To show evidence of professional standing, the ABPN requires that diplomates must hold an active and unrestricted license to practice medicine in at least one state, commonwealth, territory, or possession of the United States or province of Canada. Such license must be maintained even if the physician is out of the country for extended periods of time. All medical licenses must be unrestricted.

A. Self-Assessment Program
Diplomates of the ABPN are required to participate in broad-based self-assessment activities. Self-Assessment Activities can come from multiple self-assessment programs. Each self-assessment activity must cover new knowledge and/or current best practices in one or more of the competency areas, and provide feedback to the diplomate that can be used as the basis for focused CME, lifelong learning, and/or career development. That feedback must include the correct answer and recommended literature resources for each question, and comparative performance to peers. Beginning in 2014, diplomates are required to use only ABPN- approved products for self-assessment activities.

• At least an average of 8 of the CME credits per year (averaged over 3 years) should involve self-assessment.
• Feedback must include comparative performance to peers.
• Self-assessment examinations must include no fewer than 25 questions per examination and 2 CME credits per activity.
• The self-assessment examination must take place before the activity.
  

B. CME Activities -- Return to top
Diplomates of the ABPN are required to complete an average of 30 specialty or subspecialty Category 1 CME credits per year. CME activities must be accredited by ACCME or by the Royal College of Physicians and Surgeons of Canada, and CME must be relevant to the specialty in which the diplomate is certified. Diplomates certified in more than one area only need to accrue an average of 30 CME credits per year, as the same CME credits can be used to satisfy the MOC requirements for multiple specialties and subspecialties.

• Diplomates must accrue an average of 30 specialty or subspecialty Category 1 CME credits per year (averaged over 3 years).
• At least an average of 8 of the CME credits per year (averaged over 3 years) should involve self-assessment.

Diplomates of the ABPN fulfill the cognitive expertise component by passing a cognitive examination. To sit for a cognitive examination, all current MOC requirements must be satisfied at the time the MOC application is submitted. A passing score on the cognitive examination extends the examination renewal date to December 31, 10 years from the year of the examination. Practice-relevant, clinically oriented, multiple-choice, computer-administered examinations are delivered in over 200 Pearson VUE testing centers throughout the country. To prepare for the MOC cognitive examinations, a diplomate should keep current with research and developments in the respective field, read specialty-specific journals and practice guidelines, and attend relevant CME programs.

MOC Program participation includes meeting all MOC requirements, not just passing the MOC cognitive examination.

The Performance in Practice (PIP) component is a two-part quality improvement program designed for "clinically active" physicians (see definitions below) to participate in practice improvement activities through both chart review and second-party external review. Diplomates will be required to complete one PIP Unit every 3 years, consisting of both a Clinical Module (chart review) and a Feedback Module (Patient/Peer* second-party external review).

If a diplomate participates in an institutional quality improvement program that involves collection of chart data and comparison, and establishment of a plan to improve clinical activity for the individual physician, that institutional participation may also fulfill the Clinical module. If a diplomate participates in peer review in his/her clinical setting, that institutional activity may also fulfill the PIP Feedback Module criteria. Beginning in 2014, diplomates are required to use only ABPN-approved products for Performance in Practice Activities.

A. Clinical Modules (Chart Review) -- Return to top

• Diplomates are required to collect data from at least five patient cases in a specific category (e.g., diagnosis, type of treatment, treatment setting) obtained from the diplomate’s personal practice over the previous 3-year period.
• A minimum of 4 quality measures must be collected for each Clinical Module.
• Each diplomate must then compare data from the five patient cases with published best practices, or practice guidelines, or peer-based standards of care (e.g., hospital quality improvement programs), and develop a plan to improve effectiveness or efficiency of his/her clinical activities.
• Remeasurement: within 24 months, each diplomate must collect the same data from at least another five clinical cases in the same specific category, to see if improvements in practice have occurred. The same patients may be assessed in the original and follow-up data.
  

B. Feedback Modules (Patient** and Peer* Second Party External Reviews) -- Return to top

• Diplomates must solicit personal performance feedback from at least five peers* and five of their own patients** concerning the diplomate’s clinical activity over the previous three years.
• Diplomate must then identify opportunities for improvement in the effectiveness and/or efficiency in their practice as related to the core competencies and take steps to implement suggested improvements.
• Remeasurement: within 24 months, each diplomate must collect the same data from at least another five peers* and five patients to see if improvements in practice have occurred. Feedback may be obtained from the same or different patients and peers as in the original and follow-up feedback.
  

* Peers include other professional healthcare staff such as, psychologists, social workers, physicians, counselors, and nurses. ** Patients can include those for which the diplomate supervises the care of another provider (e.g. resident).. Model MOC PIP Peer Feedback and MOC PIP Patient Feedback forms are available on the Forms page.