The American Board of Anesthesiology

Member Board of the American Board of Medical Specialties

Maintenance of Certification in Anesthesiology (MOCA®)

Frequently Asked Questions (FAQs)



Top 5 FAQs

  1. Why does my MOCA Progress Report show an unsatisfactory (“U”) for Professional Standing?
  2. How do I report my Lifelong Learning and Self-Assessment (LL-SA) activities?
  3. If I take the Cognitive Examination before my current anesthesiology certificate expires, will I get a MOCA certificate that is valid for ten years from the date I pass the Cognitive Examination?
  4. Can I get LL-SA credit for Board Certification or Subspecialty Certification?
  5. Why are there LL-SA activities in my account that I did not report and why am I not getting credit for them?

General Inquiries

ONLY For Diplomates Holding Non-Time Limited Certificates (Issued before 2000)

Part I: Professional Standing (PS) Information

Part II: Lifelong Learning and Self-Assessment (LL-SA) Information

Part III: Cognitive Exam (CE) Information

Part IV: Practice Performance Assessment and Improvement (PPAI) Information

MOCA® Frequently Asked Questions: General Inquiries

  1. What is MOCA? Top

    2. The Maintenance of Certification in Anesthesiology (MOCA®) program enables ABA diplomates with a time-limited certificate in the specialty of anesthesiology to maintain their certification. Additionally, MOCA allows all diplomates to demonstrate continuing qualifications. Each MOCA cycle is a 10-year period of ongoing Lifelong Learning and Self-Assessment; continual assessment of Professional Standing (medical licensure); periodic assessments of Practice Performance; and assessment of Cognitive Expertise.

    MOCA is an opportunity for physicians to document maintenance of their skills in six general competencies, namely, Medical Knowledge; Patient Care; Practice-Based Learning and Improvement; Professionalism; Interpersonal and Communication Skills; and Systems-Based Practice.

  2. Can I participate in MOCA? Top

    3. All ABA diplomates may participate in MOCA.

  3. Why should I participate in MOCA? Top

    4. Time-Limited:
    If you were certified in or after 2000, you hold a time-limited certificate. MOCA is your only option for maintaining certification. When you receive primary certification, you are automatically enrolled in the MOCA program to allow you the full 10-year period to meet all MOCA requirements.

    Non-Time Limited:
    You may want or need to demonstrate your continuing qualifications now or in the future, for example, to meet a state medical board's licensure requirements. If so, you may choose to participate in the Recertification or MOCA programs. Non-time limited candidates are not required to participate in MOCA.

    As a holder of a non-time limited primary certificate, your participation in either the ABA's Recertification Program or the MOCA program is voluntary. However, MOCA is replacing the Recertification program and the last Recertification examination will be administered in 2009. The deadline for submitting a Recertification Application is December 31, 2008.

  4. How do I apply for MOCA? Top

    5. Time-Limited:
    Diplomates issued a time-limited primary certificate are automatically enrolled in the MOCA program as soon as they receive their primary certificates. This allows them the full 10-year period to meet all MOCA requirements. There is no enrollment fee.

    You can log onto the ABA Web site to submit and review your LL-SA activities and track your progress towards completing the MOCA Program requirements by viewing your MOCA Progress Report.

    Non-Time Limited:
    You may apply online by visiting the ABA Web site at www.theABA.org.

  5. How much will MOCA cost? Top

    6. Currently, there is no application fee for MOCA. There is a $750 fee for each examination opportunity. Effective January 1, 2009, the examination fee will be $900. If you paid an application fee at the time you registered in the MOCA program, $250 will be automatically credited toward your first MOCA examination fee.

  6. How long will MOCA take? Top

    7. Time-Limited:
    MOCA is a 10-year program. It is designed to allow you to complete all requirements before your current certificate expires.

    Non-Time Limited:
    Non-time limited certificate holders may complete the MOCA program in 2 to 10 years. You can determine the year in which you will finish the program by choosing when to complete specific program requirements.

