Rebecca L. Johnson, MDRebecca L. Johnson, MDChair, Pathology &Chair, Pathology &

Clinical LabsClinical Labs

Berkshire Health SystemsBerkshire Health Systems

President, American Board President, American Board of Pathologyof Pathology

MOCMOCMAINTENANCE OF MAINTENANCE OF CERTIFICATION - CERTIFICATION -

WHY SHOULD I CARE?WHY SHOULD I CARE?

History of Board CertificationHistory of Board Certification

1908 Derrick Vail, MD1908 Derrick Vail, MD

Presidential address to the American Presidential address to the American Academy of Ophthalmology & Academy of Ophthalmology & OtolaryngologyOtolaryngology

““I hope to see the time….let him I hope to see the time….let him then be permitted and licensed to then be permitted and licensed to practice ophthalmology.”practice ophthalmology.”

American Board Of American Board Of OphthalmologyOphthalmology

Am. Ophthalmologic Society, AMA, Am. Ophthalmologic Society, AMA, Academy of OphthalmologyAcademy of Ophthalmology

1915—Defined requirements1915—Defined requirements 1917—ABO established1917—ABO established

Early BoardsEarly Boards

1924—Am Board of Otolaryngology1924—Am Board of Otolaryngology 1930—Am Board of Obstetrics & 1930—Am Board of Obstetrics &

GynecologyGynecology 1932—Am Board of Derm & Syphilology1932—Am Board of Derm & Syphilology 1933—Am Board of Pediatrics1933—Am Board of Pediatrics 1934—Psychiatry & Neurology, Radiology, 1934—Psychiatry & Neurology, Radiology,

Orthopedic SurgeryOrthopedic Surgery 1935—Colon & Rectal Surgery, Urology1935—Colon & Rectal Surgery, Urology 1936—Internal Medicine, 1936—Internal Medicine, PATHOLOGY PATHOLOGY

Advisory Board Advisory Board For Medical SpecialtiesFor Medical Specialties

Est. 1933Est. 1933 Uniformity in MD certificationUniformity in MD certification Increase public awarenessIncrease public awareness Education, training, and certificationEducation, training, and certification

Advisory Board Advisory Board For Medical SpecialtiesFor Medical Specialties

Four first specialty boardsFour first specialty boards AHA, AAMC, FSMB, AMA AHA, AAMC, FSMB, AMA

Council on Med Ed & Council on Med Ed & Hospitals, NBMEHospitals, NBME

1970 - American Board of 1970 - American Board of Medical Specialties (ABMS)Medical Specialties (ABMS)

ABMS PurposeABMS Purpose

Discuss common issuesDiscuss common issues Advise BoardsAdvise Boards Coordinate workCoordinate work Jurisdiction over policies as Jurisdiction over policies as

delegateddelegated Autonomy of any BoardAutonomy of any Board Stimulate improvements in med edStimulate improvements in med ed

ABMSABMS

24 Boards24 Boards 37 Primary specialties37 Primary specialties 94 Subspecialties94 Subspecialties

2005 ~89% licensed US MDs2005 ~89% licensed US MDs Evanston, ILEvanston, IL Kevin Weiss, MD, EVPKevin Weiss, MD, EVP www.abms.orgwww.abms.org

ABMS MISSIONABMS MISSION

Improve quality of medical careImprove quality of medical care Professional and educational standards Professional and educational standards

for certificationfor certification

Assurance to the publicAssurance to the public Certification has meaning and required Certification has meaning and required

componentscomponents

ABMS & Member BoardsABMS & Member Boards

AssessAssess Education, Training, Licensure, Ethical Education, Training, Licensure, Ethical

and professional requirementsand professional requirements Initial examinationInitial examination

Construction-fair, objectiveConstruction-fair, objective Psychometrically reliable and validPsychometrically reliable and valid Assess knowledge & clinical skillsAssess knowledge & clinical skills

Limits of Board CertificationLimits of Board Certification

Assesses only medical knowledgeAssesses only medical knowledge SnapshotSnapshot

SOLUTION?SOLUTION? RecertificationRecertification Time limited certificationTime limited certification Maintenance of Certification (MOC)Maintenance of Certification (MOC)

