What is MOC? Continuous Certification

What is MOC?
The Maintenance of Certification (MOC) Program demonstrates to the public, your peers, and colleagues your
support for continuous quality improvement, professional development, and quality patient care. It is an
integral part of the quality movement in healthcare
and is highly valued by patients and physician colleagues alike. MOC builds on the validity of the initial
certification process and provides a framework for selfregulation by the profession to improve quality of care.
The program embraces the adult learning principles
of accumulated life experience, self-direction, goalorientation, achievability, and respect for diplomates’
achievements.
MOC encompasses the essential competencies involved
in delivery of quality care, which extend beyond medical
knowledge. The MOC Program must be developed and
maintained throughout your professional career. It is designed to evaluate, on a continuous basis, the six essential
competencies (initially developed in residency training) by
means of four parts. The six competencies are:
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Medical knowledge
Patient care and procedural skills
Interpersonal and communication skills
Professionalism
Practice-based learning and improvement
Systems-based practice
MOC uses four parts to evaluate the six competencies:
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Part 1: Evidence of professional standing
Part 2: Lifelong learning and self-assessment
Part 3: Cognitive expertise
Part 4: Practice quality improvement
For more information on the evidence for MOC, go to
www.abms.org/EvidenceLibrary.
Continuous Certification
Status Check for “Meeting Requirements”
How Do I Participate?
Element
Compliance Requirement
The ABR is implementing a new integrated process that
links the ongoing validity of certificates to meeting the
requirements of MOC. Under the new process, known
as “continuous certification,” ABR certificates will no
longer have “valid-through” dates. Instead, on each new
certificate in diagnostic radiology, radiation oncology, or
medical physics, the date of initial certification will be
noted and accompanied by the statement that “ongoing
validity of this certificate is contingent upon meeting
the requirements of Maintenance of Certification.”
Licensure
At least 1 valid state medical license
CME
At least 75 Category 1 CME credits in previous 3 years
SA-CME
At least 25 of the 75 Category 1 CME must be
Self-Assessment CME (SA-CME)
Exam
Passed ABR Initial Certifying or MOC exam in
previous 10 years
PQI
Completed at least 1 PQI project in previous
3 years
Fees
Current with MOC fees at any time during the
previous 3 years
For each diplomate who is a current enrollee in MOC,
continuous certification has replaced the 10-year MOC
cycle. Under the new policy, implemented in 2012, the
total number of MOC requirements will not change.
Progress will be evaluated annually in March, using a
rolling calendar-year “look-back.” The first “full” annual
look-back, including MOC Parts 1-4 and fees, will occur in
March 2016.
How Does Continuous Certification Work?
MOC
Year
Lookback date
Element(s) checked
2012
3/15/2013
Licensure and Exam
2013
3/15/2014
Licensure and Exam
2014
3/15/2015
Licensure and Exam
2015
3/15/2016
Licensure, CME/SA-CME, Exam,
PQI, and Fees
2016
3/15/2017
Licensure, CME/SA-CME, Exam,
PQI, and Fees
2017
3/15/2018
Licensure, CME/SA-CME, Exam,
PQI, and Fees
2018
3/15/2019
Licensure, CME/SA-CME, Exam,
PQI, and Fees
20XX
3/15/20XX
Licensure, CME/SA-CME, Exam,
PQI, and Fees
Part 1:
Evidence of Professional Standing
This part requires valid, unrestricted licensure to practice medicine in all states in which the diplomate holds
active license. A diplomate must report any state board
action against a license to the board within 60 days.
Part 2:
Lifelong Learning and Self-assessment
A minimum of 75 AMA Category 1 CME credits are
required every three years. Of these, 80 percent must
be related to radiation therapy or oncology, with the
remaining 20 percent either in clinically related areas or in
relevant topics such as risk assessment, ethics, statistics,
the processes of continuous quality improvement, methodologies of outcomes measurement, etc.
At least 25 of the 75 Category 1 CME credits must be
self-assessment CME (SA-CME). In addition to ABR
prequalified SAMs, the ABR will count all AMA Category
1 CME activities in “enduring materials” (including
web-based and print) and “journal-based CME” formats
toward the MOC self-assessment requirement. According to the recently adopted AMA policy for CME, these
activities include the following features that suit them
for use as self-assessment tools:
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They provide an assessment of the learner that
measures achievement of the educational purpose
and/or objective(s) of the activity with an established minimum performance level; examples include, but are not limited to, patient-management
case studies, a post-test, and/or the application of
new concepts in response to simulated problems.
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They communicate to the participants the minimum
performance level that must be demonstrated in the
assessment to successfully complete the
activity for AMA PRA Category 1 Credit™.
