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The implementation of MOC has raised many questions from Diplomates. We will attempt to provide answers to the most common ones below. If you have additional questions, please email moccoordinator@abu.org.

The Trustees of the ABU are in the process of developing policies and guidelines for MOC implementation, in conjunction with the ABMS. Since MOC is an evolving process, some of the information below may change as implementation progresses. Further details will be posted here as they are finalized.

What is Maintenance of Certification?

Maintenance of Certification (MOC) is an initiative of the American Board of Medical Specialties (ABMS) aimed at insuring that physician specialists who are certified by one of the 24 member boards of the ABMS offer quality patient care through an ongoing process of self-improvement. MOC entails four basic components. Completion of these components allows Diplomates of the ABU to maintain their general certification in urology and any urologic subspecialty certification. 

Why did the ABMS feel it necessary to develop MOC?

Two publications by the Institute of Medicine (IOM), “To Err is Human” and “Crossing the Quality Chasm”, as well as a number of studies published in the literature, identified the need to improve medical care. In response, in 1998-1999, the ABMS and the Accreditation Council for Graduate Medical Education (ACGME) established the framework of the MOC program.

What are the components of MOC?
  1. Professional standing (licensure and peer review)
  2. Lifelong learning (continuing medical education)
  3. An examination to determine basic knowledge
  4. Practice performance assessment (review of practice logs and Practice Assessment Protocols (PAPs))
What is the framework of the MOC program?

The MOC program is built around the six core competencies for physicians: patient care, medical knowledge, practice-based learning and improvement, interpersonal and communication skills, professionalism, and systems-based practice. Recognizing that not all of the competencies can be mastered during specialty training, the MOC program promotes lifelong self-assessment and improvement efforts after initial certification requirements have been met.

How does the ABU address the core competencies of MOC?

The ABU evaluates Diplomates through the MOC process using the following components:

  • Evidence of Professional Standing is addressed through the maintenance of an unrestricted license to practice medicine.
  • Evidence of Self-Assessment is demonstrated by the completion online of a Practice Assessment Protocol (PAP) four times during the 10-year MOC cycle. See the block diagram for timing.
  • Evidence of Lifelong Learning is shown by the completion of 90 hours of urology-focused continuing medical education (CME), 30 hours of which must be Category 1 as defined by the American Urological Association, twice during the 10-year MOC cycle.
  • Evidence of Performance in Practice is demonstrated through the completion of a 6-month electronic practice log during year 7, 8, or 9 of the 10-year MOC cycle.
  • Evidence of Cognitive Expertise is demonstrated through a secure computer-based, closed-book examination during year 7, 8, or 9 of the 10 year MOC cycle.
Is participation in MOC mandatory?

While Board Certification is voluntary, MOC is a requirement for all Diplomates who were originally certified in 1985 or later and have time-limited certificates in order to maintain their certification.

If a time-limited Diplomate earns a subspecialty certificate, the original urology certificate will be extended to have the same expiration date as the subspecialty certificate. The Diplomate will not be required to enter the recertification process, but will enter the MOC process as of completion of subspecialty certification, and will be required to complete all components on that schedule.  

All Trustees of the Board are required to participate in MOC during their tenure on the Board, even those with time-unlimited certificates.

Does a time-unlimited certificate exempt a Diplomate from participation in the MOC program?

Diplomates who were originally certified before 1985 and have time unlimited certificates will maintain those certificates as time-unlimited. However, if the Diplomate also earns a subspecialty certificate, the Diplomate will enter the MOC process for the subspecialty certificate. 

Participation in the MOC program is not required for Diplomates with time-unlimited certificates; however the Diplomate may choose to enter the process at any time. Requirements for hospital credentials may require evidence of continuous certification efforts. In addition, some states are considering the implementation of Maintenance of Licensure programs, similar to the MOC program.

If the Diplomate with a time-unlimited certificate fails the MOC computer-based examination, the original time-unlimited certificate remains in effect.

 Will MOC replace recertification?

The MOC program will replace recertification by 2019, by which time all time-limited Diplomates will have completed the recertification process and will have entered MOC upon completion of recertification.

If I do not participate in the MOC program, will I still be Board-certified?

If you do not participate in the MOC program, you will still be Board-certified if you hold a time-unlimited certificate. All ABU certificates issued after January 1, 1985, are time-limited and expire ten years from the year of certification. Holders of time-limited general urology certificates and holders of subspecialty certificates are subject to completion of all components of the MOC program by specified deadlines in order to maintain their Board certification.

What are the consequences if a Diplomate fails to complete the requirements of MOC before the deadline?