  7. Will I lose my diplomate status if I don't enter or complete MOCA? Top

    8. Time-Limited:
    Yes. Your certificate will expire, and you will no longer be Board certified (nor in the Examination System). The ABA will reinstate your certified status when you complete all MOCA Program requirements.

    Non-Time Limited:
    No. If you were certified before 2000, the certificate the ABA issued to you is not time-limited and does not have an expiration date. Participation in the MOCA program is voluntary and does not jeopardize your status as an ABA diplomate. If, for any reason, you do not satisfy the MOCA program requirements you will retain your status as an ABA diplomate because you hold a non-time limited certificate.

  8. What are the requirements for MOCA? Top

    9. There are four requirements for MOCA, as follows:

    1. Part I: Professional Standing (PS) Top

      2. Diplomates must hold an unrestricted license to practice medicine in at least one jurisdiction in the U.S. or Canada. Further all U.S. and Canadian medical licenses a diplomate holds must be unrestricted. No medical license you hold can be revoked, suspended or surrendered in lieu of revocation or suspension. The ABA will investigate any report of such a final action involving any medical license that you hold. Additional information about the PS requirements is provided at the end of this document.

    2. Part II: Lifelong Learning And Self-Assessment (LL-SA) Top

      3. LL-SA is personalized and self-directed professional development. It should begin with an assessment of your current knowledge and practice of anesthesiology. The next step in LL-SA is to participate in continuing medical education (CME) activities and other learning opportunities that meet your professional development needs. Additional information about the LL-SA requirements is provided at the end of this document.

    3. Part III: Cognitive Examination (CE) Top

      4. MOCA candidates must demonstrate their cognitive expertise by passing an ABA examination administered via computer under secure, proctored, standardized testing conditions. The Cognitive Examination is designed to assess core knowledge of the discipline of anesthesiology. It is clinically oriented, with an emphasis on customary practice. Additional information about the Cognitive Examination is provided at the end of this document.

    4. REVISED Part IV: Practice Performance Assessment and Improvement (PPAI) Top

      5. The current PPAI program consists of the ABA obtaining attestations and evidence of the diplomate’s clinical activity and ongoing program of practice performance assessment and improvement. The ABA minimum clinical activity requirement is the practice of anesthesiology or a recognized anesthesiology subspecialty, on average, at least one day per week during one of the previous three years.

      The ABA audits candidates to obtain evidence to support attestations about their PPAI program. Audited candidates will be required to provide documentation and other evidence to demonstrate their participation in the PPAI process. Additionally, candidates will be required to identify the department chair, practice group president or other individual from whom the ABA will solicit evidence-based attestations about your clinical practice. Evidence of one PPAI attestation acceptable to the ABA is a prerequisite for the MOCA Cognitive Examination and is a requirement for maintenance of certification in anesthesiology.

      A new three-part PPAI program will be required for all newly certified diplomates and non-time limited diplomates who enter the MOCA program after January 1, 2008. The three-part program includes: 1) case evaluation, 2) patient safety education, and 3) simulation education.

      Diplomates must complete all three PPAI activities over their 10-year MOCA cycle. Diplomates must complete at least one of the three activities in each of the following segments of their MOCA cycle: Years 1-3, Years 4-6, and Years 7-9. Each activity must be completed at least once in the diplomate’s 10-year cycle. Each year, the ABA will audit a sample of the case evaluations submitted by MOCA candidates.

      Evidence of two PPAI activities acceptable to the ABA is a prerequisite for the MOCA Cognitive Examination and three PPAI activities is a requirement for completion of maintenance of certification in anesthesiology.

      The ABA is transitioning from the current attestation program to the new three-part program over the next 4 years.

      Additional information about Practice Performance Assessment and Improvement is provided at the end of this document.

