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October 2005

MOC: Help Is on the Way

The Academy Member’s Guide to the ABO’s New Maintenance of Certification Process (pdf 838 KB)


Ron Pelton, MD, was a resident at Baylor College of Medicine in 1994 when he first learned about the recertification process in which board certification would expire after 10 years unless renewed. And he wasn’t thrilled—to say the least. “The guys who finished a few years in front of me were stoked that they wouldn’t have to recertify,” Dr. Pelton recalled. “And we were bumming. We thought that recertification was a punishment.”

But 12 years and the experience of being in a demanding, private oculoplastics practice in Colorado Springs, Colo., have changed his mind.

“It only makes sense to have a certain level of core knowledge about your specialty,” Dr. Pelton said. “And anyone who looks at the new Maintenance of Certification [MOC] process in a dispassionate way would agree. Especially our patients. The only way they can determine if we are well-educated in our practice is through this type of board certification. I don’t think we should ask patients to take that on faith.”

Dr. Pelton pointed out that private practice differs dramatically from residency in the academic setting in terms of the learning process. In an academic environment, physicians learn by “osmosis,” constantly attending grand rounds and meetings, and continually being updated on the latest breakthroughs in the field. “You can stay up to speed in your particular area without trying terribly hard,” he said.

“However,” he noted, “in private practice you sometimes feel like a lone wolf out on your own. It is a lot more difficult to stay as informed as you would like to be. The MOC process gives us a structure where we can keep up to speed on relevant core competencies.”

In June, Dr. Pelton attended a meeting at the Academy during which he learned more about the MOC process. One of his strongest impressions was the extensive support being offered by the Academy.

“It is really important to remember that the Academy is not administering this test,” said Dr. Pelton. “The American Board of Ophthalmology [ABO] is implementing this process. The Academy has focused on developing study materials to help ophthalmologists successfully complete the process.” 

Dr. Pelton, who was board certified by the ABO in 1999, is already starting to think about taking the Demonstration of Ophthalmic Cognitive Knowledge (DOCK) exam. “You don’t want to wait until the last possible moment to take it. If you do that and you don’t pass, you lose your board certification,” he explained. “Since you can take [the DOCK] two years before your board certification expires, I plan to take it in 2007, which means I will probably start studying in 2006.”

Dr. Pelton has a philosophical approach to the exam. “I really believe that this will be a good experience and that I will come away feeling like I learned something from it. If nothing else, I will have seen that I know more than I thought I knew. It will be like running a race—it will be tough, but I will be glad I did it.”

Academy on Your Side

The ABO’s new Maintenance of Certification process, which kicks in during 2006, is designed to promote lifelong learning. There are a few more components to the new MOC than the old recertification process (see “MOC Process: Requirements and Resources”), including a closed-book exam. To assist members in preparing to meet the ABO’s MOC requirements, the Academy has developed a suite of products and services called the Academy MOC Essentials. A Web site, which is also called Academy MOC Essentials (, serves as a centralized, comprehensive resource for ophthalmologists. It contains basic information about the MOC requirements as well as descriptions of and links to MOC-related products and services. These include a study guide and self-assessment products and a review course, all of which are based on the Practicing Ophthalmologists Curriculum (POC).
What is the POC? The POC is central to the Maintenance of Certification process. It is the knowledge base of clinically relevant information that identifies and defines areas of knowledge important to the delivery of quality eye care that a practicing ophthalmologist needs to know to remain certified. The POC is organized into 10 practice emphasis areas (i.e., subspecialties), along with Core Ophthalmic Knowledge. This information will serve as the basis for the content of the ABO’s examinations for the Maintenance of Certification process.

Where did the POC come from? At the request of the ABO, the Academy utilized its expertise in clinical education to develop the POC. Panels of practicing ophthalmologists in each of the 10 practice emphasis areas developed and organized the content that comprises the POC. Each panel reflected a diversity of background, practice type and geographic distribution. (Note: 50 percent of the panel members are time-limited certificate holders.)

