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September 2006


Maintenance of Certification: Has Your Time Come?
By Richard P. Mills, MD, MPH
Chief Medical Editor, EyeNet

This month, the American Board of Ophthalmology will be giving its first-ever closed-book recertification examination at computerized testing sites throughout the United States. It is a major component in the 10-year stepwise process of Maintenance of Certification (MOC), and goes by the acronym of DOCK (Demonstration of Ophthalmic Cognitive Knowledge).

If you are one of the 345 diplomates who have registered for the DOCK exam this year, you are no doubt well aware of the resources available to assist you in preparation. But for those who will be taking DOCK in subsequent years, you will be relieved to know that the Academy has assembled a wonderful set of preparatory items called the Academy MOC Essentials.

The DOCK consists of three modules of 50 questions each. One module covers Core Ophthalmic Knowledge, and every ophthalmologist is required to take it, regardless of subspecialty. The other two modules are chosen by the examinee from 10 practice emphasis areas. If your practice involves primarily cataract and glaucoma, you might choose cataract/ anterior segment (50 questions) and glaucoma (50 questions), or you could choose all 100 questions from a single practice emphasis area (e.g., glaucoma).

To ensure that all candidates have access to the same material to study for the examination, the ABO developed its questions for DOCK based on the clinically relevant content contained in the Practicing Ophthalmologists Curriculum, as published by the Academy (an outline of the POC topics is available at A former EyeNet editorial (June 2005) outlined the process for development of the knowledge base for ophthalmology, which became the POC, using panels of experts with the majority representing those who would ultimately be taking the DOCK exam.

The Academy MOC Essentials is designed to demystify MOC, explaining the terminology and the requirements, and providing three types of study resources—all based on the POC. The MOC Exam Study Guide features online and print study tools in Core Ophthalmic Knowledge and up to two of the practice emphasis areas. The MOC Exam Self-Assessment allows an online self-paced review and a timed exam simulation. The MOC Exam Review Course (held in Chicago in July) is taught by instructors who themselves created the POC. All three components are tied to the content used by the ABO in creating the DOCK exam, so it’s difficult for me to imagine that an ophthalmologist using these study aids could have trouble with the exam. But to be on the safe side, diplomates whose certificates expire up to three years from now can take DOCK early, leaving time for a repeat attempt should the unthinkable happen.

Even ophthalmologists with no time limit on their ABO certification are eligible to enter MOC voluntarily. Twenty-four other ophthalmologists and I are in that category this year, and are signed up to take DOCK this month. It will be nice to show my patients that I’ve been keeping up. So, if you don’t hear a loud scream during September, you can assume it went OK for me and my DOCKing colleagues.


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Dr. Mills no longer has an affiliation with the American Board of Ophthalmology, other than as an emeritus director, and has not helped pick the questions for his own DOCK exam.