      Year Primary Certification Expires / Year Completing MOCA Current Year in MOCA 1st PPAI Activity 2nd PPAI Activity 3rd PPAI Activity
      2010 Year 8 2005 - Attestation 2009 - Attestation --
      2011 Year 7 2006 - Attestation 2010 - Attestation --
      2012 year 6 2007 - Attestation 2011 - Attestation --
      2013 Year 5 2008 - Attestation 2012 - Attestation --
      2014 Year 4 2009 - Attestation 2011 - 2013 Case Evaluation or Patient Safety or Simulation --
      2015 Year 3 2010 - Attestation 2012 - 2014 Case Evaluation or Patient Safety or Simulation --
      2016 Year 2 2011 - Attestation 2013 - 2015 Case Evaluation or Patient Safety or Simulation --
      2017 Year 1 2012 - Attestation 2014 - 2016 Case Evaluation or Patient Safety or Simulation --
      2018 -- 2009 - 2011 Case Evaluation or Patient Safety or Simulation 2012 - 2014 Case Evaluation or Patient Safety or Simulation 2015 - 2017 Case Evaluation or Patient Safety or Simulation

  9. When must I complete the MOCA requirements? Top

    10. MOCA is designed to allow you to complete all program requirements by the end of the 10th year following your enrollment or application. The colored cells in the following timeline indicate when assessments occur during the 10 year cycle:

    Year in MOCA Program
    Activity 1 2 3 4 5 6 7 8 9 10
    Enrollment/Application X                  
    Professional Standing X X X X X X X X X X
    LL-SA X X X X X X X X X X
    Cognitive Exam             X      
    Practice Performance X X X  

  10. If I don't complete MOCA in 10 years, do I have to start the program over? Top

    11. No. As you continue in the Program, you will retain credit only for those requirements completed during the previous 10 years. For example, if you participate through Year 11, you would lose credit for any LL-SA activities completed in or before Year 1; if you participate through Year 12, you would lose credit for any LL-SA activities completed in or before Year 2, etc.

  11. How long will my MOCA certificate be valid? Top

    12. The MOCA certificate will be valid for a period of 10 years.

ONLY For Diplomates Holding Non-Time Limited Certificates (Issued before 2000)

  1. Why MOCA instead of Recertification? Top

    2. The MOCA program is an improvement over the Recertification program. By participating in the MOCA program, you explicitly demonstrate your commitment to practice improvement through ongoing self-assessment and education.

    MOCA is replacing the Recertification Program and the last Examination will be administered in 2009. The deadline for submitting a Recertification Application is December 31, 2008.

  2. What if I need to demonstrate continuing qualifications in the next year? Top

    3. You may be able to complete the MOCA program on an expedited basis in as little as 24 months.

  3. Is the expedited MOCA process different? Top

    4. Not really. You must report 350 LL-SA credits completed in the 10 years before your MOCA certificate is issued, or after your date of certification, which ever period is shortest. When the ABA audits your LL-SA activities, you will be required to submit supporting documentation for the LL-SA activities you reported during the year of the audit and the two previous years. In addition to continual Professional Standing assessment, you will undergo a Practice Performance assessment within 12 months of registering for the expedited MOCA process. You also must pass the Cognitive Examination.

  4. Can I complete the expedited MOCA process more than once? Top

    5. No. You may complete MOCA on an expedited basis only once. If you wish to demonstrate continued qualifications after completing MOCA on an expedited basis, you must complete the full 10 year MOCA program.

  5. What happens if I don't complete the expedited MOCA process in 24 months? Top

    6. You may continue to participate in the MOCA program. The ABA will conduct a second Practice Performance assessment if you have not completed all MOCA requirements within 36 months of registration.

Part I: Professional Standing (PS) Information

  1. Why does my MOCA Progress Report show an unsatisfactory (“U”) for Professional Standing? Top

    2. Your Professional Standing may be unsatisfactory for one of two reasons:

    1. You have restrictions* on one or more of your medical licenses.
    2. All of your medical licenses are unrestricted but the ABA does not have an unexpired, unrestricted medical license on file for you. You will need to click on “Update your medical license and USMLE information” via your Portal Account and provide the ABA with a valid expiration date for any active medical licenses you hold. Your Professional Standing will change to satisfactory “S” by the next business day.