Evolution from Certification to Evolution from Certification to MOCMOC

1936 2016

Re-Certification

Time-Limited

MOC

1969

Unlimited Certification

2006

ABMSABMS

1993 Member Boards 1993 Member Boards agree to Recertificationagree to Recertification

1997/98 ABPath 1997/98 ABPath Voluntary RecertificationVoluntary Recertification

1998 ABMS 1998 ABMS Task Force on CompetencyTask Force on Competency

Mission statement—Diplomates are Mission statement—Diplomates are competentcompetent

Define competenceDefine competence Research and assessment, validationResearch and assessment, validation Template to assess competenceTemplate to assess competence Peer review of certificationPeer review of certification Collaborative methods of assessmentCollaborative methods of assessment

MOC Relevant•Accountability for competence•Accountability for practice quality •Reshape Continuing Medical Education

MOC is Essential; Tied to:•Hospital Credentialing•Maintenance of Licensure•Pay for Performance

GOALSGOALS

Three Trends Make MOC Three Trends Make MOC RelevantRelevant

Public wants accountability for Public wants accountability for performanceperformance Purchaser decision about qualityPurchaser decision about quality

Quality can be measuredQuality can be measured

Patient’s perceptions and health status Patient’s perceptions and health status

Guideline adherence and achieving outcomesGuideline adherence and achieving outcomes

Quality can be improvedQuality can be improved Health care results from systemHealth care results from system

Change system processes improves careChange system processes improves care

Relevance of MOC For A Relevance of MOC For A Composite Measure of Composite Measure of

Physician QualityPhysician Quality Customers Customers

Healthcare purchasers & patientsHealthcare purchasers & patients Health plans, medical staffs, group practicesHealth plans, medical staffs, group practices

CompetitorsCompetitors National Committee for Quality AssessmentNational Committee for Quality Assessment Center for Medicare and Medicaid ServicesCenter for Medicare and Medicaid Services Doctor Quality web sitesDoctor Quality web sites

CollaboratorsCollaborators JCAHOJCAHO State Medical Boards/FSMBState Medical Boards/FSMB

Changing View of Changing View of ProfessionalismProfessionalism

AutonomyAutonomy CollaboratioCollaborationn

AuthorityAuthority EvidenceEvidence

AssertionAssertion MeasurementMeasurement

ControlControl TransparencyTransparency

AccountabilityAccountability

Develop evidence of Develop evidence of achieving best results for achieving best results for patient carepatient care

Communicate results Communicate results regularly and widely to regularly and widely to those to whom those to whom accountability is owedaccountability is owedProfession Public

ABMS & ACGMEABMS & ACGMELifetime CompetenciesLifetime Competencies

MEDICAL KNOWLEDGEMEDICAL KNOWLEDGE PATIENT CAREPATIENT CARE INTERPERSONAL & INTERPERSONAL &

COMMUNICATION SKILLSCOMMUNICATION SKILLS PROFESSIONALISMPROFESSIONALISM PRACTICE BASED LEARNING & PRACTICE BASED LEARNING &

IMPROVEMENTIMPROVEMENT SYSTEMS BASED PRACTICESYSTEMS BASED PRACTICE

SafeSafe

TimelyTimely

EfficientEfficient

EffectiveEffective

Equitable Equitable

Patient CenteredPatient Centered

MOC – A Composite Measure of Competence

and Quality

Competencies IOM Quality Aims

Evolution of MOCEvolution of MOC

1936--Certification

Training

Competence/Practice

Examination

1998 Voluntary Recertification

CME

License & privileges

Examination (optional)

2006 - Maintenance of Certification

Certification after training

Milestone evidence of competence

I. Professional standing

II. Lifelong learning & self-assessment

III. Cognitive expertise

IV. Practice performance & improvement

Can apply to all certificates

Single credential

o Board Certification

o Maintenance of License

o Hospital Privileges

o Public accountability

American Board of PathologyAmerican Board of Pathology

1936 Michigan1936 Michigan Primary CertificationPrimary Certification

AP/CP, AP, CPAP/CP, AP, CP Subspecialty certificationSubspecialty certification

1010 ACGME approved fellowshipACGME approved fellowship

Change in training requirementsChange in training requirements

AMERICAN BOARD OF AMERICAN BOARD OF PATHOLOGYPATHOLOGY

PRIMARY CERTIFICATIONPRIMARY CERTIFICATION ANATOMIC & CLINICAL PATHOLOGYANATOMIC & CLINICAL PATHOLOGY ANATOMIC PATHOLOGYANATOMIC PATHOLOGY CLINICAL PATHOLOGYCLINICAL PATHOLOGY

