Changes Coming to MOC: Will Physicians Get Relief?

Leigh Page


June 05, 2018

In This Article

Old Exams May Linger

Who will use the old exam? Some boards say that they may eventually get rid of it, but a number of them plan to assign the exam to physicians who score poorly on the shorter exams. Also, some physicians may want to continue with the big exam.

"Some people—maybe even myself—are going to still want the 10-year exam," says Smith. He says that in the past he has done well on the ABPN exam, without having to study a great deal for it, and the total number of questions on the new tests, though spaced out over time, will exceed the number of questions on the 10-year exam.

Another neurologist, Kim Monday, MD, of Houston, Texas, thinks that shorter testing intervals are better for neurology. "The specialty has experienced an explosion of knowledge in areas like genetics in the last few years," she says. "Waiting 10 years to be tested is too long." Smith says that he basically agrees with this view.

A Safety Net for Those Who Don't Pass

Even under the old exams, "all boards provide multiple opportunities for physicians to retake the exam," according to a February 2018 statement by the ABMS and its member boards.[25]

But this is not a watertight guarantee, according to Susan T. Hingle, MD, professor in the Department of Internal Medicine at SIU Medicine in Springfield, Illinois. In the ABIM MOC, she says, physicians who take the exam and fail at the end of their 10-year cycle will lose their certification if the next exam date is after the cycle is over. That is one reason why the exams are called "high stakes."

In the new online tests—which are called "low stakes"—boards broaden the safety net somewhat for those who don't pass the exam. Many boards allow one or two failures and then may redirect doctors who don't pass back to the standard exam.

For example, the ABIM directs that physicians who fail two consecutive sessions of the Knowledge Check-In would have to take the traditional 10-year exam from then on.[26]

Under MOCA-Peds, the four lowest-scoring tests are discounted.[12] And low performers in the MOCA Minute would take a new online exam, the Anesthesiology Special Purpose Examination, a 4-hour, computer-based exam with 200 multiple-choice questions.[27]


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