A couple of years ago, physicians around the country were up in arms over the strong arm tactics of their medical boards coercing them to pay for ever pricier exams in order to maintain their board certifications. These monopolistic, non elected board members used their positions of power to enrich themselves and their organizations at the expense of doctors, since many would not be allowed to practice their craft without the precious certificates.
The American Board of Anesthesiology too felt the pressure to reform the process. In response, they developed MOCA 2.0. One of the biggest advances of MOCA 2.0 is the elimination of the once a decade recertification exam. Instead of studying furiously like taking your first written boards, the ABA replaced it with an annual 120 question MOCA Minute. Each quarter, the anesthesiologist is supposed to answer 30 questions to track their progress in maintaining their knowledge base.
This makes recertification a lot less intimidating than taking another do or die exam every ten years. However there were always questions about how the MOCA Minutes were being scored. If you take one exam, it's easy to decide where you fit on the curve and whether you've passed or failed. But how do they score mini exams every quarter over ten years? How do they know if you've been reading your journals and reviewing your texts? Well the ABA has a website for that, and it isn't pretty.
As you can imagine, trying to decide if somebody is maintaining their anesthesia knowledge every three months is quite convoluted. They use something called the Measurement Decision Theory to calculate if you're smart enough to maintain your board certification. It looks something like this:
So if you're one of those slackers in medical school who graduated by the skin of your teeth, how low a score can you get and still satisfy the ABA requirements for maintaining your knowledge base? First of all it's not that hard. Here is my score so far:
Basically our professional careers and livelihoods are now governed by game theory. Whether this is an improvement over the previous one-exam-to-rule-them-all has yet to be determined. In the meantime, download the app and do your quarterly mini tests in the comfort of the operating room during one of those interminable multi hour cases. You'll be finished with your ABA obligations sooner than it takes for the surgical intern to close that skin incision.