When M-O-C Means Y-O-U – What You Need to Know About ABNS MOC

A convenient feature at www.MyAANS.org tracks and categorizes continuing education credits earned toward ABNS maintennace of Certification. Of 150 CME credits needed for each cycle. 60 credits must be in category 1 whlie 90 credits can be in category 1 or 2.

Recent graduates of neurosurgery programs no doubt are well aware that since 1999 the American Board of Neurological Surgery has issued 10-year certificates. Presently 35 percent of all diplomates have a time-limited certificate, and by 2027 nearly all diplomates will need to undergo the ABNS Maintenance of Certification process. Furthermore, although MOC is not required for the majority of neurosurgeons who currently are board-certified, it may become mandated by insurance companies, hospital credentialing boards, and state licensing organizations. For those who already know that they will be participating in MOC and for those whose participation may be required in the future, this article will describe the basic MOC components and how they will be evaluated by the ABNS.

There are four basic components to the MOC process:
1. Professionalism
2. Lifelong Learning and Self-Assessment
3. Cognitive Knowledge
4. Performance in Practice

To show professionalism, every three years the diplomate must document an unlimited medical license, admitting privileges to practice neurosurgery, and have a questionnaire filled out by the chief of staff for the diplomate’s primary hospital.

Lifelong learning will be measured by documentation of continuing medical education credits on a three-year cycle. The AANS has a convenient feature at www.MyAANS.orgthat will track and categorize CME credits. Of a total of 150 CME credits needed for each cycle, 60 credits must be in category 1 while 90 credits can be in category 1 or 2. At least 80 percent of the credits must be neurosurgical in nature, and courses attended must not be sponsored by industry.

International meetings will not count toward the CME requirements for MOC, and at least 60 category 1 credits must come from meetings sponsored or endorsed by the AANS or the CNS. In addition, these category 1 credits can come from study of approved enduring materials such as journals and audio and video products. The remaining 90 credits may come from a variety of sources. Other acceptable sources of category 1 credits include courses and opportunities such as Grand Rounds that are approved by the Accreditation Council for Continuing Medical Education, publishing peer-reviewed articles; presentations at meetings; and recertification by the ABNS. Sources of category 2 credits, which are broad in nature, include consultation with colleagues, teaching non-healthcare workers, online learning and research, and attendance at non-ACCME approved meetings. Self-assessment occurs every three years via the SANS test produced by the Congress of Neurological Surgeons.

Every 10 years, diplomates will take a secure, computer-based, cognitive exam that will focus on general neurosurgery, general neurosurgery plus complex spine, or general neurosurgery plus pediatrics. This test may be taken in years eight, nine, or 10 of the recertification process and will closely match the SANS format. The pass rate for this exam is expected to be very high.

The last component of MOC is the evaluation of performance in practice. Every three years, 10 consecutive key cases (from a list of 14 commonly performed neurosurgical procedures) must be submitted. The same type of case (for example, clipping of a supratentorial aneurysm) must be used during the entire 10-year cycle. The chief-of-staff questionnaire is also pertinent in this section as elements of interpersonal skills, communication, and systems-based practice will be evaluated.

The entire MOC process will be completed by year 10. The process then will start anew in January of the following year.

The MOC process may change as unforeseen issues impact different parts of the process. For instance, the trend toward recognition of subspecialization by other medical boards will need to be addressed by the ABNS. For some diplomates this may entail collection of additional cases and demonstration of specific competence. A consideration for the ABNS will be ensuring that specialty recognition does not devalue the traditional certificate.

MOC clearly is much more than a test that must be passed once every 10 years. In fact, the cognitive exam may be easiest part of the entire process. For additional information and to stay current with MOC developments, I recommend regularly reviewing MOC information at www.abns.org and www.aans.org.

Lawrence S. Chin, MD, is chair of the Department of Neurosurgery at Boston University School of Medicine and a member of the AANS Maintenance of Certification Committee. Send topic ideas for this department to Dr. Chin, Education editor, at [email protected]. The author reported no conflicts for disclosure.

The author thanks H. Hunt Batjer, MD, chair of the American Board of Neurological Surgery, for his assistance with this article.

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