Maintenance of Certification

What is Maintenance of Certification?

In an effort to assure the public that board-certified specialists have remained current with evolving knowledge, that their practices meet acceptable standards, and that they are recognized and respected as specialists by their patients and peers, the 24 Member Boards of American Board of Medical Specialties (ABMS) agreed to evolve their recertification programs to one of continuous professional development – ABMS Maintenance of Certification® (ABMS MOC®). ABMS MOC assures that the physician is committed to lifelong learning and competency in a specialty and/or subspecialty. MOC is also a professional response to the need for public accountability and transparency. Through MOC, physicians demonstrate that they can assess the quality of care they provide compared to peers and national benchmarks and then apply the best evidence or consensus recommendations to improve that care.

Beginning in 2002, all American Board of Otolaryngology (ABOto) diplomates must participate in MOC which was developed to assist with staying up-to-date in the specialty. The MOC program, when fully implemented, is a ten year cycle which involves annual updates on the individual diplomate, self-assessment, evaluation of performance in practice, and an examination the diplomate must pass to renew his/her certificate.

The MOC process is founded on six core competencies for quality patient care. These core competencies were first adopted by the Accreditation Council for Graduate Medical Education  (ACGME) and later by the ABMS. For details regarding the competencies, please refer to ABMS webpage on MOC Competencies and Criteria.

The MOC program is divided into four parts, or components, that are designed to measure the six core competencies mentioned above. Details of each component are as follows:

1. Professional Standing

The ABOto requires all MOC participants meet their state medical board’s requirements for CME. These vary from 0 to 50 CME units per year. Participants licensed in states that have no CME requirements are required to obtain at least 15 CME units, 60 percent of which must be in otolaryngology. MOC participants sub-certified in Neurotology or Sleep must obtain 60 percent of their credits in those specialty areas (Otology and Neurotology for those sub-certified in Neurotology). See AMA’s webpage on State Medical Licensure Requirements for further information.

All diplomates interested in recertification must:

1. Hold a valid certificate issued by the American Board of Otolaryngology.
2. Hold a valid, unrestricted license to practice medicine in all locations where licensed, as defined by ABOto policy.
3. 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.

2. Lifelong Learning and Self-Assessment

The ABOto is in the process of developing its first self-assessment module. As this and other modules are developed, MOC participants will be expected to complete the requisite number of modules over the 10 year MOC cycle.
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 - Neurotology Subspecialty certified individuals need only participate in the Neurotology MOC program to maintain the primary and neurotology certificates. 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 - Sleep Medicine Subspecialty certified individuals need only participate in the Sleep Medicine MOC program to maintain the primary and sleep medicine certificates. 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.

3. Cognitive Expertise

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, which will be conducted in a secure, proctored environment and will be subject to psychometric and statistical analysis.

2. Candidates will be required to complete a core component examination which includes knowledge fundamental to the practice of otolaryngology-head and neck surgery, as well as knowledge of practice environment issues such as quality assurance, safety, regulations, ethics of practice, professionalism, legal and reimbursement issues, AND one module, to be selected by the candidate, which focuses on a specific area of otolaryngology. The planned modules are:

• General otolaryngology
• Rhinology
• Facial plastic and reconstructive surgery
• Allergy
• Head and neck surgery
• Otology
• Pediatric otolaryngology/bronchoesophagology
• Laryngology

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

This area remains under development.