    * The ABA defines a restriction as the revocation, suspension or surrender in lieu of revocation or suspension.

  2. Do I have to tell the ABA about actions taken against my medical license(s)? Top

    3. Yes, ABA candidates for initial certification and ABA diplomates have the affirmative obligation to advise the ABA of any and all restrictions placed on any of their medical licenses and to provide the ABA with complete information concerning such restrictions within 60 days after their imposition. Such information shall include, but not be limited to, the identity of the State Medical Board imposing the restriction as well as the restriction's duration, basis, and specific terms and conditions. Candidates and diplomates discovered not to have made disclosure may be subject to sanctions on their candidate or diplomate status.

    ABA candidates and diplomates can report medical licensure actions via their personal portal account, as well as by mailing or faxing a letter with the pertinent information.

Part II: Lifelong Learning And Self-Assessment (LL-SA) Information

  1. How much LL-SA must I complete? Top

    2. You must complete a total of 350 credits during the 10-year MOCA cycle. At least 250 credits must be Category 1 CME offered by sponsors accredited by the Accreditation Council for Continuing Medical Education (ACCME) or eligible for Category 1 credit from the American Medical Association's Physician Recognition Award (PRA) Program. The ABA will grant MOCA candidates a maximum of 70 LL-SA credits per year for all LL-SA completed on or after January 1, 2006. You must report 200 CME credits as a prerequisite to the Cognitive Examination.

    The LL-SA (CME) requirements were prorated for diplomates certified between 2000 and 2003 based on the number of years from the opening of the MOCA program in 2004 to the year their certification expires.

    Year
    Certified    		 LL-SA Credit Requirements
    Total Minimum Category 1 Cognitive Exam Prerequisite
    2000 210 150 120
    2001 245 175 140
    2002 280 200 160
    2003 315 225 180
    2004 and After 350 250 200

  2. What is the difference between Lifelong Learning and Self-Assessment activities? Top
    • Lifelong Learning activities are designed to increase your knowledge (e.g., lectures and conferences).
    • Self-Assessment activities are designed to help you determine your current level of knowledge (e.g., question and answer activities).
  3. Will I get credit for my current CME activities? Top

    4. Time-Limited
    Yes. You may receive credit for LL-SA activities completed after the date you were certified.

    Non-Time Limited
    Yes. You may receive credit for LL-SA activities completed within the 10 year MOCA cycle. The 10 year MOCA cycle is calculated by taking the year in which the diplomate wants to complete the MOCA program and looking back 10 years in time.

  4. Can I get LL-SA credit for Board Certification or Subspecialty Certification? Top

    5. The ABA will not grant LL-SA credit for specialty or subspecialty certification. However, the ABA will grant 50 LL-SA credits towards the Category 1 CME requirement for 12 months of fellowship training in an ACGME-accredited subspecialty program, or in an anesthesiology subspecialty fellowship program sponsored by an ACGME-accredited core anesthesiology program. In order to receive credit toward the MOCA program, you need to have completed the fellowship in or after the year you received your primary certification in Anesthesiology from the ABA.

  5. What kind of activities can I report as Category 1 CME? Top

    6. The ABA will grant full credit only for Category 1 CME from sponsors approved by the Accreditation Council for Continuing Medical Education (ACCME) or eligible for Category 1 credit from the American Medical Association's Physician Recognition Award (PRA) Program.

    Additionally, the ABA will grant LL-SA Category 1 credit for CME activities approved as Category 1-A by the American Osteopathic Association.

  6. What kind of activities can I report as Other LL-SA? Top

    7. The ABA will grant full "Other LL-SA - Documented" credits for documented CME activities sponsored by organizations that are not ACCME or AMA PRA Category 1 accredited (e.g., foreign CME, ACLS training).

    The ABA will grant a maximum of five "Other LL-SA - Undocumented" credits for CME activities that are not sponsored (e.g., yearly committee membership, individual publications, individual lectures, monthly journal readings).

