Enhancing the value of MOC.

T he 24 member boards of the American Boards of Medical Specialties (ABMS) launched the Maintenance of Certification (MOC) program in 2006. MOC provides reassurance to patients and the public that physicians are actively keeping up with the growth and complexity of medical knowledge. MOC is recognized as a marker of quality by insurers, hospitals, credentialing organizations, and the federal government. The American Board of Nuclear Medicine (ABNM) has required physicians certified since 1992 to recertify every 10 years by passing a secure examination. Since 2007, physicians have also been required to participate in the 4 parts of MOC: professionalism and professional standing; life-long learning and self-assessment; assessment of knowledge, judgment, and skills; and improvement in medical practice. Physicians certified prior to 1992 who do not participate in MOC will not have their life-time certificates revoked and will be listed as “not required” to meet MOC requirements on the ABMS website (www.certificationmatters. org). This site informs the public that a physician is certified and participating in MOC. A complete description of the ABNM MOC program can be reviewed at www.abnm.org. Part III of MOC, which is designed to assess knowledge, judgment, and skills, provokes the most anxiety among physicians. The MOC exam is a 3.5-hour computer-based exam with approximately 130 multiple-choice questions. The MOC exam emphasizes clinical knowledge. Although the ABNM has some sample questions on its website and gives physicians an opportunity to take the resident In Training Examination to prepare for the MOC exam, the board does not provide any specific educational resources. Studying for the MOC exam can be a daunting process, especially for physicians whose practices are limited to specific areas that exclude others, such as adult versus pediatric nuclear medicine or general nuclear medicine versus hybrid imaging. To facilitate studying and increase knowledge, the ABNM has developed a list of key articles that will be the source for approximately 30% of the questions on the MOC exam, as well as the initial certification exam. These key articles will identify core knowledge for all nuclear medicine physicians and provide the foundation for more focused learning. The initial 50 articles were identified by the ABNM. The list will increase to approximately 100 articles with the assistance of the SNMMI. The articles are not meant to cover the entire field of nuclear medicine but to provide the most important and up-to-date information necessary for the practicing physician. The list will be reviewed annually. New articles will be added, and older articles will be replaced with more current information. The list of key articles will enable busy physicians to efficiently keep up to date by identifying the most important and useful articles. It is also hoped that the articles will decrease anxiety about taking the MOC exam and encourage more physicians with lifetime certificates to participate in MOC. Some articles, such as continuing education articles from The Journal of Nuclear Medicine, provide self-assessment credit to enable physicians to meet the Part II MOC requirement for lifelong learning and self-assessment. The eventual goal is to have all of the articles provide Part II credit. Physicians will be able to conveniently earn the average 8 hours of self-assessment credit required per year. Earning self-assessment credit at home will be especially helpful to physicians who are unable to attend professional society meetings because of lack of time or institutional support. It is hoped that these enhancements will increase the common knowledge base of all nuclear medicine physicians, make it easier for physicians to keep up with growing medical knowledge, and encourage more physicians to participate in MOC, which benefits physicians and their patients. If you would like to share thoughts about the enhancements being made to the ABNM MOC program, have additional ideas on how to further improve the program, or want to suggest an article to be included in the list of key articles, please write to [email protected].