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General – The American Board of Dermatology
General – Maintenance of Certification (MOC) Background and Overview
QUESTIONS + ANSWERS
General – The American Board of Dermatology
What does it mean to be board certified?
Becoming Board certified is a process that involves much more than preparing for and passing an examination. Certification by the American Board of Dermatology (ABD) is the public’s assurance that the certified individual has satisfactorily completed rigorous training in an accredited program, as well as having passed a comprehensive examination. Initial certification is simply the portal into a career-spanning process of maintenance of certification (MOC) to continue that assurance to the public.
Who are the certifying and accrediting organizations in dermatology?
The ABD certifies dermatologists who meet qualifications in dermatology, dermatopathology, and pediatric dermatology. The ABD is a Founding Member of the American Board of Medical Specialties (ABMS), an organization consisting of 24 Member Boards. The ABMS reviews and approves Member Board maintenance of certification processes. The ABMS Member Boards certify the majority of medical specialists in the US.
The major accrediting organization for training programs in the US is the Accreditation Council for Graduate Medical Education (ACGME). The ACGME, in concert with its Residency Review Committees (RRC), sets and maintains national standards of graduate medical training. In dermatology, it currently accredits 115 residency programs, 53 dermatopathology fellowships, and 63 procedural dermatology fellowships. The ABD is involved in the process through the contributions of members of its Board of Directors who serve on the RRC along with appointees from the AMA.
Who are the educational and advocacy organizations in dermatology?
There are many specialty and subspecialty groups that function as educational and advocacy organizations. The largest of these is the American Academy of Dermatology (AAD). These educational and advocacy organizations are independent of the ABD. For more information, see What is the difference between the ABD and the AAD? For a discussion of the differences between certifying Boards and professional Societies refer to the following article: Boards Evaluate, Societies Educate by Harry Hurley.
What is the American Board of Dermatology? Who are its directors?
The American Board of Dermatology (ABD) is one of 24 medical specialty boards that make up the American Board of Medical Specialties (ABMS). It exists to assure safe, high quality dermatologic care for the public by setting, promoting and assuring standards of excellence in the practice of our specialty. The ABD is a voluntary, non-profit organization formed for the primary purpose of protecting the public interest by establishing and maintaining high standards of training, education and qualifications of physicians rendering care in dermatology.
The ABD is composed of 17 Directors (16 dermatologists and one Public Member), an Executive, Associate and Assistant Director, and 5 staff members. Each director is elected to the board and serves a 9-year term.
For further information, see About the American Board of Dermatology.
What is the difference between the American Board of Dermatology (ABD) and the American Academy of Dermatology (AAD)?
The American Board of Dermatology (ABD) is an autonomous body that acts as the certifying agency for the specialty of dermatology.
The American Academy of Dermatology (AAD) is the largest national professional society for the specialty of dermatology. Its purposes are to educate dermatologists and the public, and to represent the specialty on issues concerning other professional organizations, the public, industry, and the government. Membership in the AAD is not limited to Board certified dermatologists, but includes other dermatologists, other physicians and health care providers from all over the world who have an interest in the field of dermatology.
For more information, see What is the difference between the ABD and the AAD?
For a discussion of the differences between certifying Boards and professional Societies refer to the following article: Boards Evaluate, Societies Educate by Harry Hurley.
What are the ABD’s expectations of professionalism in its diplomates?
Please refer to the American Board of Medical Specialties Definition of Medical Professionalism.
General – MOC Background and Overview
What is the purpose of MOC (Maintenance of Certification)?
MOC is a program that offers assurance to the public that the competency the Diplomate evidenced when awarded initial certification in Dermatology is maintained during continuing professional life.
How are the requirements for MOC determined?
The ABD is one of the 24 Member Boards of the American Board of Medical Specialties (ABMS). The ABMS established the four-part structure of its Maintenance of Certification program (ABMS MOC®) based on six core competencies adopted by ABMS and the Accreditation Council for Graduate Medical Education (ACGME). The individual Member Boards of ABMS develop their MOC plans within the overall structure of ABMS MOC and submit their MOC programs to ABMS for approval. As an ABMS Member Board, the ABD must follow the requirements of the ABMS. For example, the ABD MOC examination was initially a 6-week-long, open-book, unproctored exam, but requirements of the ABMS mandated a change to a proctored exam.
What is the basic structure of MOC?
