Changes Coming to MOC: Will Physicians Get Relief?

Leigh Page


June 05, 2018

In This Article

The ABIM Model of Short Exam

The ABIM has developed a different kind of short exam, called the Knowledge Check-In. Physicians will take an online test every other year on their computer. While you can answer one or two MOCA Minute questions at a time, the Knowledge Check-In involves answering 90 questions in one sitting, which is expected to take 2-3 hours.

Unlike in the MOC exams, you can use one outside resource for the Knowledge Check-In: UpToDate, a well-known clinical decision-support resource. The American College of Physicians reports that you will be told right away if you pass or fail the exam, but more detailed feedback will come 2 or more weeks later.[16]

The rollout for the Knowledge Check-In, which starts in June, will be by far the largest of any of the new tests and will last through 2020. In all, there are 250,000 ABIM physicians, including general internists, cardiologists, gastroenterologists, and many other internal medicine subspecialists, and they represent 28% of all doctors certified by ABMS boards.[17]

Due to the 10-year MOC cycle—which will continue even as the 10-year exam is sidelined—only roughly one tenth of ABIM physicians will be choosing the new test when it opens in their subspecialty. The rollout starts with general internists and nephrologists in 2018 and then continues with eight more subspecialties in 2019 and nine final ones in 2020.

Other Boards With the Basic ABIM Approach

Based on limited information about the new tests, four other boards appear to follow the basic approach of Knowledge Check-In—providing one test all at once or in a limited period of time:

American Board of Surgery (ABS): The new assessment, which will start with general surgeons in 2018, involves 40 questions and must be taken every 2 years. You need to get 80% correct to pass it.[18]

American Board of Orthopedic Surgery (ABOS): The new Web-Based Longitudinal Assessment will be taken once a year, starting in January 2019. You have to answer a total of 120 questions correctly by the end of year six.[19]

American Board of Plastic Surgery (ABPS): In the ABPS Knowledge Check-In, which starts in 2019, physicians answer 200 questions each year during the month of April. The test runs for 8 years of the 10-year MOC cycle.[20]

American Board of Emergency Medicine (ABEM): The frequency of this new online test, which starts in 2020, has not been announced yet, but it appears to be spaced like the Knowledge Check-In. Each test will last an hour and will focus on one or more content areas. You can retake the test if you don't pass. The ABEM's ConCert recertification exam will continue.[21]

Models Based on Reading Journal Articles

Several boards are introducing online assessments that involve reading a number of designated journal articles and then answering questions about them. The American Board of Obstetrics and Gynecology (ABOG) has been doing this for years in a Part II activity and is now using this approach in its new assessment, which was launched in 2016.

In the ABOG pilot, physicians receive a list of at least 50 papers from the current medical literature three times a year. They must choose 30 of them and correctly answer four questions per article on an online assessment tool.[22]

At least three other boards are using this model:

American Board of Psychiatry and Neurology (ABPN). A. Gordon Smith, MD, chair of the Education Committee at the American Academy of Neurology (AAN) and chair of the Department of Neurology at Virginia Commonwealth University in Richmond, Virginia, says that the ABPN is using this general approach for its exam alternative, which starts its rollout in January 2019 with general psychiatry and general neurology. In the ABPN approach, physicians read 30-40 journal articles and answer five questions per article.[23]

American Board of Ophthalmology (ABOp). The board has opted for a hybrid approach in its new online test, called Quarterly Questions, which was launched in 2017. Physicians get 50 new questions per year, 10 of which are article-based.[24]

The American Board of Allergy and Immunology. This board will use journal articles in its new online test, called the Continuous Assessment Program, which is due to start in 2018. Physicians will receive 40 questions that they can answer over a 6-month period.[22]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.