  7. Does all LL-SA have to be Category 1 CME? Top

    8. No. You may receive up to 100 LL-SA credits for activities that are not Category 1 CME.

  8. Will I have to complete LL-SA activities every year? Top

    9. No. There are no yearly minimum requirements for LL-SA activities. However, ABA diplomates should continually seek to improve the quality of their clinical practice and patient care through self directed professional development. MOCA candidates should complete LL-SA activities in at least five of the 10 years in the MOCA cycle. Please note, you will receive a maximum of 70 LL-SA credits per year for all LL-SA completed on or after January 1, 2006.

  9. How do I report LL-SA activities? Top

    10. You must report all LL-SA activities online via your portal account on the ABA Web site at www.theABA.org. Click here for Instructions.

    Please do not mail or fax LL-SA documentation to the ABA to report LL-SA.

  10. Can I “bundle” related activities and report them as one activity? Top

    11. Yes, as long as the sponsor of the activity is the same and the activities are completed in the same calendar year. You can total the amount of credit you receive for a recurring activity and report completion on a monthly, quarterly, biannual, or annual basis.

  11. Will the ABA audit my LL-SA activities? Top

    12. Yes. All MOCA candidates will be audited at least once during their 10 year cycle. The ABA will identify the LL-SA activities you reported during the year of the audit and the two previous years and request that you submit supporting documentation. Do not submit LL-SA documentation to the ABA until we request this information from you.

  12. Why are there LL-SA activities in my account that I did not report and why am I not getting credit for them? Top

    13. Third-party CME providers may submit CME activities and credits to the ABA electronically for ABA diplomates. The ABA will import the activities into your account. The provider reported activities are displayed in red in your LL-SA activity listing.

    NOTE: The ABA will not audit activities imported into your account from registered 3rd party CME providers.

    These activities require your review and attestation before the ABA can consider them “complete”. To complete and finalize an activity, click on the edit edit button in the far right column of the activity and input responses for the following 3 sections: (1) Activity Type, (2) Attestation, and (3) General Competencies. After completing these 3 sections, click on the 'SAVE CHANGES' button and you will then receive credit for the activity.

Part III: Cognitive Examination (CE) Information

  1. When can I take the Cognitive Examination? Top

    2. You can appear for the Cognitive Examination as early as year 7 of the 10 year MOCA cycle. Starting in 2007, the examination will be given during a two week period in both January and August.

  2. If I take the Cognitive Examination before my current anesthesiology certificate expires, will I get a MOCA certificate that is valid for ten years from the date I pass the Cognitive Examination? Top

    3. No, the Cognitive Examination is only one of four components of the MOCA program, so regardless of when you fulfill the examination requirement, the earliest you will receive a MOCA certificate is the day after your current certificate expires. You are in no way penalized for taking the Cognitive Examination before your current certificate expires.

  3. Where do I take the Cognitive Examination? Top

    4. As of January 2008, the Examination is given at Pearson Vue testing centers all over the United States.

  4. How much will MOCA cost? Top

    5. Currently, there is no application fee for MOCA. There is a $750 fee for each examination opportunity. Effective January 1, 2009, the examination fee will be $900. If you paid an application fee at the time you registered, $250 will be automatically credited toward your first MOCA examination fee.

  5. How do I qualify for the Cognitive Examination? Top

    • Have Practice Performance Assessment and Improvement (PPAI) participation acceptable to the ABA.
    • Maintain a Professional Standing satisfactory to the ABA.
    • Have at least 200 LL-SA credits applied toward the MOCA program requirement by the examination decision deadline.

  6. How do I register to take the Cognitive Examination? Top

    7. If you have met all of the qualifications to appear for the Cognitive Examination, the ABA will send you a letter at least 4 months before the date of the examination. At that time you will be asked to respond to the examination announcement and submit the examination fee online via your portal account. Additionally, you will receive information on how to schedule yourself for the examination at a Pearson Vue testing center located near you.

  7. What should I do to study for the examination? Top

    8. The ABA does not sponsor or make recommendations regarding review courses, study material, etc. Available on the ABA Web site is an Examination Content Outline, as well as an Examination Tutorial. The tutorial can be downloaded to your computer and shows the format of the computer-based examination.