AMERICAN BOARD OF AMERICAN BOARD OF PATHOLOGY- PATHOLOGY-

SUBSPECIALTYSUBSPECIALTY Blood Banking/Transfusion MedicineBlood Banking/Transfusion Medicine Chemical PathologyChemical Pathology CytopathologyCytopathology Dermatopathology*Dermatopathology* Forensic PathologyForensic Pathology HematologyHematology Medical MicrobiologyMedical Microbiology Molecular Genetic Pathology*Molecular Genetic Pathology* NeuropathologyNeuropathology Pediatric PathologyPediatric Pathology

ABP Cooperating SocietiesABP Cooperating Societies

ACLPSACLPS ADASPADASP AMA Pathology Section CouncilAMA Pathology Section Council APCAPC ASCPASCP ASIPASIP CAPCAP USCAPUSCAP

Maintenance of CertificationMaintenance of Certification

ABMS initiativeABMS initiative

AllAll 24 specialty boards 24 specialty boards

2006 -Time-limited (10 year) primary 2006 -Time-limited (10 year) primary and subspecialty certificatesand subspecialty certificates

Participation in MOC process Participation in MOC process requiredrequired

Completed within 8-10 yearsCompleted within 8-10 years

ABMS BoardsABMS BoardsRecertificationRecertification

19701970 Family MedicineFamily Medicine 77

19761976 SurgerySurgery 1010

Thoracic SurgeryThoracic Surgery 1010

19801980 Emergency MedicineEmergency Medicine 1010

1985 1985 UrologyUrology 1010

19861986 OB/GYNOB/GYN 66

Orthopedic SurgeryOrthopedic Surgery 1010

20062006 PATHOLOGYPATHOLOGY 1010

MOC ComponentsMOC Components

I.I. Professional StandingProfessional Standing

II.II. Lifelong Learning & Self-Lifelong Learning & Self-AssessmentAssessment

III.III. Cognitive Expertise (the Cognitive Expertise (the EXAM!)EXAM!)

IV.IV. Evaluation of Performance Evaluation of Performance in Practicein Practice

Part IPart IProfessional StandingProfessional Standing

Maintenance of a full and unrestricted license Maintenance of a full and unrestricted license in at least one U.S. jurisdiction, territory, or in at least one U.S. jurisdiction, territory, or CanadaCanada

Documentation of medical staff membership Documentation of medical staff membership and privileges or, if not applicable, scope of and privileges or, if not applicable, scope of practicepractice

Documentation of licensure and medical staff Documentation of licensure and medical staff privileges at 4privileges at 4thth and 8 and 8thth year year

Part IIPart IILife Long Learning- Self-Life Long Learning- Self-

AssessmentAssessment 70 Category 1 CME credits / 2 year cycle 70 Category 1 CME credits / 2 year cycle 20 CME credits / 2 yr cycle must be SAMs20 CME credits / 2 yr cycle must be SAMs 80% CME related to individual’s practice80% CME related to individual’s practice Updated electronic record of activities Updated electronic record of activities

every 2 yearsevery 2 years A fellowship fulfills Part II requirements A fellowship fulfills Part II requirements

for 2 year period for 2 year period Incomplete fellowships proratedIncomplete fellowships prorated

Part IIPart IILife Long Learning and Self-Life Long Learning and Self-

AssessmentAssessment Content specificationsContent specifications

Important advancements, key Important advancements, key conceptsconcepts

Basis for CME and self-assessmentBasis for CME and self-assessment Prep for MOC exam.Prep for MOC exam. Direct MOC test question Direct MOC test question

developmentdevelopment Practical “need to know” Practical “need to know”

information, used in daily practice, information, used in daily practice, required for competencerequired for competence

