The world of maintenance of certification as imposed by the American Board of Medical Specialties is facing a backlash as never before. Following the spectacular expose published in Newsweek about the greed and impropriety at the American Board of Internal Medicine, in which millions of dollars were paid out in executive salaries, real estate, and first class air travel, hundreds of doctors rose up in protest. In a surprising turnaround, the ABIM apologized for the excessive burden that the MOC has become and promised to reform the process.
Every physician wondered which medical board would follow the ABIM's changes. Now the American Board of Anesthesiology has decided that its MOCA program also needs to be changed. In an email to anesthesiologists yesterday, the ABA calls its new program MOCA 2.0.
MOCA 2.0 has several major modifications from 1.0. One of the biggest is the removal of the much despised simulation exam. This portion is hugely disruptive to most anesthesiologists, requiring them to spend thousands of dollars for the exam, travel to a simulation center, and time spent studying for and taking the test. It was one of the most divisive tests ever devised by the ABA and the ABMS, no matter how popular the organizations claim the simulations are. I count myself as one of the lucky ones who was first board recertified before the simulation was enacted and now it is being abolished before my next recertification. Hallelujah. There will be no tears shed for the end of this monstrosity.
Next, the recertification exam itself is gone. Can you believe it? No more exams again, EVER! Instead, the ABA has instituted an online program called MOCA Minute. Once a week, the ABA will post a question on its website that had the highest failure rates during certification exams. The user will have one minute to answer the question. If they answer the question incorrectly, there will be a brief explanation of the answer but it doesn't count against anything. No punishment. No repeating another question. The diplomate will have to answer 30 questions per calendar quarter or 120 per year. They can be bunched up together so one doesn't have to log in every week. But the ABA will only count 30 per quarter even if you answer more. This prevents people from doing all their requirements at the end of the year. The MOCA Minute does not replace the CME requirements that are already a part of MOCA or for your state medical licensure.
MOCA Part 4, or the Improvement in Medical Practice, is still evolving. This portion has always been nebulous in its requirements and implementation. They are withholding details of the new system for now.
Has the ABA also changed the cost of participating in MOCA? Yes and no. Thousands of dollars have now been saved by eliminating the simulation exam. But the ABA still expects one to pay $2,100 to be recertified. Instead of paying it all at once to take the exam, now they want to extract $210 every year for ten years. Credit cards accepted.
What hasn't changed? The need to be board certified by the ABA in the first place. Many lifetime certified physicians are still incensed that their certificates now read certified but not participating in MOC on the ABA's website, an asterisk in a perfectly legitimate career. Even these new changes will not appease doctors who feel any extra work to maintain their certificates is overly burdensome. These are the people who are flocking to the alternative certification program NBPAS. But for now, the removal of the recertification exam and the simulation is a huge step forward. Hopefully the ABA will continue to be responsive to the outcry of its members for simplification of a process that has huge implications for their livelihoods.