Maintenance of Certification (MOC) is the process through which diplomates of
the American Board of Orthopaedic Surgery can maintain their primary certificate
in Orthopaedic Surgery.
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MOC has been developed in response to external regulatory forces and public
demand. The American Board of Medical Specialties (ABMS) has defined the general
"competencies" of a competent physician. These include Medical
Knowledge, Patient Care, Interpersonal and Communication Skills,
Professionalism, Practice-based Learning and Improvement, and Systems-based
Practice. Each member Board must develop methods to systematically assess these
competencies on a periodic basis as part of the maintenance of certification
process.
The ABOS MOC program will address these general competencies using the four
components specified by the ABMS.
These Components are:
- Evidence of Professional Standing
- Evidence of Life-long Learning and Self-Assessment
- Evidence of Cognitive Expertise and
- Evidence of Performance in Practice
Please refer to additional information at
www.abms.org for a detailed
description of the deliberations that have led to the development of MOC.
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The current recertification process includes evaluation of professional
standing, a minimum of 120 Category 1 Continuing Medical Education credits, and
a secure examination to test cognitive knowledge. In addition, ongoing learning
and continuing efforts to improve practice are part of the description of the
competent physician. All Member Boards of the ABMS are developing programs by
which diplomates will demonstrate continuing participation in these areas.
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The ABOS will evaluate a competent physician through the MOC program using
the four components as follows:
- Evidence of Professional Standing will require that the diplomate
maintain a full and unrestricted license to practice medicine in the United
States or Canada.
- Evidence of Life-Long Learning and Self-Assessment will be
addressed through on-going three-year cycles of 120 credits of Category 1
Orthopaedic or relevant Continuing Medical Education (CME) that include a
minimum of 20 CME credits of Self-Assessment Examinations (SAE).
- Evidence of Cognitive Expertise will occur through a secure
examination, as is currently in place for recertification.
- Evaluation of Performance in Practice will include a stringent
peer review process and a few performance indicators: sign your site,
preoperative antibiotics, informed consent and postoperative
anti-coagulation.
The Credentials Committee currently collects peer review data on
recertification candidates. This process will be expanded to include patient
questionnaires that address doctor-patient communication skills as well as
patient satisfaction. The ABMS is currently developing these questionnaires for
use by all ABMS Member Boards.
In addition, the diplomate applying for a computer-based test will submit a
three-month case list, and the diplomate applying to take the oral examination
will submit a six-month case list to the Credentials Committee. This information
will also be used to develop a database about the practice of Orthopaedic
Surgery in this country. Aggregate data will be provided to the diplomates for
comparison with their own practices.
The QI(Quality Improvement) focus of the 4th component of MOC will begin to
look at diplomates’ participation in programs and practices to deliver
better and safer patient care.
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A diplomate must hold a full and unrestricted license to practice in all
states and jurisdictions where he/she holds a license.
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Ongoing continuing medical education is a part of every diplomate
professional life. Documentation of a minimum of 120 credits of category 1 CME
is required during the three years prior to application for the MOC
credentialing and testing. In addition, documentation of a second three-year
period of CME/SAE will be required when the full 10 year MOC cycle is in place,
starting with the Diplomates of 2017.
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Although there are different forms of continuing medical education, only
Category 1 CME is acceptable to meet the MOC requirements. For MOC purposes, CME
must be topically related to Orthopaedics or Orthopaedic subspecialties. These
topics are broadly defined to include topics such as infection, medical
management of orthopaedic complications, risk management and others. In
addition, the ABMS has specified that Ethics, Professionalism, and Patient
Communication, and Cultural Competency are areas that must be addressed. Credit
will also be allowed for CME required by individual state Medical Licensing
Boards.
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