Cover all disciplines of pathology Cover all disciplines of pathology

Part IIPart IILife Long Learning-Self-Life Long Learning-Self-

AssessmentAssessment

AP and CP Content Committees’ AP and CP Content Committees’ “Content Outlines” on line, “Content Outlines” on line, updated annuallyupdated annually

Fundamental information for daily Fundamental information for daily practice; important, validated new practice; important, validated new knowledgeknowledge

Outlines are not templates for Outlines are not templates for exam or endorsements of authorsexam or endorsements of authors

Self-Assessment Modules Self-Assessment Modules (SAMs)(SAMs)

Elements of SAMsElements of SAMs Educational productEducational product Self-administered examSelf-administered exam Minimum performance levelMinimum performance level FeedbackFeedback

SAM requirement for 2006-09 period SAM requirement for 2006-09 period waived because of insufficient offeringswaived because of insufficient offerings

Certificates issued by societies should Certificates issued by societies should reflect regular CME versus CME / reflect regular CME versus CME / SAMSAM

Part III--Cognitive ExpertisePart III--Cognitive Expertise

Examination is mandatory Examination is mandatory ““Secure” and closed book Secure” and closed book At least once per yearAt least once per year Taken 8-10 years after initial Taken 8-10 years after initial

certificationcertification Potential 3 year period of Potential 3 year period of

qualificationqualification

Part III - Cognitive ExpertisePart III - Cognitive Expertise

Modular exams related to practiceModular exams related to practice Exams will include:Exams will include:

Fundamental knowledgeFundamental knowledge Current practice-related knowledgeCurrent practice-related knowledge Emphasis on information new to field Emphasis on information new to field Practice environment knowledgePractice environment knowledge

Part IIIPart IIICognitive ExpertiseCognitive Expertise

AP/CP certified individuals may AP/CP certified individuals may chose to maintain their chose to maintain their certification in AP/CP, AP only or certification in AP/CP, AP only or CP onlyCP only

Individuals with subspecialty Individuals with subspecialty certification may choose to certification may choose to maintain only their subspecialty maintain only their subspecialty certificationcertification

Part IIIPart IIICognitive ExpertiseCognitive Expertise

MOC exam:MOC exam: ““tailor” exam to practice by selecting tailor” exam to practice by selecting

modules. modules.

Menu of multiple modules Menu of multiple modules

At least one general module of AP or At least one general module of AP or CP must be selected by AP/CP CP must be selected by AP/CP examineesexaminees

Part III - Cognitive ExpertisePart III - Cognitive ExpertiseMOC EXAMMOC EXAM

6 modules of 25 questions (150 total 6 modules of 25 questions (150 total questions)questions)

80% practical (virtual microscopy, 80% practical (virtual microscopy, case-based questions etc); 20% case-based questions etc); 20% written written

Modules graded as one examModules graded as one exam

AP/CP MOC Exam

General module

Specialty module

+

+

+

+ 4 add. = 6 total

+ 3 add. = 6 total

+ 3 add. = 6 total

AP

CP

Option 1

Option 2

Option 3

AP only MOC Exam CP only MOC Exam

General module

Specialty module

AP

CP

6 total 6 total

or or

or

or

or

or

or

or

or

or

3 max

+

+

ModulesModulesClinical PathologyClinical Pathology

General CP I, II, III, IV

Hematology I, II

Blood Bank I, II Immunopathology

Blood Bank-Coagulation

Microbiology I, II

Coagulation Chemistry I, II

ModulesModulesAnatomic PathologyAnatomic Pathology

Gen AP I,II Breast

Gen Surg Path I,II Cardiovascular

General Cytology I, II Dermatology I, II

Cytology, Gyn Endocrine

Cytology, Non Gyn GI-Liver-Biliary

Bone-Soft Tissue Autopsy

Revised 11/08

ModulesModulesAnatomic Pathology cont’dAnatomic Pathology cont’d

Genitourinary Pediatric Pathology

Gynecologic Pulmonary/Mediastinal

Head-Neck Transplant pathology

Medical Renal Forensic Pathology

Neuropathology

Revised 11/08

Common Modules*Common Modules*Anatomic and Clinical PathologyAnatomic and Clinical Pathology

* May be used to fulfill AP or CP specialty modules

General Hemepath I (Lymph node-Spleen)

Flow Cytometry

General Hemepath II (Bone Marrow)

