New Options For Making the Most of MOC, Continuing Education

Maintenance of Certification (MOC) has been a hot-button issue and a top priority for the ACC since the American Board of Internal Medicine (ABIM) changed its MOC requirements in 2014. At the time, the ACC Board of Trustees defined a three-pronged approach to navigating the changes: 1) the ACC would be the trusted source of information for its members regarding MOC; 2) the ACC would create and maintain a robust selection of educational opportunities for members choosing to maintain their ABIM certification; and 3) the ACC would engage ABIM in efforts to change and improve the MOC process.

In a recent leadership page published in the Journal of the American College of Cardiology (JACC), ACC President C. Michael Valentine, MD, FACC, former ACC President Richard A. Chazal, MD, MACC, and ACC Executive Vice President William J. Oetgen, MD, MBA, FACC, note that the College has been successful in operationalizing all three of these principles over the last four years. Most recently, the College has been working diligently to address the MOC assessment (formerly Part III) aspect of the MOC process – arguably one of the most contentious areas for physicians.

Last year, the ACC, along with the American College of Physicians and the American Society of Clinical Oncology, began exploring a third MOC assessment option with the ABIM called “collaborative maintenance pathways” (CMPs). These collaborative society-ABIM programs would better integrate “lifelong learning” and performance-based assessment in the fulfillment of the MOC requirements, while preserving the value of a performance-based independent credential. The ACC CMP would be used by diplomates to maintain currency in cardiovascular knowledge and maintain ABIM certification over a five-year cycle. The CMP option offered by the ACC would feature modified versions of ACC’s Self-Assessment Programs (SAPs) such as the Adult Clinical Cardiology Self-Assessment Program (ACCSAP). Both the ACC and the ABIM are cautiously optimistic that an agreement can be reached.

In the meantime, the ACC Board of Trustees has approved a plan to move forward with the creation of two variations of the next edition of ACCSAP starting in 2019. One variation, “ACCSAP for Medical Knowledge,” will provide multimedia learning material and a “practice question” bank that, when successfully completed, will provide sufficient CME credits to fulfill most state licensure requirements, as well as Medical Knowledge MOC points for those learners who may wish to report their MOC activity to the ABIM. The second variation, “ACCSAP for MOC,” will offer the same multimedia learning material and “practice question” bank, with accompanying CME credits and Medical Knowledge MOC points as the first variation. It will also contain access to a distinct, secured “performance question” bank which, when successfully completed, could fulfill ABIM’s MOC Assessment requirements as part of the CMP.

“By providing two variations of ACCSAP, [cardiologists] can choose the best path for them as individuals,” wrote Valentine, Chazal and Oetgen in JACC. “Both variations will provide verifiable learning, including knowledge and CME credits and MOC points; an affordable mechanism for ongoing education that can be done at one’s own pace; and reassurance to the public that physicians completing the process have had a thorough review of contemporary cardiology. For those choosing to maintain their ABIM certification in Cardiology, the product offers a great option.”

Looking further ahead, the College is working closely with SCAI, HRS, and HFSA to create additional SAPs that could fulfill ABIM MOC Medical Knowledge and Assessment requirements for interventionalists, electrophysiologists and heart failure specialists. These cardiovascular subspecialty SAPs would also function on a five-year cycle and be designed as exact analogs of ACCSAP. In addition, multiple state legislative activities could impact MOC in the future. Initial legislation has addressed (and prohibited) the use of MOC in licensing activities, while more recently, legislative interest has extended to limiting MOC use for hospital or payer credentialing. This is a dynamic and rapidly-changing environment that the ACC is watching closely.

Keep up with all things MOC on ACC's newly updated MOC Information Hub at

Clinical Topics: Arrhythmias and Clinical EP, Heart Failure and Cardiomyopathies, Invasive Cardiovascular Angiography and Intervention, Implantable Devices, SCD/Ventricular Arrhythmias, Atrial Fibrillation/Supraventricular Arrhythmias, Statins, Acute Heart Failure, Interventions and Imaging, Angiography, Nuclear Imaging

Keywords: Education, Medical, Continuing, Self-Assessment, Test Taking Skills, Leadership, Trustees, Multimedia, Certification, Self-Evaluation Programs, Heart Failure, Cardiovascular Diseases, Angiography, Medical Oncology, Electrophysiology, Heart Diseases, Cytidine Monophosphate

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