Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

A physician’s MOC debacle: Nevermind that $2,100 exam he just passed

Physician on FIRE, MD
Physician
March 5, 2017
68 Shares
Share
Tweet
Share

A couple years ago, I reached the seven-year mark after my initial board certification with the American Board of Anesthesiology (ABA). At the time, it was a significant milestone. I was eligible to take the all-important Maintenance of Certification in Anesthesia (MOCA) exam.

Diplomates of the ABA — that’ right, I’m considered a diplomate — in other words, a board-certified anesthesiologist. Diplomates were encouraged and incentivized to take the $2,100 exam early in the three-year eligibility window.

The exam was only offered twice a year. There were testing dates during a few weeks in the summer or a few weeks in the winter. You could take the exam up to three times to pass and maintain board certification.

In other words, if you fail, you could take it six months later, and if you fail again, you get one more shot. Waiting until the last opportunity would take away your ability to retake the exam before initial board certification could expire.

Like a dutiful diplomate, I signed up.

I really didn’t feel much like studying in the spring and summer for the exam, so I passed on my first opportunity, signing up for winter window.

I didn’t feel much like studying for this test at all, but I knew that I had better put the time in. Just like I’d rather work a bit longer and retire with more money than I need, I’d rather go into an exam with more knowledge than required.

I also felt a need to study because the vast majority of the material on the exam had little relevance to my actual job. The exam covered all topics that an anesthesiologist might encounter, such as chronic pain (which I don’t manage), open heart surgery (which I haven’t seen in years), and brain surgery (don’t see that, either).

There were esoteric facts to memorize, and memorize I did.

I committed to memory all sorts of minutiae that might be only peripherally related to anesthesia. Facts that are taught to be tested, and serve little practical purpose.

For a couple months, I studied when I could. I took advantage of down time at work in the afternoons and evenings, and took myself to the library on some days off.

I would be taking the exam in the second of six opportunities. As much as I wasn’t planning to fail, failure was a viable but expensive option since I’d have four more testing windows in which to retake the test.

Taking the test early seemed prudent.

About a month after the exam, I received wonderful news via mail. I passed!

This was the last of my MOCA requirements for the initial ten-year period. According to the letter accompanying the score report, “Upon successful completion of all MOCA requirements, you will be issued a certificate that well be valid for 10 years from the date of issuance.”

Two months after receiving that letter, I received more news. A MOCA redesign that the ABA had beta tested the prior year was to be implemented for all. The exam that I just passed was replaced with MOCA 2.0. Thousands of fellow diplomates who certified the year I did or the year before who had not yet spent the $2,100 were now excused from having to take the exam.

Wait … wait. What?!

That’s right. Doing the responsible thing, the thing that the ABA encouraged, turned out to be a huge waste of time and money.

I’m not so naive to believe that decision was made casually or abruptly. In other words, when I took the exam in January, the Board had to have known that changes were coming, but had not been finalized, or at least not announced. They gladly took my money and time, anyway. One last money grab before the next one.

The next money grab? Yes, I was told I would also be enrolled in the new computerized MOCA 2.0 program, and expected to pay $210 a year for it. There would be no “grandfathering in.” I would essentially receive no credit for the exam I took, and of course, there was no getting back all the time I put into studying for and taking the exam.

I called the ABA and expressed my extreme displeasure. Others did, too. Eventually, the ABA actually backpedaled a bit and decided I wouldn’t be charged for MOCA 2.0 for ten years since we had just paid the equivalent of ten years worth of the program to take the exam. I would still be required to enroll in the program, and answer quiz questions on a quarterly basis.

That $2,100 test, by the way, was a 200 question multiple choice exam that took me 100 minutes to complete. That’s $1,260 per hour for those keeping score at home. I traveled five hours roundtrip to a computerized testing station to take it, too, as there were no computers offering the test any closer to my home.

Since my original board certification is valid through the end of this year, I have not yet enrolled in MOCA 2.0, but will be required to start in January, 2018 if I want to maintain my certification.

The problem with maintenance of certification

Before MOC was born, we physicians were already required to do continuing medical education, subject to peer review, and many of us maintain many other time-limited certifications, such as ACLS, BLS, and PALS.

It’s not that physicians are not interested in keeping up our knowledge and skills, it’s just that MOC has not been shown to be an effective way to maintain skills or improve patient care. However, it has been shown to be a costly burden in terms of both time and money.

Do I feel slighted? Yes, but I am far from alone. Dozens of doctors have been sharing their MOC stories, and tens of thousands of others feel slighted, too. The number of physicians currently being subjected to unproven costly MOC requirement likely measures in the hundreds of thousands.

I can’t reclaim the time I’ve spent on MOC, but I am encouraged by the pushback, the resolutions from state and national societies, and the bravery of the physicians who are challenging the status quo.

“Physician on FIRE” is an anesthesiologist and can be reached at his self-titled site, Physician On FIRE.  

Image credit: Shutterstock.com

Prev

Does Adderall make you underachieve?

