Introduction
Maintenance of Certification (MOC), now often called Continuing Certification, is the process by which board-certified physicians maintain their specialty credentials. While state medical boards require CME for license renewal, specialty boards have their own MOC requirements that may or may not overlap with state CME.
This guide explains the four-part MOC structure, how CME fits in, and specific requirements for major specialty boards in 2026.
Understanding the MOC Framework
The Four Parts of MOC
All ABMS member boards follow a similar four-part framework:
| Part | Component | Purpose |
|---|---|---|
| Part I | Professional Standing | Maintain unrestricted medical license |
| Part II | Lifelong Learning/Self-Assessment | CME and knowledge assessment |
| Part III | Cognitive Expertise | Board examination (written/online) |
| Part IV | Practice Performance | Quality improvement activities |
MOC vs. State CME: Key Differences
| Aspect | State CME | MOC |
|---|---|---|
| Purpose | License renewal | Board certification |
| Required by | State medical boards | Specialty boards |
| Consequence of non-compliance | License lapse | Certification lapse |
| Hours | State-determined | Board-determined |
| Topics | May include mandates | Usually specialty-specific |
| Assessment | Typically none | Self-assessment and/or exam |
MOC Part II: Lifelong Learning and CME
How CME Integrates with MOC
| Component | Description |
|---|---|
| CME credits | AMA PRA Category 1 or equivalent |
| Self-assessment | Knowledge self-evaluation |
| MOC Points | Many boards award MOC points for qualifying CME |
| Specialty relevance | Content should relate to certification |
CME That Qualifies for MOC Credit
| Credit Type | MOC Acceptability |
|---|---|
| AMA PRA Category 1 with MOC | Directly applicable |
| Board-developed CME | Specifically designed for MOC |
| CME from ACCME-accredited providers | Usually qualifies |
| Point-of-care activities | Some boards accept |
| Quality improvement CME | Often dual Part II/IV credit |
Requirements by Major Specialty Board
American Board of Internal Medicine (ABIM)
| Component | Requirement |
|---|---|
| CME Points | 100 MOC points per 5-year cycle |
| Self-Assessment | Required (included in Part II) |
| Part III Exam | Knowledge assessment every 10 years |
| Part IV | Practice assessment activities |
| Alternatives | LKA (Longitudinal Knowledge Assessment) option |
2026 Update: ABIM offers the Longitudinal Knowledge Assessment (LKA) as an alternative to the traditional 10-year exam. LKA involves answering 30 questions quarterly over 5 years.
American Board of Surgery (ABS)
| Component | Requirement |
|---|---|
| CME | 250 CME credits per 5-year cycle |
| Self-Assessment | 30 self-assessment credits per 5 years |
| Examination | Continuous Certification Program |
| Practice Quality | Quality improvement activity |
American Board of Family Medicine (ABFM)
| Component | Requirement |
|---|---|
| CME | 50 points per year (25 self-assessment) |
| Self-Assessment | Knowledge Self-Assessment quarterly |
| Performance | Performance improvement activity |
| Certification | Certification for Family Medicine exam |
American Board of Pediatrics (ABP)
| Component | Requirement |
|---|---|
| MOC Points | 40 Part II points per 5 years |
| Self-Assessment | MOCA-Peds continuous assessment |
| Practice Quality | QI activity per 5-year cycle |
| Exam | MOCA-Peds (quarterly questions) |
American Board of Psychiatry and Neurology (ABPN)
| Component | Requirement |
|---|---|
| CME | 200 CME per 10 years (40 self-assessment) |
| Article-Based Assessment | 8 units per 3 years |
| Practice Assessment | PIP unit required |
| Exam | Periodic exam or alternative |
American Board of Obstetrics and Gynecology (ABOG)
| Component | Requirement |
|---|---|
| CME | 60 Category 1 credits per 3 years |
| Self-Assessment | Annual self-assessment requirement |
| FOCUS | Focused Ongoing Certification |
| Simulation | Patient safety activities |
American Board of Emergency Medicine (ABEM)
| Component | Requirement |
|---|---|
| CME | 250 CME over 10 years |
| Self-Assessment | LLSA (Lifelong Learning Self-Assessment) annually |
| Oral Boards | Now optional/alternative pathways |
| ConCert | Continuous Certification program |
American Board of Anesthesiology (ABA)
| Component | Requirement |
|---|---|
| CME | 250 CME per 10 years |
| MOCA Minute | Weekly knowledge questions |
| Practice Assessment | Simulation course or alternatives |
| QI | Quality improvement participation |
American Board of Orthopedic Surgery (ABOS)
| Component | Requirement |
|---|---|
| CME | 120 hours per 3-year cycle |
| Self-Assessment | 20 SAE credits per 3 years |
| Oral Exam | Recertification examination |
| Web-Based | Web-based score improvement |
American Board of Radiology (ABR)
| Component | Requirement |
|---|---|
| CME | 75 CME per 10 years |
| OLA | Online Longitudinal Assessment |
| PQI | Practice Quality Improvement |
| Self-Assessment | Self-assessment modules |
Navigating Multiple Requirements
Overlapping CME Strategy
| Strategy | How It Works |
|---|---|
| Choose MOC-approved CME | Counts for both state and MOC |
| Self-assessment CME | Meets Part II and state requirements |
| Specialty-focused learning | Relevant to board and practice |
| Track credits separately | Some count for state but not MOC |
Sample CME Plan for ABIM-Certified Internist
| CME Type | Hours | MOC Credit | State Credit |
|---|---|---|---|
| ABIM-approved online modules | 20 | 20 points | Yes |
| Medical journal CME | 15 | 15 points | Yes |
| Self-assessment activities | 15 | 15 points | Yes |
| Hospital grand rounds | 10 | Varies | Yes |
| State mandatory topics | 10 | Usually no | Yes |
| Total | 70 | 50+ points | 70 hours |
Time-Unlimited Certificates
Physicians with Older Certifications
| Certification Era | MOC Required? |
|---|---|
| Pre-1990 (most boards) | No formal MOC required |
| Time-unlimited certificates | Optional participation |
| Current certificates | MOC mandatory |
Note: Even with time-unlimited certification, voluntary MOC participation may be required by hospitals, insurers, or employers.
