FAQs for Permanent Certificate Holders
Based on the new Maintenance of Certification (MOC)
requirements, will my certification status change?
No. The American Board of Pediatrics (ABP) awarded
certificates without an expiration date in good faith, and those
certificates will not change.
What are time-limited certificates?
Time-limited certificates are those that expire based on
Beginning May 1, 1988 (with the exception of the
subspecialties of Pediatric Critical Care Medicine and Pediatric
Pulmonology, which began with time-limited certification as new
subspecialties in the mid-1980s) ABP certificates had to be
renewed every seven years. This recertification process was
accomplished by passing an open-book, at-home examination. In
2003, this policy was changed to include a secure examination
administered at testing sites every seven years. The
recertification process has now evolved into the Maintenance of
Certification (MOC) program, only one part of which is a secure
What is Maintenance of Certification (MOC)?
The MOC program is a four-part process that assures the
public of your competency in the field of pediatrics. Your
professionalism is demonstrated by:
- your unrestricted license to practice medicine (Part 1)
- your medical knowledge is current because you engage in
self-assessment and learning activities (Part 2),
- passing a secure examination (Part 3),
- your active involvement in measuring and improving the
quality of patient care (Part 4).
Why is the new MOC program necessary?
The 1990s were the beginning of a conscious and concerted
effort by those both inside and outside the medical profession
to begin to systematically evaluate the quality of delivered
medical care. It also became necessary, to codify the reasons
for inadequate care and medical error, and to make
recommendations for system-wide improvement. Health service
researchers began to document widespread unexplained variation
in care delivered, even by board-certified physicians. In
addition, the Institute of Medicine (IOM) published the
summaries of phase 2 of their Quality Initiative project. The
publication of To Err is Human: Building a Safer Health
System (1999) and Crossing the Quality Chasm: A New
Health System for the 21st Century (2001) received
widespread and immediate public attention. The IOM also made
specific recommendations for change, including the goals that
care should be safe, effective, efficient, equitable,
patient-centered, and timely. These two reports accelerated
calls for change in medical education, how care is delivered,
and how certified physicians are evaluated throughout their
During this same period, the Accreditation Council for
Graduate Medical Education (ACGME) and the American Board of
Medical Specialties (ABMS) jointly identified the areas in which
a physician must be competent to practice quality medicine. Six
core general competencies were eventually defined. These
measurable competencies (patient care, medical knowledge,
professionalism, systems-based practice, practice-based learning
and improvement, and interpersonal and communication skills)
were adopted in 1999/2000. The implementation, measurement, and
mastery of these competencies have been endorsed by all of
organized medicine and now define a competent physician. The
four parts of the ABP MOC program measure these competencies and
allow the ABP to assure the public, licensing boards, payers,
and others that Diplomates meet these new standards. Because
maintaining certification is a commitment to quality and
influences better care, the ABP is committed to making MOC a
benchmark standard that fulfills multiple requirements for
licensing, accreditation, and hospital credentialing.
How does MOC affect initial certification and subsequent
It affects the concept of certification and recertification
in a very important way. Beginning in 2010, with the
introduction of the fully developed MOC program, the concept of
recertification as previously structured will cease to exist.
The more continuous evaluation process is known as Maintenance
of Certification (MOC). Certification beginning in 2010 is
contingent upon pediatricians fulfilling the requirements of the
four-part MOC program. Parts 1, 2, and 4 requirements are
completed every five years. Part 3, the secure examination, is
required every ten years. If these MOC requirements are not met,
ABP certification will end. In 2010, the ABP will recognize two
categories of pediatricians: those who have permanent
certificates; and those who are certified and have met the
current requirements of the MOC.
Do other Boards have similar MOC programs?
Yes. The American Board of Medical Specialties (ABMS) boards
have MOC programs based on the same four part model.
Why should I be involved in MOC when I remain certified
by the ABP?
Groups outside the ABP are less likely to accept a credential
awarded 10, 20, or more years ago as evidence of your current
ability to provide quality medical care. For example, state
licensing boards are considering requiring physicians to
participate in Maintenance of Licensure (MOL), a program that
will include a secure examination. The Joint Commission has
strongly encouraged hospitals to show evidence that they are
measuring the six core competencies of their medical staff every
two years as part of the credentialing process. In addition,
payers are beginning to require similar evaluations. There are
also pay-for-performance models that require evidence of
continuous participation in an ongoing evaluation of
professional competence for inclusion in their process.
How will participation in MOC help me fulfill
requirements related to hospital credentialing and insurance company
The American Board of Medical Specialties (ABMS) and the ABP
are working hard to ensure that outside groups, organizations or
other regulatory agencies that need to measure a physician's
competence can successfully utilize the MOC program as the gold
standard within the medical industry. For specific examples, see
How MOC is Recognized.