How can the POC help me? Because the ABO is basing its MOC examinations on the POC, this knowledge base is very valuable to an ophthalmologist preparing to meet the MOC requirements. The Academy has developed its Academy MOC Essentials products and services using the POC, which means that these materials ensure your study time is well-spent. Read on to learn about the Academy MOC Essentials and other resources to aid your success.

Academy MOC Essentials Web Site:

To get your bearings, visit this area of the Academy’s Web site. You will find it a good home base for learning about Maintenance of Certification and discovering tools and services that will help you through the process. Among its offerings you will find the following:

Basic information about MOC. Maintenance of Certification involves more than the American Board of Ophthalmology’s closed-book exam. This section of the Academy MOC Essentials site gives a clear overview of the requirements and provides a link to the ABO Web site for further information. It gives straightforward answers to question such as “Who is affected?” and “What are the requirements?”

Exam topics. View the topics from which the ABO will pull exam questions for both its closed-book (DOCK) exam and its open-book (PORT) tests. This outline summarizes the Practicing Ophthalmologists Curriculum. It provides an overview of the information you will be tested on and will point your study efforts in the right direction.

Other tools and services. Here you’ll find online CME reporting; links to ethics and clinical CME courses; an e-mail update service for any MOC-related news in your areas of clinical interest; and information about and demos of the study materials available for purchase (described below).

MOC Exam Study Guide

Organized in outline format for easy review, the MOC Exam Study Guide provides materials covering Core Ophthalmic Knowledge. Core (for short) is the fundamental ophthalmic knowledge every practicing ophthalmologist should know regardless of his or her subspecialty, and it constitutes the mandatory portion of the DOCK and PORT examinations.

The Study Guide also provides materials for up to two practice emphasis areas (PEAs) of your choosing. The PEAs are basically subspecialties as defined by the ABO, and they make up the elective portions for your DOCK and PORT exams. You may choose to be tested in one or two practice emphasis areas. (See “Your Electives,” below, for a list of the PEAs.)

With purchase of the MOC Exam Study Guide, you receive both online access and books so you can study wherever and however you please.

Online guide. The Web-based portion of the study guide allows you to review material, make notes and insert bookmarks to aid in further review. Plus, it tracks the material you’ve completed, which is especially handy when you take a break and need to be reminded where you left off. While you may opt to delay selection of a second practice emphasis area, it behooves you not to. Once you purchase the guide, you’re on the clock. Access to the online format expires one year from date of purchase.

Print guide. When you purchase the MOC Exam Study Guide, you will automatically receive books for Core and your selected practice emphasis areas. Each book is 8-1/2 x 11 inches to easily fit in your briefcase and has spiral binding so it lies flat while you study.

Price: $225 member, $450 nonmember. To order, visit

Your Electives

The Practicing Ophthalmologists Curriculum is a knowledge base of information deemed most clinically relevant for a practicing ophthalmologist. The POC comprises Core Ophthalmic Knowledge—what every ophthalmologist should know in order to practice—and 10 practice emphasis areas. PEAs are subspecialty areas as defined by the ABO. They are also the elective portions for your DOCK and PORT exams:

  • Comprehensive Ophthalmology
  • Cataract/Anterior Segment
  • Cornea/External Disease
  • Glaucoma
  • Neuro-Ophthalmology and Orbit
  • Oculoplastics and Orbit
  • Pediatric Ophthalmology/Strabismus
  • Refractive Management/Intervention
  • Retina/Vitreous
  • Uveitis


MOC Exam Self-Assessment

Use this online self-assessment tool to gauge your strengths and weaknesses before sitting for the DOCK or PORT exams. Purchase gives you access to two modes of study: self-paced review and timed practice exams. These cover questions in Core and your choice of one or two practice emphasis areas. Password-protected access to these online study tools lasts one year, and you earn CME credits for studying.

Self-paced review. This portion of the self-assessment provides questions in Core and your one or two selected practice emphasis areas (approximately 250 questions in each PEA). Study at your leisure and, as you go along, see the answers and the POC content on which questions were based. Bookmark and take notes on questions for later review of materials.