MOC Changes and Alternatives
2025-2026 Updates
| Board | Change |
|---|---|
| ABIM | LKA now standard option |
| ABP | MOCA-Peds continuous assessment |
| ABFM | Ongoing certification model |
| Multiple boards | Moving away from high-stakes single exam |
Continuous Certification Trend
Many boards are shifting from periodic high-stakes exams to: - Quarterly knowledge assessments - Ongoing point accumulation - Flexible timeline for completion - Multiple assessment opportunities
Key Takeaways
- MOC has four parts: Professional standing, lifelong learning, cognitive assessment, practice performance
- CME is Part II but must often include self-assessment component
- Requirements vary by board - check your specific specialty
- CME can count for both state license and MOC with proper planning
- LKA/continuous assessment replacing traditional 10-year exams for many
- Time-unlimited certificates may not require MOC but employers may expect it
Frequently Asked Questions
Do I need MOC if I have a time-unlimited certificate?
If you received board certification before your board implemented time-limited certificates (varies by board, often pre-1990), you technically aren't required to participate in MOC to maintain your certificate. However, many hospitals, insurance companies, and employers require current MOC participation regardless of certificate type. Check with your credentialing organizations.
Can my state CME count toward MOC?
Some but not all state CME counts toward MOC. For CME to count for both, it typically needs to be: (1) AMA PRA Category 1; (2) relevant to your certified specialty; and (3) preferably designated as MOC-approved by an ACCME-accredited provider. State-mandated topics (opioids, ethics) may not count toward MOC if not specialty-relevant.
What happens if I don't complete MOC?
Your board certification will lapse or show as "not meeting requirements." This doesn't affect your medical license (that's separate from the state board), but it can impact hospital privileges, insurance participation, employment, and professional reputation. Many hospitals and insurers require current board certification with MOC compliance.
How is the Longitudinal Knowledge Assessment (LKA) different from the traditional exam?
Traditional MOC exams require passing a comprehensive test every 10 years (stressful, high-stakes). LKA spreads assessment across 5 years with 30 questions per quarter (ABIM) or similar formats (other boards). LKA is open-book, lower stress, and focuses on learning rather than a single pass/fail moment. Many find LKA more manageable.
How do I find CME that counts for MOC?
Look for CME activities that explicitly state "ABMS MOC" credit or specify your board (e.g., "qualifies for ABIM MOC Part II"). ACCME's CME Finder (cme.accme.org) allows filtering for MOC-eligible activities. Your specialty board's website typically lists approved CME sources. Hospital CME departments can often guide you to qualifying activities.
Conclusion
Maintenance of Certification adds another layer to physician credentialing beyond state licensure. Understanding how your specialty board's MOC requirements integrate with—and differ from—state CME requirements allows you to plan efficiently and meet both sets of obligations.
Use CredentialMate to track CME credits for both state license renewal and MOC, ensuring you meet all requirements without duplication or gaps.
References
[1]: ABMS - Maintenance of Certification https://www.abms.org/newsroom/abms-commitment-to-board-certification-and-maintenance-of-certification-moc/ Last verified: January 2026
[2]: ACCME - CME for MOC Program Guide https://accme.org/data-reporting/maintenance-of-certification/ Last verified: January 2026
[3]: ABIM - MOC Requirements https://www.abim.org/maintenance-of-certification/ Last verified: January 2026
[4]: ABFM - Continuous Certification https://www.theabfm.org/continue-certification Last verified: January 2026
[5]: ABMS - Board Eligibility and MOC Status https://www.abms.org/board-eligibility-and-moc-status-for-credentialing-professionals/ Last verified: January 2026
[6]: IU School of Medicine - MOC FAQ https://medicine.iu.edu/continuing-education/attend/maintenance-of-certification/faq Last verified: January 2026