Maintenance of Certification Introduction   Maintenance of Certification is a quality improvement program in which all the ABMS boards participate, and is the response to the very active and prominent national healthcare quality movement. The main purpose of the ten year MOC cycle is to improve patient care provided by physicians after residency and fellowship and fills a void in the certification continuum. MOC is a program in evolution and changes have already have been made in the ABOto MOC program since its implementation in 2002. Individuals certified in 2002 and thereafter receive certificates that are valid for ten years. Revalidation is accomplished by satisfactory completion of the ABOto Maintenance of Certification Program, which meets the guidelines established by the American Board of Medical Specialties. MOC is an ABMS initiative that varies in implementation detail from board to board, but all MOC programs consist of four parts: 1. PROFESSIONAL STANDING a. hold a valid certificate issued by the American Board of Otolaryngology. b. hold a valid, unrestricted license to practice medicine in all locations where licensed, as defined by ABOto policy. c. hold privileges to practice otolaryngology-head and neck surgery in hospitals or surgical centers accredited by the Joint Commission on the Accreditation of Health Care Organizations or AAAHC, or must provide a letter of explanation why this requirement cannot be met. d. Participants must complete a brief form and submit a fee annually. A penalty fee will be assessed for late submissions. 2. LIFELONG LEARNING AND SELF-ASSESSMENT a. Primary Certification - MOC participants are required to complete a sufficient number of CME credits to meet their state's requirement for licensure for each license held. Sixty percent of the hours must be specifically related to otolaryngology. A few states do not have specific requirements and for individuals in these states, a minimum of fifteen (15) CME credits are required. Random audits will be conducted by the ABOto to assure compliance. It is the diplomate's responsibility to maintain the CME record. or Neurotology Certification - Participants in the Neurotology Maintenance of Certification process are required to complete a sufficient number of CME credits to meet their state's requirement for licensure for each license held. Sixty percent of the hours must be either otology or Neurotology subspecialty related. A few states do not have specific requirements and for individuals in these states, a minimum of fifteen (15) CME credits are required. Random audits will be conducted by the ABOto to assure compliance. It is the diplomate's responsibility to maintain the CME record. or Sleep Medicine Certification - Participants in the Sleep Medicine Maintenance of Certification process are required to complete a sufficient number of CME credits to meet their state's requirement for licensure for each license held. Sixty percent of the hours must be sleep medicine subspecialty related. A few states do not have specific requirements and for individuals in these states, a minimum of fifteen (15) CME credits are required. Random audits will be conducted by the ABOto to assure compliance. It is the diplomate's responsibility to maintain the CME record. b. As of 2010, the participant is required to successfully complete one ABOto self-assessment module in a specialty area of his/her choice per year. Successful completion means achieving a score of 80% or higher on the module which the participant can take more than once. The Self-Assessment modules provide an opportunity for diplomates to assess their knowledge, review the subject, and demonstrate improvement in their understanding of the topic. In addition, each module contains a video panel discussion on controversial areas covered in the module as well as a recommended reading list. Non-MOC participants are encouraged to use the modules to improve their clinical skills. The modules are available at the MOC/BC Decker website. 3. COGNITIVE EXPERTISE For information on the the Maintenance of Certification Exam click here. 1. The Scope of Knowledge Study is the definition of the content for the specialty and will be used for the development of the revalidation examination. 2. MOC participants are required to pass the eighty-question Part III exam during the last three years of their MOC cycle. Each exam consists of twelve questions in Clinical Fundamentals which covers topics all otolaryngologists should know regardless of their practice focus. Clinical Fundamentals includes questions on patient safety, professionalism, emergency airway management, etc. The other questions are in a practice focus area of the participant's choice. The available practice focus areas are: General otolaryngology Facial plastic and econstructive surgery General Otolaryngology Head and neck surgery Laryngology Otology Pediatric otolaryngology/bronchoesophagology Rhinology/Allergy Passing the primary Part III examination, along with completion of the other MOC components, renews the primary certificate for another ten years from the date of expiration. Since the questions in each area are at the primary certification level, passing a practice focus exam does not indicate advanced expertise in that area, and may not be used for advertising or promotional purposes. Neurotology for holders of the Neurotology Subspecialty Certificate. Successful completion of both the core component examination and the Neurotology exam will result in renewal of both the primary and subspecialty certificates. Sleep Medicine for holders of the Sleep Medicine Subspecialty Certificate. Successful completion of both the core component examination and the Sleep Medicine exam will result in renewal of both the primary and subspecialty certificates. 4. EVALUATION OF PERFORMANCE IN PRACTICE The ABOto is developing this portion of MOC which should be available in 2011.