If I choose to participate in the MOC program, will I be
No. The term "recertified" will no longer be used by the ABP
except to document the prior history of a specific pediatrician.
Effective January 1, 2010, the ABP will recognize two categories
of diplomates: those who have permanent certificates; and those
who are certified and have met the current requirements of MOC.
If I choose not to participate in MOC, how will I be
You will never lose the designation of an ABP Certified
Diplomate. Your name will not, however, be listed as "meeting
the requirements of the MOC program" on the ABP Website and will
not be used when written confirmation of such participation is
How do I get started in MOC if I have not recertified?
The first requirement is that you take the secure Part 3
examination (either the general pediatrics examination or the
examination in your subspecialty). You will then be eligible to
enroll and participate in the MOC program and may choose to
fulfill the other parts of the MOC program in the next five
years. A successful examination is valid for ten years.
What is the Part 3 examination like?
The examination measures pediatric clinical expertise and the
knowledge that a pediatrician in practice (general or
subspecialty) possesses without the use of reference materials.
The examination is designed and developed by your peers and is
independent of the initial certification examination. The
subject areas being tested are shared with the American Academy
of Pediatrics (AAP) and are used by the AAP PREP Committee in
designing educational materials. Also, the general pediatrics
self-assessment module available on the ABP Website is an
example of what the examination is like and its degree of
What if I don't pass the test? Will I lose my
No. Your certification status will not be affected if you
fail the examination. Failure will remain confidential and you
can retake the examination an unlimited number of times within
one year of your application.
What happens if I pass the MOC examination and then
decide not to do the other parts of MOC?
Your examination will still be valid for ten years and your
certification will not be affected by your decision. You will
not, however, be designated as "meeting the current
requirements" unless you are enrolled in MOC. You may enter the
MOC program at any time during the next ten years by fulfilling
the re-entry MOC requirements.
Why should I begin the program in 2011?
Permanent certificate holders will have a unique opportunity
to enter the MOC program before the program is fully
implemented in 2010. If you pass the Part 3
examination in 2011, your examination fee includes access to the
ABP MOC activities at no additional charge. Your name will be
listed as "meeting the requirements of MOC" on the ABP Website
and in response to inquiries made to the ABP by hospitals,
payers, state licensing boards, and the public through 2014.
What happens if I choose to start in 2011, but then do
not fulfill the other requirements of the MOC program by December
Your permanent certificate will not be affected. However,
beginning in 2015, you will lose the designation of "meeting the
current requirements of MOC" until you re-enter the full MOC
program. Your successful Part 3 examination will be valid until
2019. Remember, the activities you need to continue the program
can be completed at no additional cost to you for the first
five-year MOC cycle.
What happens if I decide to enroll in MOC after 2010?
If you enroll in MOC in 2010 or later, you have 2 years to
pass the examination. In addition, you'll need to submit valid
licensure, complete 100 points in Parts 2 and 4, and one patient
survey during the same 2 year time period. Your designation as
an active participant will begin as soon as you meet all
requirements. This requirement is the same as those who have let
their certification lapse and want to become certified again.
I have taken a recertification examination in the past.
Will I have to take another if I want to enter the MOC program?
If you have passed the examination within the past
ten years, you will not have to
re-take an examination to enter the MOC program. Your
recertification examination will be valid for ten years from the
date of the examination. If you have passed the recertification
examination within five years, there will be no additional
charge for entering MOC in 2011.
What does my 2011 examination fee include?
Your fee includes access to the examination and once you pass
it, the designation that you have "met the current requirements
of MOC" until the end of 2014. At that time, you'll re-enroll in
MOC and pay a fee. That fee will include access to your next
Part 3 examination in 2019 at no additional
charge. In 2015, your new MOC cycle begins.
What is the fee to enroll in MOC?
In 2011, the fee will be $990. Fees are adjusted annually. If
you have paid for an examination in the past five years, there
will be no additional charge to enroll in MOC.
How much time will all this take?
That depends on the individual. If ABP activities are used,
it is estimated to take about 15 hours a year. If you are
involved in an ABP-approved collaborative quality improvement
project as a Part 4 activity, you are already participating
(without getting credit) in an MOC activity. If you routinely
use PREP, you have already participated in a Part 2 activity.
The secure examination is one half day.
Will I receive Continuing Medical Education (CME) credit
for participation in MOC?
Many of the MOC activities are approved for CME credit. The
American Medical Association (AMA) grants CME credit for
completion of the secure examination.
Are the requirements for MOC likely to change
significantly over time?
While the ABP acknowledges your permanent certification
status, it cannot assure you that the MOC requirements will not
change. MOC will evolve yet the ABP has a place in the process
that continuously assesses the competencies of our diplomates.
The ABP will continue to make its MOC program the standard by
which others can, and will, measure our certified pediatricians.
We will continue to improve the process with the help of our
members and diplomates.