Maintenance of Board Certification or MOC
As another year nears its end, it is time for the yearly Maintenance of Board Certification (MOC) chores. I have two American Board of Medical Specialties (ABMS) recognized board certifications. One is from the American Board of Plastic Surgery and the second is from the American Board of Surgery. Both represent years of training and hard work and the relatively new requirement for the completion of yearly chores.
Achieving Board Certification
Achieving Board Certification is an important milestone in a doctor’s training. It certifies that they graduated from a recognized residency training program and that they have passed a series of written and oral examinations. If you are a plastic surgeon and have gone through the process, the expression, “Plastic surgeons eat their young,” may come to mind. The process is both rigorous and anxiety promoting.
The Qualifying Examination is a written exam that must be passed to qualify for the oral exams. Back in the olden days, we all had to fly to a designated city for the examination, so it was an even more expensive and time consuming commitment. For my plastic surgery board examination, the testing was done in Houston, TX, in the summer. There is some bonding that occurs when a group survives a stressful situation together. Now, with the advent of computer testing centers, rather than one central location for the examination, many cities offer the examination each year. When sitting for the exam, you may be the only one taking the American Board of Plastic Surgery‘s written exam, making it even more impersonal.
The Oral Exams
In order to qualify for the oral exam, not only do you have to pass the written exam, you have to submit six months of your own cases. Every single one of them, with notarized confirmation from the medical staff office of every hospital and surgery center where you hold privileges that every case has been submitted. From these, specific cases are selected for you to bring to the exam. Each case must have all the charting, billing and before and after pictures for the examiners to review. You submit your books upon arrival, and wait to see if they qualify you for the exam. If they are insufficient, you will have to try again next year. If your books pass scrutiny, then the oral examinations proceed.
The oral exams are very personal. There are three groups of oral examiners to negotiate. Two groups test you with standard patient cases. You are given a brief history, physical examination and pictures, and off you go. The questions start with, “What are you going to do doctor?” and progress through your rationale. If you are doing well, one of the other examiners will often interrupt your best plans with, “Well, that didn’t work. Now what are you going to do?” All the while, remaining poker faced, but you know inside they are smirking, at least a little bit. The third oral examination session is similar to the other two, except they are your cases. Everything is fair game, not just your patient care, but your charting, picture taking, billing and outcomes.
Maintenance of Board Certification
Shortly before I graduated, once you passed your oral examination you were done. You were done. You were Board Certified forever. No more fees, no more travel, no more exams. But that is no longer true. Now, there is a price to pay and chores to perform every year, including a written examination every ten years.
The examinations are given at computer based testing centers throughout the nation. All sorts of examinations are given at these centers and most have nothing to do with medicine. The staff at these institutions have strict rules to enforce – rules designed to stop cheating and protect the proprietary information that is contained on the examination. I recently visited one such institution to take my ten-year recertification examination for the American Board of Surgery.
The testing center is located about an hour from my office, so much more convenient than flying to Houston. After showing my ID, my examination slip and signing into the building, I was escorted to the testing center like I was in custody. I dutifully called the plastic surgeon covering for me to let them know I would not me in possession of my phone for the duration of the exam. Before I let them know that I would call as soon as I was finished, I was getting the evil eye. It seems using a cell phone, even in the reception area outside of the examination, is not allowed. Did I mention the exam is anxiety promoting?
Why Maintain Board Certification?
This question is becoming more and more controversial as the fees, exams and other hurdles are raised higher and higher each year. Those in favor claim that board certification is good, and recertification makes sure that your doctor is still good. Those opposed site the ever escalating cost and time required and the lack of evidence that it makes us better doctors. Personally, I don’t mind. It is a hassle, and it does not change the way I practice. On the other hand, it shows my patients that I am committed to being the best, and I don’t mind being tested on it. Plus, when I pass, I have the lovely certificate shown above to show everyone.
My Board Certifications
I completed a General Surgery residency in 1994. I passed my General Surgery Boards in 1995 and have recertified twice. I am good until 12/31/2025, as long as I complete my yearly chores and pay my yearly fees.
I completed a Plastic Surgery residency in 1997. When I finished my training, it took two years to take the certification exams. I passed my Plastic Surgery Boards in 1999, and have recertified once, so I am good until 12/31/2019. Looking forward to the next exam.
American Board of Medical Specialties
There are many boards out there, but the “real” boards are those under the umbrella of the American Board of Medical Specialties (ABMS). This is the longest standing body for Medical Certification in the US. The American Board of Plastic Surgery was born from members of the American Board of Surgery and the American Board of Otolaryngology who did what is now recognized as Plastic Surgery, and remains the only ABMS Board certifying Plastic Surgeons.
Board Certified Plastic Surgeon
So now you know more about how I spend my time away from patient care. Plastic Surgery is not all glamour; there is always more paperwork to do. If you are considering Plastic Surgery, be certain to check your doctor’s training. Good training, and maintenance of that training, are essential for providing the safest and most predictable results.
If you are in the San Francisco Bay Area and would like to schedule an appointment with me, call (925) 943-6353. And if you want to check out my qualifications, here are some links to help you:
Check if your doctor is Board Certified by another American Board of Medical Specialties board. You will need to register to use this site, but it is safe, free and fast.
Check if your doctor has an unrestricted California Medical License. Read the disclaimer and click “Continue to Search” at the bottom. If you are not in California, Google your local medical board for a link.