March 4, 2017 Kevin 0
…
Next

Physicians must stop losing their own

March 5, 2017 Kevin 6
…

Tagged as: Surgery

Post navigation

< Previous Post
Does Adderall make you underachieve?
Next Post >
Physicians must stop losing their own

More by Physician on FIRE, MD

  • Personal finance strategies to combat physician burnout

    Physician on FIRE, MD
  • A physician volunteered for his hospital’s board. He was sued for millions.

    Physician on FIRE, MD
  • If you are a practicing physician, you need rest

    Physician on FIRE, MD

Related Posts

  • A physician’s addiction to social media

    Amanda Xi, MD
  • A physician’s first 100 days on Twitter

    Sol Adelsky, MD
  • How a physician keynote can highlight your conference

    Kevin Pho, MD
  • Chasing numbers contributes to physician burnout

    DrizzleMD
  • The black physician’s burden

    Naomi Tweyo Nkinsi
  • Why this physician supports Medicare for all

    Thad Salmon, MD

More in Physician

  • Don’t be caught off guard: Read your malpractice policy today

    Aaron Morgenstein, MD & Laura Fortner, MD
  • The dark side of medicine: an urgent call to action against greed

    Don Gaede, MD
  • Dr. Glaucomflecken for president!

    Aaron Morgenstein, MD & Amy Bissada, DO & Corinne Sundar Rao, MD
  • What is driving physicians to the edge of despair?

    Edward T. Creagan, MD
  • Do residents deserve the title of physician?

    Anonymous
  • When an MBA degree meets medicine: an eye-opening experience

    Arthur Lazarus, MD, MBA
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Surviving and thriving after life’s most difficult moments

      Rebecca Fogg, MBA | Conditions
    • Don’t be caught off guard: Read your malpractice policy today

      Aaron Morgenstein, MD & Laura Fortner, MD | Physician
    • The dark side of medicine: an urgent call to action against greed

      Don Gaede, MD | Physician
    • The surprising power of Play-Doh in pediatric care: How it’s bringing families together

      Alexander Rakowsky, MD | Conditions
    • Breaking free from gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • Fresh Produce Is an Increasingly Popular Prescription for Chronically Ill Patients
  • Dear Congress, Here's How to Fix the Clinician Shortage
  • How Did Pulse Oximeters Perform in Black Kids?
  • Coffee and Heart Function; Ionizing Radiation and CVD
  • Health Inequity Should Be Labeled as a 'Never Event'

Meeting Coverage

  • Switch to IL-23 Blocker Yields Deep Responses in Recalcitrant Plaque Psoriasis
  • Biomarkers of Response With Enfortumab Vedotin in Advanced Urothelial Cancer
  • At-Home Topical Therapy for Molluscum Contagiosum Gets High Marks
  • Outlook for Itchy Prurigo Nodularis Continues to Improve With IL-31 Antagonist
  • AAAAI President Shares Highlights From the 2023 Meeting
  • Most Popular

  • Past Week

    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • The struggle to fill emergency medicine residency spots: Exploring the factors behind the unfilled match

      Katrina Gipson, MD, MPH | Physician
    • Healing the damaged nurse-physician dynamic

      Angel J. Mena, MD and Ali Morin, MSN, RN | Policy
    • What is driving physicians to the edge of despair?

      Edward T. Creagan, MD | Physician
    • Beyond the disease: the power of empathy in health care

      Nana Dadzie Ghansah, MD | Physician
    • Deaths of despair: an urgent call for a collective response to the crisis in U.S. life expectancy

      Mohammed Umer Waris, MD | Policy
  • Past 6 Months

    • The hidden dangers of the Nebraska Heartbeat Act

      Meghan Sheehan, MD | Policy
    • The real cause of America’s opioid crisis: Doctors are not to blame

      Richard A. Lawhern, PhD | Meds
    • Nobody wants this job. Should physicians stick around?

      Katie Klingberg, MD | Physician
    • The vital importance of climate change education in medical schools

      Helen Kim, MD | Policy
    • The fight for reproductive health: Why medication abortion matters

      Catherine Hennessey, MD | Physician
    • Resetting the doctor-patient relationship: Navigating the challenges of modern primary care

      Jeffrey H. Millstein, MD | Physician
  • Recent Posts

    • Surviving and thriving after life’s most difficult moments

      Rebecca Fogg, MBA | Conditions
    • Don’t be caught off guard: Read your malpractice policy today

      Aaron Morgenstein, MD & Laura Fortner, MD | Physician
    • The dark side of medicine: an urgent call to action against greed

      Don Gaede, MD | Physician
    • The surprising power of Play-Doh in pediatric care: How it’s bringing families together

      Alexander Rakowsky, MD | Conditions
    • Breaking free from gaslighting [PODCAST]

      The Podcast by KevinMD | Podcast
    • The pros and cons of using ChatGPT for your health care needs

      Liudmila Schafer, MD | Tech

MedPage Today Professional

An Everyday Health Property Medpage Today iMedicalApps
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

A physician’s MOC debacle: Nevermind that $2,100 exam he just passed
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...