ABMS MOC consists of 4 components:
Component 1 is evidence of continuing professionalism in maintaining a valid, unrestricted license to practice medicine in the United States or Canada. (License Attestation)
Component 2 demonstrates that the Diplomate has kept abreast of current medical knowledge with self-assessment and self-learning (continuing medical education - CME) activities. (Patient Safety CME Attestation, Self-Assessment Exercises)
Component 3 is a cognitive examination. Successful completion of this examination is evidence that the Diplomate has remained current with appropriate medical knowledge.
Component 4 assures the public that the Diplomate is using this medical knowledge to improve the quality of care provided to patients. (Practice Assessment QI)
For more specific details about these four components, see MOC FAQs.
Why should all dermatologists participate in MOC?
Please see The Value of MOC.
Why is the MOC process voluntary for diplomates certified prior to 1991?
Prior to 1991, certificates issued by the ABD did not contain an expiration date; therefore, such certificates are known as "lifetime" certificates because they are valid provided the diplomate maintains a current, valid and unrestricted license to practice medicine. The ABD will not change the rules after the fact, and therefore lifetime certificate holders have the same certificates they received initially. Diplomates who hold a lifetime certificate are strongly encouraged, but not required, to participate in MOC. The ABD believes that it will become increasingly necessary for lifetime certificate holders to participate in MOC as MOC becomes the standard for defining competence by the public, payers, hospitals, credentialing agencies and more. Time-limited certificates have been issued since 1991. They are valid for a period of 10 years. Diplomates are required to satisfactorily participate in the MOC process in order to extend the validity of their certificates. See also MOC FAQ:What are the differences between lifetime certificates and time-limited certificates?
What is the difference between Recertification and Maintenance of Certification?
From 1991-2006 the ABD recertification process consisted of a requirement to have (1) a full, valid, and unrestricted license to practice medicine, (2) 90 hours of CME credits in the 3 years prior to taking a recertification examination, (3) an ethics letter and hospital affiliation letter, and (4) the recertification examination. This examination was initially an open-book examination taken on-line. The need to ensure the identity of the person taking the examination required the ABD to administer a secure proctored, closed book examination which began in 2010.
In 2006 the recertification process evolved into the Maintenance of Certification (MOC) program, a program of continuous professional development. This allows the Diplomate to demonstrate ongoing competency after completing residency. This continuous program of MOC is in distinction to the bolus of CME and an examination which made up the recertification process. For more details see MOC: Overview and History and FAQ:What are the requirements for participating in MOC?
What are the differences between lifetime certificates and time-limited certificates?
Between 1933 and 1990, certificates in Dermatology issued by the ABD had no expiration date. These certificates will not change as long as the Diplomate maintains a full, valid, unrestricted license to practice medicine. Time-limited certificates require engagement in a renewal process during a 10-year period. The first year that the ABD issued a time-limited certificate was in 1991. All 24 boards comprising the American Board of Medical Specialties (ABMS) now issue time-limited certificates. For more details see MOC: Overview and History.
What is “continuous MOC” that some of the other boards are now instituting?
As of 2012, Pediatrics, Family Medicine, Psychiatry and Neurology, and Radiology have eliminated specific “end dates” for their participating Board Certified physicians. Ongoing certification with each Member Board is contingent upon meeting their individual MOC requirements, and therefore no specific end date to certification is provided. To maintain certification, diplomates must successfully complete specialty-specific requirements throughout their ongoing MOC cycles.
However, credentialers look to board certification as an important quality marker, and the MOC program is being incorporated into that process. For credentialers who need an end date to complete primary source verification, the individual Member Boards provide an annual reverification date to ensure accurate certification status. For information regarding these Member Board dates as well as other implementation details, see the ABMS Summary Table: MOC – No End Dates.
Currently in Dermatology, if a diplomate has not completed all required MOC elements by the end of a given year they are "not participating in MOC". However, at the moment, they maintain their “certification” status until the end of their current 10-year cycle. At that time, if they have not completed all other MOC requirements, they will not be allowed to sit for the next exam and, therefore, will no longer be deemed “certified” by us.
Is MOC status posted online for the public to see?
Yes. The American Board of Medical Specialties (ABMS) now posts on its Certification Matters website the certification and recertification status of all ABD diplomates. Included in the status information is whether a diplomate with time-limited certification is “meeting MOC requirements.” The designation “meeting MOC requirements” attests that all components of MOC were completed by December 31st of the previous year. For purposes of public reporting, diplomates with time-limited certificates who are on track to enter MOC based upon their year of initial certification are considered to be participating in MOC. The ABMS will soon include a statement that diplomates with lifetime certificates are not required to participate in maintenance of certification.