Molecular Pathology

Molecular-Cytogenetics

Lab Man / Informatics

Revised 11/08

Part III—Exam & MOC MythsPart III—Exam & MOC Myths

High stakes—Low failure rateHigh stakes—Low failure rate Irrelevant—ModularIrrelevant—Modular Not useful—Improves MK, Pt. CareNot useful—Improves MK, Pt. Care Time consuming—Payoff- meet pt Time consuming—Payoff- meet pt

and regulatory expectations for and regulatory expectations for quality, accountability, self-quality, accountability, self-regulationregulation

Part IV. Evaluation of Part IV. Evaluation of Performance in PracticePerformance in Practice

Demo to pts, public, professionDemo to pts, public, profession Safe, effective, pt centered, timely, Safe, effective, pt centered, timely,

efficient, equitable health careefficient, equitable health care Improve quality of PCImprove quality of PC CI of practice performanceCI of practice performance EvaluateEvaluate

Individual physician performanceIndividual physician performance

Part IV. Evaluation of Part IV. Evaluation of Performance in Practice - ABMS Performance in Practice - ABMS

PrinciplesPrinciples Phase-in; evaluate effectiveness; Phase-in; evaluate effectiveness;

improveimprove Reflect activities of diplomateReflect activities of diplomate Assessment based onAssessment based on

EBM/guidelinesEBM/guidelines Expert consensusExpert consensus Normative peer comparisonsNormative peer comparisons

Part IV. Evaluation of Part IV. Evaluation of Performance in Practice- ABMS Performance in Practice- ABMS

PrinciplesPrinciples Compare diplomate to standardsCompare diplomate to standards

• Baseline, plan to improve, measureBaseline, plan to improve, measure

Assess all 6 competencies during Assess all 6 competencies during cyclecycle

Key disease or clinical processesKey disease or clinical processes Collaborative/shared databasesCollaborative/shared databases Proven educational & assessment Proven educational & assessment

methodsmethods MOC for inactive and no PC MDsMOC for inactive and no PC MDs

Part IV. Evaluation of Part IV. Evaluation of Performance in Practice - ABMS Performance in Practice - ABMS

PrinciplesPrinciples

Provide feedback to improve PC, Provide feedback to improve PC, workflow, efficiencyworkflow, efficiency

Not be duplicative-P4PNot be duplicative-P4P Collaborate with specialty societiesCollaborate with specialty societies Begin assessment during residencyBegin assessment during residency

Part IVPart IVPerformance in PracticePerformance in Practice

Four personal attestations Four personal attestations (4(4thth and and 88thth year) year)

Lab accreditation Lab accreditation (4(4thth and 8 and 8thth year) year) except forensic labsexcept forensic labs

Laboratory participation in inter-Laboratory participation in inter-laboratory PI programs laboratory PI programs (2 yrs)(2 yrs)

Individual participation at least 1 Individual participation at least 1 laboratory PI-QA program/yr. laboratory PI-QA program/yr. (2 (2 yrs)yrs)

Part IVPart IVPerformance in PracticePerformance in Practice

Society-sponsored programs or Society-sponsored programs or created by created by departments/institutionsdepartments/institutions

On-line application for Part IV On-line application for Part IV programs programs

Programs must be ABP-approvedPrograms must be ABP-approved

Part IV. Evaluation of Performance Part IV. Evaluation of Performance in Practicein Practice

Attestations as to:Attestations as to: Interpersonal and Interpersonal and

communication skillscommunication skills ProfessionalismProfessionalism EthicsEthics Effectiveness in systems-based Effectiveness in systems-based

practicepractice

Part IV. Evaluation of Performance in Part IV. Evaluation of Performance in Practice –Interpersonal & Practice –Interpersonal &

Communication SkillsCommunication Skills

44thth year after certification and at application for exam year after certification and at application for exam

Attestations from:Attestations from: ABP-certified pathologistABP-certified pathologist Credentials Com or equivalent (e.g. CMO) Credentials Com or equivalent (e.g. CMO) Board-certified physician in another Board-certified physician in another

specialtyspecialty Technologist or physician’s assistant (360)Technologist or physician’s assistant (360)

