Continuing Certification

Commission Report/ABMS Action Plan

The American Board of Anesthesiology (ABA) diplomate community received an email from me last month about the Continuing Board Certification: Vision for the Future Commission report and the subsequent American Board of Medical Specialties (ABMS) action plan.

We recognize that your first professional priority is caring for your patients, closely followed by tackling the ever-growing administrative tasks we must complete in any given week. So, you may not be paying attention to the Commission report or ABMS’ response to it.

But you should. Here’s why.

The Commission’s recommendations affect you, me and all of our colleagues in anesthesiology. What ABMS does with the recommendations has a direct impact on board-certified anesthesiologists because it will chart the trajectory for continuing certification.

As I mentioned in my recent email, our Board has been on a journey for the last several years to enhance MOCA, making it more relevant and less burdensome for diplomates. We believe the roadmap we’re following aligns with the Commission’s recently issued vision. Here’s how:

The Commission recommends that continuing certification programs integrate professionalism (Part 1), lifelong learning (Part 2), assessment (Part 3), and advancing practice (Part 4) – the four components of the MOCA Program. We agree.

While we do not produce CME, we’ve created tools to help diplomates find relevant CME based on their MOCA Minute performance, integrating the assessment and lifelong learning components. Diplomates may use their Knowledge Assessment Reports (KAR) to link to relevant CME related to incorrectly answered questions. They may also search our CME Explorer, which we developed with our colleagues at the Accreditation Council for Continuing Medical Education to serve as a repository of CME activities developed by third-party providers.*

These tools – the KAR and CME Explorer – personalize the program by guiding each diplomate to learning resources that will be most beneficial in practice rather than having only generalized CME requirements that may not suit their learning needs.

ABMS has committed to develop new, integrated standards for continuing certification programs by 2020. These new standards will address the Commission’s request for greater flexibility, consistency across the Member Boards, and feedback to diplomates.  The ABA welcomes efforts to provide consistent goals for physician certification while allowing the Member Boards the flexibility to develop certification standards and tools that best suit physicians’ areas of practice.

The Commission also recommends that Member Boards incorporate longitudinal and other innovative, formative assessment strategies into continuing certification programs. We did so when we launched MOCA Minute in 2016. We are further along than others in the Member Board community and we continue to explore new ways to adapt technology to promote learning through convenient and meaningful assessment.

We’re hoping to further enhance MOCA’s value by sharing de-identified aggregate data about diplomates’ MOCA Minute performance with CME providers to guide the development of future learning resources. We are developing the infrastructure to support greater collaboration, including developing a dashboard that can inform CME providers of high-priority topics in need of additional educational tools.

The Commission recommends that the Member Boards facilitate independent research to demonstrate the value of continuing certification. We remain committed to doing so. We’ve published several studies that demonstrate the efficacy of initial certification and MOCA 1.0, and are continuing to broaden our research agenda to explore the effect of MOCA 2.0 on physician knowledge retention and patient outcomes.

The Commission also recommends that Member Boards facilitate voluntary re-engagement of non-time limited or lifetime certificate holders in the continuing certification process. We believe that all practicing clinicians benefit from participating in MOCA 2.0 and continue to solicit our lifetime certificate holders to voluntarily participate. Thirty-six percent of our non-time limited diplomates are participating and we will continue to encourage more to join them. We are also reviewing how we display the status of lifetime certificate holders in our Diplomate/Candidate Directory to help the public better understand our diplomates’ certification status, including whether they are participating in continuing certification.

While we’d like to get all of this done quickly, we’d much rather get it done right. Building a better continuing certification program is an evolutionary process. We’re committed to working together with the anesthesiology community to make meaningful changes that add value to the diplomate experience.

Let us know what Commission recommendations or ABMS action items we should focus on first, and how we could encourage greater diplomate engagement in our journey forward.

*The ABA does not financially benefit from diplomate participation in CME activities.

About the Author

Dr. Culley is an attending physician and vice chair of research at the Brigham and Women’s Hospital in Boston and an associate professor of anesthesiology at Harvard Medical School in Boston. She is secretary of the ABA’s Board of Directors and serves on the Board’s Credentialing and Continuing Certification and Research Committees.



  1. We recognize professionalism as a core value for becoming a physician and being board certified yet there is little discussion about what constitutes professionalism. We actually are much better at recognizing unprofessional behavior than professional behaviors which we take for granted. We assume it is inherent in a persons DNA and arrives when one becomes a doctor or gets board certified yet we see behaviors all around us daily that we would consider unprofessional and are detrimental to those who exhibit them. It might be useful to hear/read some of the senior members of the anesthesiology communities’ views on professionalism and to perhaps generate a discussion about this topic.

  2. you are certainly right you are never recognized when you are professional yet if people try to make you the target of criticism if you don’t conform and will jump on a witch hunt to comment on unprofessional will eventually ruin a person.

  3. While the ABA does not financially benefit from CME above the table, the fees for testing, MOC, and “consulting work(selling information about tests) makes being an ABA member the most financially rewarding retirement job ever. I withdrew from the ASA and all societies and am writing a book about the loss of ethics in Medicine.

  4. The Commission has recommended implementation of longitudinal and other innovative assessment strategies for MOC. — What focus, if any, has there been on sub-specialty board re-certification for co-sponsored diplomates (e.g. Sleep Medicine–co-sponsored by ABIM)? The ABIM will offer an alternative option to the Sleep Medicine re-certification examination in 2020 to their diplomates, as does Neurology and Psychiatry, however it appears that the ABIM, as the ABA’s co-sponsor, may not extend this option to anesthesiologists who are dual boarded in Sleep Medicine?? How can that be possible and is there any explanation as to why ABIM should be able to extend this option to their diplomates but deny it to anesthesiologists?

    1. Dr. Stierer,
      We’ve reached out to ABIM to inquire about offering the Knowledge Check-In to diplomates of co-sponsoring boards and are awaiting a response. We support your position. We piloted offering MOCA Minute – Pain Medicine to diplomates of co-sponsoring boards this past summer and will make it available in 2020. Having gone through the process of developing the technical infrastructure to offer MOCA Minute to diplomates of co-sponsoring, we understand that it requires close collaboration between the boards and some investment. In time, we believe that the Member Board community will mature its longitudinal assessment opportunities, making them available to all diplomates regardless of their primary board. This kind of development will take time, but we’ll be sure to keep our diplomates informed as we learn more from our collaborating boards.