It is very likely that you will come across the acronym “MOC” and hear the term “maintenance of certification,” and wonder what they have to do with CME. The short answer is “A lot!” Here are some questions and answers that will get you on your way to understanding why.

Question: What is “maintenance of certification,” and why is it important?

Answer: All physicians who do not have lifetime certification have to renew their certification on a specific cycle depending upon their certification board. Cycles run from six to ten years. To recertify, in the past, most physicians had to provide evidence of having a current medical license and to pass a test in their area of specialty. That would qualify the physician to continue practice for another six-to-ten year cycle.

The American Board of Medical Specialties (ABMS), the umbrella group over all the certification boards, has now said that this recertification procedure is not sufficient and that physicians must participate in a “Maintenance of Certification” Program. This MOC Program is more rigorous than the old recertification process, and CME providers can assist physicians in working their MOC Program.

Question: What does a Maintenance of Certification Program entail?

Answer: There are four components to a Maintenance of Certification Program. These are as follows:

• Evidence of professional standing
• Evidence of self-assessment and lifelong learning
• Evidence of cognitive expertise
• Evidence of performance in practice

Question: What does “evidence of professional standing” mean?

Answer: “Evidence of professional standing” generally means that a physician must demonstrate to his or her certification board that he or she has a current unrestricted license to practice medicine. Some certification boards have additional requirements like the submission of letters from superiors at work and/or professional colleagues verifying their professional status and expertise. CME organizations cannot assist with this component of MOC.

Question: What does “evidence of self-assessment and lifelong learning” mean?

Answer: CME organizations can definitely assist physicians with this MOC component by offering a self-assessment examination that will assist the physician in planning his or her lifelong learning program and by providing CME activities that cover both all six areas of core competencies and the medical information that will be on the MOC cognitive examination. Because some Boards have not been happy with the CME available to their physicians, they have been mandating that physicians use what they create for their continuing education. This can hurt the CME field tremendously.

Question: What does “evidence of cognitive expertise” mean?

Answer: “Evidence of cognitive expertise” means that the physician must pass a cognitive examination which used to go by the name “recertification examination.” CME organizations can assist physicians in preparing for this examination by providing CME in all areas that are on the cognitive examination. Since most of the MOC exams are given on computer, helping your physicians to understand how to take a computer exam can help too.

Question: What does “evidence of performance in practice” mean?

Answer: “Evidence of performance in practice” is just being now being defined by the 24 ABMS certification boards. Different boards require very different things of their physicians. The best way to learn what the physicians you serve need to do is to go to the web site of the particular certification board(s) to see what is required. Some certification boards are very happy to work with CME providers in developing materials for this area.

Question: Where can I learn more about this important topic?

Answer: The IACME will be addressing this topic from time to time, and the national Alliance for Continuing Medical Education also has resources in this area. Looking at the web site of the American Board of Medical Specialties (www.abms.org) world be helpful as would looking at the web pages of the particular board(s) that serve your physicians.

The IACME message board at Yahoo Groups can address such issues. If you would like further ideas on incorporating core competencies into your CME programming, contact the IACME Communications Committee and then look for future articles on this website.