Timed practice exams. You will have access to nine practice examinations, three each for Core and your selected PEAs. (If you choose just one PEA, you’ll receive six exams in that area.) Each exam contains 50 multiple choice questions, and a countdown clock keeps track of your time. But you can pause the exam to answer the phone, pick up the kids from school, etc. Complete the test, and the program confidentially tallies your score and compares it with your earlier results. After you’ve finished an exam, review the questions and see the answers and the POC content from which the question was composed.

CME. Earn up to 30 category 1 CME credits total.
Price: $325 member, $650 nonmember. To order, visit

MOC Exam Preparatory Kit
The prep kit combines the MOC Exam Study Guide (both online and print components) and the MOC Exam Self-Assessment, which includes the self-paced and timed formats.

Price: $450 member, $900 nonmember. To order, visit

MOC Exam Review Course

The Academy is offering an in-depth MOC exam preparation course in Chicago from July 21 to 23, 2006. The content for this course is taken directly from the POC, and it will be taught by the physicians who developed the knowledge base. Registration includes admission to one Core exam course and a course in one additional practice emphasis area. An extra day’s attendance to study another PEA will be available for an additional fee. Receive up to 8 category 1 CME credits per day.

Watch for price and registration details.

Academy MOC Essentials, MOC Exam Study Guide, MOC Exam Self-Assessment, MOC Exam Preparatory Kit and MOC Exam Review Course are all trademarks of the American Academy of Ophthalmology. Perspective was written by Lori Baker Schena, contributing writer. This article was compiled by Patty Ames, executive editor.

MOC Process: Requirements and Resources   
Use this chart as an at-a-glance reference to the MOC process requirements and to the resources available to tackle them.
ABO RequirementsWhat This Means to YouAvailable Resources
Evidence of Professional Standing
Valid and unrestricted license to practice medicine in the United States, U.S. Territories or Canadian province
The ABO will verify licensure status (disciplinary actions) for all diplomates through continual electronic monitoring of the Disciplinary Action Notification System. 
Not applicable.
Evaluation of Practice Performance
Office Record Review (ORR)
You must select three of the ABO’s ORR modules and compare five of your patient records to each, for a total of 15 patient records. Typically completed in years 3 or 4 of the MOC cycle.¹The ORR will be available online, on-demand via the ABO Web site beginning January 2006. The description and content of all ORR modules are available on
Evidence of Commitment to Lifelong Learning and Self-Assessment
Periodic Ophthalmic Review Test (PORT)
Continuing Medical Education (CME)
PORT: Most ABO diplomates must complete two PORT online exams in the 10-year MOC cycle, one in Core and one in a PEA of your choice. (The PORT is not to be confused with the DOCK, which requires testing in two PEAs.) Each PORT module is 50 questions, and may be taken in your home or office. Typically completed in years 5 to 7.¹

CME: During each 10-year MOC cycle, you must complete an average of 30 category 1 CME credits each year. Three hours during the 10-year cycle must be ethics CME.
MOC Exam Self-Assessment earns you CME credits while you study for the PORT exam.

MOC Exam Study Guide aids in study for the PORT exam. No CME credits, though.

Academy MOC Essentials Web Site offers links to several helpful tools related to CME. These include:

CME Central where you can report, view and print out the CME you have earned. While there, click the “CME Courses and Products” link, which leads to a number of CME-bearing activities.

The Ethical Ophthalmologist. This series of courses offers ethics CME in online and audio-CD formats.
Evidence of Cognitive Expertise
Demonstration of Ophthalmic Cognitive Knowledge (DOCK)
This is a closed-book, proctored exam administered at approximately 300 nationally distributed computer-based testing centers. It consists of three 50-question modules, one in Core (required) and two in practice emphasis areas of your choice (you may select one PEA twice if you like). Typically completed in years 8 to 10.¹MOC Exam Study Guide
MOC Exam Self-Assessment
MOC Exam Review Course
NOTE: This is not intended to be a comprehensive guide to the MOC process requirements. For details, go to the ABO’s Web site,

1 The American Board of Ophthalmology’s MOC program is designed to be spread out over the 10-year certification cycle. However, while the ABO transitions to MOC, the timeframe for the MOC components is slightly different according to the year a diplomate was certified or recertified. See for specific requirements.