOC for Subspecialties:
Maintaining certification in an ABPMR subspecialty also requires completion of Parts I-IV of the MOC program. However, completion of Parts I, II, and IV for primary recertification also count towards the subspecialty recertification requirements. The only additional work needed to maintain subspecialty certification is passing an additional MOC exam in that subspecialty. An exception to this requirement is the Pediatric Rehabilitation Medicine Subspecialty Exam which can be taken in place of the primary MOC Exam.
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