The American Board of Medical Specialties (ABMS) developed maintenance of certification (MOC) in 1999 to ensure that board-certified physicians maintained their knowledge and skills throughout their careers, and to ensure the public that physicians retained their qualifications. In 2000, all 24 ABMS member boards, including the American Board of Anesthesiology (ABA), were required to develop MOC programs and provide time-limited certificates to their diplomates.

The ABA’s current Maintenance of Certification in Anesthesiology Program® (MOCA®) is based on 10-year cycles and includes an assessment of Professional Standing (medical licensure), Lifelong Learning and Self-Assessment, a decennial examination of Cognitive Expertise and periodic evaluations of Practice Performance. It is designed to document diplomates’ proficiency in the six core competencies: medical knowledge, patient care, practice-based learning and improvement, professionalism, interpersonal and communication skills, and systems-based practice.

In the 14 years since MOC’s inception, a growing body of evidence suggests that MOC...

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