Part IV. Evaluation of Performance Part IV. Evaluation of Performance

in Practice in Practice Laboratory Laboratory AccreditationAccreditation

Timeline: 8Timeline: 8thth-10-10thth year with exam year with exam applicationapplication

Document accreditation status of Document accreditation status of laboratory laboratory

Part IV. Evaluation of Performance in Part IV. Evaluation of Performance in

Practice Practice Laboratory Laboratory ImprovementImprovement

Every 2 years after certificationEvery 2 years after certification

Documentation to ABP of successful Documentation to ABP of successful participation in inter-laboratory participation in inter-laboratory improvement and quality assurance improvement and quality assurance programs relevant to the practiceprograms relevant to the practice

Part IV. Evaluation of Performance in Part IV. Evaluation of Performance in PracticePractice

Individual Improvement & QA Individual Improvement & QA ActivityActivity

Every 2 years after certificationEvery 2 years after certification Documents individual participation in Documents individual participation in

at least one QA program/year relevant at least one QA program/year relevant to professional activities, to professional activities, oror

Document use of appropriate Document use of appropriate protocols, outcome measures, & protocols, outcome measures, & practice guidelines to improve practice guidelines to improve practicepractice

Quality Improvement Quality Improvement SystemSystem

Collect Performance

Measures

Collect Performance

Measures

Analyze & Compare

Performance

Analyze & Compare

Performance

Change a Practice Process

Change a Practice Process

Report to Board,

Payer, or Patients

Report to Board,

Payer, or Patients

Time

Qu

alit

y M

easu

re

GoalGoal

Six Core Competencies In Medical Six Core Competencies In Medical PracticePractice

Medical knowledgeMedical knowledge Patient carePatient care Interpersonal and communication Interpersonal and communication

skillsskills ProfessionalismProfessionalism Practice-based learning and Practice-based learning and

improvementimprovement Systems-based practiceSystems-based practice

Involvement of Specialty Involvement of Specialty Societies in MOCSocieties in MOC

ABP --standard setting organizationABP --standard setting organization Cooperating Societies:Cooperating Societies:

CME CME Self-assessment toolsSelf-assessment tools Programs for evaluation of practice Programs for evaluation of practice

performanceperformance Verification of satisfactory performanceVerification of satisfactory performance Remedial education programsRemedial education programs ContentContent

MOC Cost to DiplomatesMOC Cost to Diplomates

Fee for electronic databaseFee for electronic database $50/year$50/year

CMECME Self-assessment modulesSelf-assessment modules Cognitive examCognitive exam

Currently $2200Currently $2200

Requirements For MOC Parts I-Requirements For MOC Parts I-IVIV

Part I: Professional StandingPart I: Professional Standing

Part II: Life-Long Learning and Self-Part II: Life-Long Learning and Self-AssessmentAssessment

Part III: Part III: Cognitive ExpertiseCognitive Expertise

Part IV: Part IV: Evaluation of Performance in Evaluation of Performance in PracticePractice

Failure to meet MOC Failure to meet MOC RequirementsRequirements

Must participate and demonstrate Must participate and demonstrate satisfactory performance in all 4 parts satisfactory performance in all 4 parts of MOCof MOC

Performance below expectations Performance below expectations requires an implementation plan to requires an implementation plan to improve performanceimprove performance

Failure to satisfy performance criteria Failure to satisfy performance criteria results in loss of certification December results in loss of certification December 31st of 10 year anniversary of initial 31st of 10 year anniversary of initial certificationcertification

Transition to MOCTransition to MOC

Holders of life-time certificates:Holders of life-time certificates: Voluntary recertificationVoluntary recertification Participate in MOCParticipate in MOC Original certificate NOT jeopardizedOriginal certificate NOT jeopardized

Holders of time-limited certificates:Holders of time-limited certificates: Must participate in MOCMust participate in MOC

Candidates for initial certification:Candidates for initial certification: Must participate in MOC after Must participate in MOC after

certificationcertification

Voluntary Voluntary Recertification Recertification

and MOCand MOC

Voluntary RecertificationVoluntary Recertification

1998 ABMS initiative1998 ABMS initiative Assessment of individual credentialsAssessment of individual credentials Measure quality of professional Measure quality of professional

practicepractice Evaluate basic parameters of Evaluate basic parameters of

practicepractice

Voluntary RecertificationVoluntary Recertification

Diplomates of ABP with non-time-Diplomates of ABP with non-time-limited certificatelimited certificate