A Diplomate is required to make application to the MOC process in Level 1 two years after successful completion of certification, recertification or subspecialty certification. Certification is contingent upon the Diplomate completing the required elements of MOC according to schedule, so if the Diplomate has not entered the process by Level 2, the Diplomate will no longer be certified.  Requirements to re-enter the process are outlined in the current handbook  .

When do I begin the MOC process?

Beginning in 2007, all Diplomates with time-limited certificates will enter into the MOC process in the year when they are certified or recertified. For example, those Diplomates whose original certification or recertification expires in 2016 will need to complete Level 1 of MOC in 2018. Those Diplomates whose original certification or recertification expires in 2017 will need to complete Level 1 of MOC in 2019. Those Diplomates whose original certification or recertification expires in 2018 will need to complete Level 1 of MOC in 2020. Letters with usernames and passwords to access the website will be mailed to the Diplomate in May of the year they are required to enter a process.

How will I know when I have to do something?

The office of the American Board of Urology will notify Diplomates holding a time-limited certificate when each phase of MOC is required. At that time the handbook, Information for Applicants for Maintenance of Certification, detailing the MOC process, will be available here. If you are unable to access the handbook online, please call the ABU office at 434/979-0059.

It is the responsibility of the Diplomate to keep the ABU informed of any change of address information.  

What will I have to do?

The components of MOC are similar to the components required for Recertification. Diplomates will be required to periodically complete self-assessment programs developed by the Board, meet continuing medical education requirements, and submit a practice log as part of this process. Successful completion of an examination will be required within the two year period prior to expiration of the Diplomate’s current certificate.

The first level of MOC will include submission of an online application, verification of an unrestricted medical license, and completion of an online Practice Assessment Protocol (PAP) in an area of their practice. Requirements for Levels 2, 3, and 4 include verifying unrestricted medical licensure, completion of further PAPs; completion and documentation of CME credits, satisfactory peer reviews, and an adequate practice log submission, culminating with a computer-based examination at the end of Level 4.

What is a Practice Assessment Protocol (PAP)?

The PAPs are non-graded learning tools developed by the Board and based on current AUA Clinical Guidelines. They will involve a self-review of a small number of sequential cases in a specific area (e.g., evaluation of hematuria, treatment of superficial bladder cancer, etc.); a comparison of the Diplomate’s evaluation and management of these cases to accepted practice guidelines; and the successful answering of a short series of questions regarding the clinical guidelines. The applicant will be linked via the internet to an AUA Guideline or similar document with the appropriate answers.  This process will be completed via the internet and the Board office will be automatically notified when the PAP is completed.

How many CME credits are required for the MOC program?

Ninety hours of CME credits in the three years prior to the deadline, 30 hours of which must be Category 1 as defined by the Accreditation Council for Continuing Medical Education (ACCME) , are required at Level 2 and Level 4 of MOC.

How do I document my CME credits?

The CME provider issues written verification of participation in a CME activity. For Category 1 credits, the Diplomate will need to furnish the Board a notarized copy of the certificate or written verification at time of application for MOC. Diplomates are required to maintain a record of their self-assessment, CME, and Practice Assessment Protocol (PAP) activities, and attest to the completion of them in their application for the MOC process.  A sheet to track Category 2 credits can be downloaded here.

What fees will I have to pay for MOC?

 A $200 annual certificate fee charged to all participating ABU diplomates replaces the recertification and maintenance of certification fees.  Annual fees must be current in order for a diplomate to participate in MOC.

Will a new certificate be issued every two years?

Upon successful completion of Level 1, Level 2 or Level 3, the Diplomate will receive a letter verifying that phase of MOC has been completed.  A new full-sized certificate will be sent upon successful completion of Level 4.

Who will be notified when I complete each level of MOC?

The American Board of Medical Specialties, American Urological Association, and the American College of Surgeons will be notified when the Diplomate has successfully completed each level.

Can I get a verification that I have completed MOC if my state requires this as part of maintenance of my medical license?

Yes, the ABU will send a letter to you at no charge upon your request. If a letter needs to be sent to a third party, there is a $50 fee to help offset the expense involved. Send your request and payment by check or money order to the Board office.

Will changes be made to the MOC program?

Due to the evolving nature of the MOC movement, it is highly possible that refinements will be made to the MOC program in the future.  All changes will be posted on this website when they go into effect.

600 Peter Jefferson Parkway, Suite 150, Charlottesville, VA 22911
Amy H. Woodson, MOC Coordinator Lori R. Davis, Administrator Donna Payne, Staff Associate Gerald H. Jordan, MD, Executive Secretary Charles S. Hall, Information Technology Coordinator Lindsay W. Franklin, Certification Coordinator Denise D. Files, Senior Staff Associate James R. Surgener, Recertification Coordinator