Maintenance of Certification (MOC), also known as Continuing or Continuous Certification, is the process by which a physician who has initially become board certified in the specialty practice of their choice maintains their board certification status. The American Board of Medical Specialties (ABMS) Program for MOC involves ongoing measurement of six core competencies defined by ABMS and the Accreditation Council for Graduate Medical Education (ACGME):

  • Practice-based Learning and Improvement
  • Patient Care and Procedural Skills
  • Systems-based Practice
  • Medical Knowledge
  • Interpersonal and Communication Skills
  • Professionalism

A CME activity accredited by the Accreditation Council for Continuing Medical Education (ACCME) that is designated for AMA PRA Category 1 CreditTM, is planned in the context of one or more of the ABMS/ACGME Competencies, and includes an evaluation that is designed to assess changes in learners' competence, performance or the impact on patient outcomes (which is an ACCME expectation), may be registered for MOC credit for one of the following types if it meets the respective additional requirements:

Part II: Lifelong Learning and/or Self-Assessment

MOC requirement of ABMS board-certified diplomates to participate in high-quality, unbiased educational and self-assessment activities. Some boards may refer to activities that include diplomate self-assessment as SAMs (Self-Assessment Modules).


  • CME with Evaluation and Feedback
    - Evaluation: Component that assesses individual learner competence, performance, and/or the impact on patient outcomes. This should measure the competence or performance of the individual learner and not of the activity (not anonymous). 
    -Feedback: All activities must include feedback to participants, identifying learner results with rationales for correct answers or attainment of applicable skill(s), and/or relevant citations where appropriate. 

Additional Requirements:

  • Inform learners about the participation threshold (what they need to do to earn MOC credit (passing standard), including participation in the evaluation component), prior to engagement in the activity. 
  • Provide feedback to the learner about their engagement with the activity, and whether the learner met the requirements to earn MOC credit for the activity. 

Part IV: Improvement in Medical Practice

MOC requirement of ABMS board-certified diplomates to engage in ongoing assessment and improvement activities to improve patient outcomes and demonstrate use of evidence and best practices compared to peers and national benchmarks. 


  • Improvement Activity- often referred to as Improvement in Medical Practice, Practice Assessment, Practice Improvement and/or Quality Improvement. 

Additional Requirements:

  • Address a quality or safety gap that is supported by a needs assessment or problem analysis, or supports the completion of such a needs assessment as part of the activity.
  • Have specific, measurable aim(s) for improvement.
  • Include interventions intended to result in improvement.
  • Include data collection and analysis of performance data to assess the impact of interventions.
  • Define meaningful clinician participation in their activity, describes the mechanism for identifying clinicians who meet the requirements, and provides participant completion information. 

Information obtained from the ACCME's PDF icon CME for Maintenance of Certification Program Guide