Maintaining certification: The debate continues

When you hear “maintenance of certification,” does it make you cringe? If so, why?

If you’re like many of the participants in a recent poll, you may find that maintaining your certifications through the Maintenance of Certification (MOC) program is too expensive, time-consuming or complicated.

While physicians are in general agreement that they should keep their knowledge of the latest diagnostic and treatment guidelines updated, the MOC certification process is viewed as overly burdensome. The program, sponsored by the American Board of Medical Specialties (ABMS), involves certification through one of 24 medical specialty boards or one of the American Osteopathic Association specialty boards.

Sermo (, a popular network for MDs and DOs, asked more than 1,000 physicians what factors make the process “so onerous.” Participants could give more than one response. As you can see from the table, opinions ran the gamut.

Despite some negatives, the ABMS member boards had certified more than 800,000 U.S. physicians as of March 2013, and more than 450,000 physicians were participating in MOC, according to the ABMS website ( The average annual fee charged for MOC participation in January 2013 was approximately $300.

Exam fees are another matter. For example, the website for the American Board of Physical Medicine and Rehabilitation cites exam fees of $1,395 for Certification Part I, $1,910 for Certification Part II, $745 for MOC and $1,800 for Subspecialty: Brain Injury Medicine – among other exams.

The American Board of Colon and Rectal Surgery provides an “MOC Fee Schedule” on its website, citing a nonrefundable exam application fee of $350 (required every 10 years), a nonrefundable late registration fee of $200 and a $750 fee payable when a candidate receives approval for the exam.

However, ABMS studies have shown that both patients and physicians recognize the value of MOC. Many who responded to the consumer survey said that, if they found out a physician was not maintaining certification, they “would look for a new one or cease referring that physician.”

In the ABMS physician study, specialists saw the benefits of “identifying areas for improvement in practice, providing valuable patient feedback and generating high-quality performance data.”

Physician Opinions of MOC


Too Expensive


Prefer focus to be content, not revenue


Too time-consuming


Shouldn’t be tied with maintaining board certification


Too complicated


Not relevant to daily practice


Currently using self-study


Nothing – MOC works well