• They provide a reference to appropriate biblio graphic sources to allow for further study.
Part 3:
Cognitive Expertise
The diplomate is expected to maintain the essentials
of core knowledge fundamental to the practice of radiation oncology. This part requires having passed the
MOC exam or an ABR initial certification exam within
the past 10 years. The exam is proctored, secure, and
computer-based.
The exam is a comprehensive test covering the knowledge base required for the practice of radiation oncology. The examination covers eight clinical content
areas: gastrointestinal cancers, genitourinary cancers,
gynecological cancers, breast cancer, lymphomas and
leukemias, head and neck cancers, pediatric cancers,
and central nervous system tumors. Other topics
include sarcomas, thoracic malignancies, palliation,
radiation and cancer biology, and physics. Radiation
and cancer biology, as well as physics, are related to
day-to-day clinical practice.
Diplomates may take the exam any time it is offered
during the MOC process, including multiple times
if necessary. An exam is offered two times per year.
Diplomates’ practice experience can help them immensely as they take the exam. An exam study guide,
which includes content distribution and sample questions, is available on the ABR website.
Part 4:
Practice Quality Improvement (PQI)
ABR’s MOC Program provides its diplomates with a
robust mechanism for continuous professional development. Through Part 4, MOC also offers a pathway
to participation in practice quality improvement
(PQI). The PQI initiative is a framework to facilitate
improvement of medical care and/or its delivery for
an individual, a group, or an institution. Quality and
safety in medical care have become a national priority, and Part 4 of MOC permits radiation oncologists to
demonstrate both their commitment to this enterprise and, in some instances, their compliance with
associated external requirements.
PQI and the PDSA Process
PDSA stands for “Plan – Do – Study
– Act,” a four-step process commonly used for continuous quality
improvement. This simple but
powerful tool may serve as the
basis for an action-oriented
iterative process by linking multiple
PDSA cycles repeated in sequence. An initial cycle is
performed to obtain baseline data, followed by
subsequent cycles applied to assess the effects of
quality improvement initiatives.
PLAN. Identify an area of your practice judged to be in
need of improvement and devise a measure to assess
the degree of need. Develop a plan to implement the
measure and obtain the required data. Finally, set a
target or goal for the measure to be reached.
DO. Set your plan in motion and collect data.
STUDY. Determine how well your measure compares
to the desired goal. Explore root causes for lacking
goal achievement.
ACT. Consider what can be done to address the root
causes and develop an improvement plan to imple-
ment during the next PDSA cycle. After improvement
plan implementation, begin another PDSA cycle to
assess the degree of any gain achieved. The cycle can
be used continuously until the goal is reached or employed intermittently to document the stability of any
gain achieved. More detailed PDSA information, along
with generic templates that can be used as step-bystep guides in completing your projects, can be found
on the ABR website.
Part 4 (PQI) Frequently Asked Questions
Does radiation oncology have defined topic areas for
PQI projects?
No. Numerous examples of PQI projects are available,
but no specific topic areas have been defined. Please
note that a PQI project is not required to be a research
project for publication.
Useful Links
The American Board of Radiology
www.theabr.org
Maintenance of
Certification
(MOC)
ASTRO Gateway
www.astro.org
(available through your My ASTRO account)
CME Gateway
www.cmegateway.org
ABMS Public Website
www.certificationmatters.org
myABR
https://myabr.theabr.org
For Radiation Oncology
How will my participation be recorded with the ABR?
The ABR has established a personal portal on its interactive website (https://www.myabr.theabr.org) for
each diplomate. Each ABR diplomate should sign in and
“attest” to PQI participation and answer a few questions. Diplomates should keep records of their data and
updated improvement plans in their own secure files.
What documentation is required if I am audited?
The ABR requires a short document that simply outlines the elements of your PQI project: data collection, data analysis, improvement plan, creation and
implementation, and remeasurement.
Is there an approved list of metrics that are acceptable for PQI projects?
The ABR does not publish such a list. Diplomates are
referred to lists of evidence-based and consensus-driven metrics developed by societies and other national
quality-related organizations for their PQI projects.
Please note that the ABR will conduct yearly,
random audits. If you are audited, you will be asked
to submit documentation of your current progress
on MOC Parts 1,2, and 4.
The American Board of Radiology is a Member
Board of the American Board of Medical
Specialties (ABMS):
www.abms.org
MOC Evidence Library:
www.abms.org/EvidenceLibrary
5441 E. Williams Circle, Tucson, AZ 85711-7412
520-519-2152 • Fax: 520-790-3200
[email protected]
08/14