  8. How long will the examination take? Top

    9. The MOCA Cognitive Examination is a four-hour computer-based examination. You will be required to complete at least 150 out of the 200 multiple choice questions. You may omit up to 50 questions without penalty.

Part IV: Practice Performance Assessment and Improvement (PPAI) Information

  1. CURRENT PROCESS: I am scheduled for a PPAI Attestation evaluation this year, what should I do? Top

    2. The ABA will mail you forms to complete regarding your practice performance assessment and improvement activities, as well as your clinical activity. Please complete the forms expeditiously and mail or fax them back to the ABA.

  2. Is there a specific order in which I need to complete the three PPAI requirements?

    3. No, you can complete the Case Evaluation, Patient Safety Education and Simulation Education in any order. You must complete at least one of the three activities in each of the following segments of your MOCA cycle: Years 1-3, Years 4-6, and Years 7-9. Each activity must be completed at least once in your 10-year cycle.

  3. NEW: What is a Case Evaluation and where can I find examples? Top

    4. All diplomates enrolled in MOCA are required to satisfactorily complete the MOCA Practice Performance Assessment and Improvement (PPAI) process. One component of the PPAI process is a four-step case evaluation as described below:

    First, the diplomate must complete a two-step assessment of his/her current practice of anesthesiology:

    1. Collect: The diplomate collects a meaningful sample of data, over an extended period of time, from one of the following:
      • Clinical outcomes data on patients from a specific period of time or group of patients
      • Feedback from patients that relates to clinical care given
    2. Compare: The diplomate compares the outcomes with evidence-based practice guidelines approved by the ASA. If not available or pertinent, outcomes are compared to explicit expert consensus, or to peer (inside and/or outside group) data to determine areas for improvement.

      3. In the next two steps, the diplomate works towards the improvement of his/her practice:

    3. Implement: The diplomate designs and implements a plan to improve outcomes in one of four selected areas:
      • Clinical reminders
      • Personal education
      • Change in system or process
      • Clinical pathway
      The development of a practice improvement plan may be an individual or a group effort and implementation may be done by a group or by the diplomate. If the group approach is used, it must be possible to extract the individual diplomate’s data from the group data.

    4. Evaluate: The diplomate collects new data on patient outcomes, compares the latest outcomes to the chosen guidelines or standards, and determines the amount of improvement since the original assessment. The goal is for the diplomate to improve or maintain a high standard of practice.

      5. Completing and Submitting a Case Evaluation to the ABA

      At the end of the four-step process, the diplomate prepares a summary of the four steps. NOTE: Diplomates are advised not to make reference to patient identifiers or the name/location of the institution and/or practice in the case summaries.

      When the document is complete, the diplomate submits it to the ABA by mail or fax. All Case Evaluations are subject to audit and review.

      Sample Case Evaluations
      Click on the topcs below to see sample case evaluations:

  4. Which CME Providers offer Patient Safety Education acceptable to the ABA? Top

    5. Both the American Society of Anesthesiologists (ASA) and the American Board of Medical Specialties (ABMS) will offer Patient Safety Modules acceptable to the ABA in 2008.

    The ASA Patient Safety Modules are available at http://psmcme.asahq.org.

    To access the ABMS Patient Safety Modules offered by HealthStream, click here.
    (NOTE: Internet Explorer must be used to access this Web site.)

  5. How many Patient Safety CME credits do I need to fulfill the Patient Safety Education requirement? Top

    6. 20 Category 1 Patient Safety CME credits must be completed during the three year segment (either Years 1-3, Years 4-6 or Years 7-9) to fulfill the requirement.

  6. Which CME Providers offer Simulation Education Courses acceptable to the ABA? Top

    7. The American Society of Anesthesiologists (ASA) is currently working on developing a simulation endorsement network with centers located throughout the United States. Once available, the ABA will post information about the endorsed simulation centers on the ABA Web site.