Recertification certificate dated Recertification certificate dated January 1 of the year following January 1 of the year following completion of processcompletion of process

Valid for 10 yearsValid for 10 years Expiration--no effect on original Expiration--no effect on original

certificatecertificate

Voluntary Recertification Voluntary Recertification RequirementsRequirements

Possess lifetime primary certificatePossess lifetime primary certificate Current valid, full, and unrestricted Current valid, full, and unrestricted

license to practice medicine or osteopathy license to practice medicine or osteopathy in US, its territories, or Canadain US, its territories, or Canada

Provide a written statement attesting Provide a written statement attesting physically and mentally ability to practice physically and mentally ability to practice pathologypathology

Voluntary Recertification Voluntary Recertification RequirementsRequirements

150 CME credits during the 3 years 150 CME credits during the 3 years prior to application prior to application 100/150 hours must be Category 1100/150 hours must be Category 1 80/100 Category 1 hours must be directly 80/100 Category 1 hours must be directly

related to practicerelated to practice

Verify that primary laboratory or work Verify that primary laboratory or work environment is accredited environment is accredited

Voluntary Recertification Voluntary Recertification RequirementsRequirements

Written statement documenting medical Written statement documenting medical staff standing staff standing

References from the head of the References from the head of the department or section chief and from department or section chief and from chief of the medical staff chief of the medical staff

Demonstrate membership in Demonstrate membership in appropriate professional organizationsappropriate professional organizations

Recertification ExaminationRecertification Examination

Optional secure examinationOptional secure examination

Computer based, ABP test centerComputer based, ABP test center

May be mandatory if candidate does May be mandatory if candidate does not fully meet the other not fully meet the other requirementsrequirements

Voluntary Recertification vs MOCVoluntary Recertification vs MOC

Requirements differ in degreeRequirements differ in degree CMECME

VR – 150 hours in 3 years prior to VR – 150 hours in 3 years prior to application; application;

100 Category 1 100 Category 1 MOC - 25 hours/yr, all Category 1 AND 1 MOC - 25 hours/yr, all Category 1 AND 1

SAM /yr for SAM /yr for 10 years 10 years 80% of CME related to practice80% of CME related to practice

Voluntary Recertification vs MOCVoluntary Recertification vs MOC

Practice evaluationPractice evaluation VR – licensure, references, laboratory VR – licensure, references, laboratory

accreditation, medical staff standing, accreditation, medical staff standing, quality of practice assessed by quality of practice assessed by referencesreferences

MOC – licensure, references, laboratory MOC – licensure, references, laboratory accreditation, inter-laboratory accreditation, inter-laboratory improvement and QA programs, improvement and QA programs, individual improvement and QA individual improvement and QA programsprograms

Voluntary Recertification vs MOCVoluntary Recertification vs MOC

ExaminationExamination VR – voluntary, (now) secure, combined VR – voluntary, (now) secure, combined

AP and CP questionsAP and CP questions MOC – mandatory, secure, closed-book MOC – mandatory, secure, closed-book

exam, modularexam, modular

Voluntary Recertification vs MOCVoluntary Recertification vs MOC

ConsequencesConsequences VR – failure to meet requirements or VR – failure to meet requirements or

decision not to recertify subsequently decision not to recertify subsequently has no effect on original certification has no effect on original certification statusstatus

MOC – failure to meet requirements MOC – failure to meet requirements results in loss of certificationresults in loss of certification

MOC-Special Circumstance MOC-Special Circumstance PhysiciansPhysicians

Not in active practiceNot in active practice Must complete MOC Parts I, Must complete MOC Parts I,

II, IIIII, III Will not need to complete Will not need to complete

Part IVPart IV

MOC MOC Unanswered QuestionsUnanswered Questions

MOLMOLHospital CredentiallingHospital CredentiallingHealth Plan CredentiallingHealth Plan Credentialling

AMERICAN BOARD OF AMERICAN BOARD OF PATHOLOGY PATHOLOGY

<www.abpath.org><www.abpath.org>