Diane Davis Davey, MD
January 2015—Last year was the first year that the American Board of Pathology offered Maintenance of Certification Part III subspecialty examinations. Sixty-four diplomates took a pilot exam in 2013, but it included only anatomic pathology and clinical pathology modules. The secure examination may be taken in years seven to 10 after enrollment in MOC, with no more than 12 years elapsing between examinations. All 2014 examinations were given in Tampa, Fla., but there are plans to offer testing in other locations in the future. Diplomates who were certified in 2006 or later must meet MOC requirements or their certificates will expire early and they will no longer be certified. MOC is open to all ABP diplomates, and participation will not jeopardize non-time-limited certificates issued before 2006.
The AP/CP MOC examination is modular and includes one mandatory 50-question module in AP/CP combined, AP only, or CP only. This required module includes about 10 questions on topics such as safety, accreditation, and quality assurance. The remainder of the 150-question examination includes four 25-question elective modules to be selected by the diplomate. The elective AP modules include general, nongynecologic, and gynecologic cytopathology selections.
Each subspecialty examination is 150 questions, with some subspecialties having modules. The ABP determined that the AP/CP 50-question required primary module could be combined with the 150-question subspecialty exam and graded together. This means that an MOC participant can maintain certification in AP, CP, and cytopathology by completing a 200-question module that is graded as one in a single session. There are no glass slides or virtual microscopy in the MOC examinations. The cytopathology subspecialty examination is not modular and consists of about 80 percent practical and 20 percent written questions.
Fifty-six diplomates took the March 2014 MOC exam and all passed their selected primary, subspecialty, or combined exam. Eighty-six diplomates took the August exam and the pass rate was 97 percent.
Ten diplomates completed the cytopathology subspecialty March MOC examination and all passed. Of the 18 diplomates who took the fall cytopathology MOC exam, there was one failure. Of the 28 total cytopathology participants in 2014, 16 took the combined AP/CP/cytopathology examination (200 questions), two took the combined AP/cytopathology examination (200 questions), and 10 took the subspecialty cytopathology exam. The individuals who took only the 150-question subspecialty examination had non-time-limited AP or AP/CP certificates, had in addition combined the MOC AP/CP with another subspecialty examination, or had taken the 2013 pilot examination. The 96 percent pass rate for the cytopathology subspecialty MOC examination in 2014 exceeds the pass rate for initial subspecialty certification and compares favorably with other medical specialty MOC examinations.
In addition to the Part III secure examinations, other required components of MOC include professionalism and professional standing, encompassing medical licensure and staff privileges (Part I); continuing medical education and self-assessment module (SAM) credits (Part II); and improvement in medical practice, which includes laboratory accreditation, individual and laboratory performance improvement, and peer evaluations (Part IV). Diplomates must submit documentation for Parts I, II, and IV activities to the ABP every two years. For Part II, each MOC participant must obtain a minimum of 70 approved CME credits every two years, and at least 20 of the 70 credits must include successful completion of SAMs. A cytopathologist can easily fulfill Part IV activities through laboratory accreditation, participation in annual gynecologic cytology proficiency testing, and participation in cytopathology interlaboratory comparison programs. Several of the latter include CME credits, which double count for Part II and Part IV activities. A patient safety course approved by the American Board of Medical Specialties must be completed once during every 10-year cycle.
Rebecca Johnson, MD, CEO of the ABP, gave two CAP webinars on the MOC program and exam on Oct. 28 and Nov. 4, 2014, and each was viewed by more than 500 sites. These webinars will be made available on the CAP website. Additional information is also posted on the Maintenance of Certification page of the ABP website at www.abpath.org/MOCGenInfo.htm (accessed Nov. 7, 2014).
- Davey DD. Maintenance of certification: how does it affect cytopathologists? Cancer Cytopathol. 2014;122:81–82.
- Johnson RL. The American Board of Pathology’s Maintenance of Certification program update. Arch Pathol Lab Med. 2014;138:512–517.
Dr. Davey is a professor of pathology and assistant dean for graduate medical education at the University of Central Florida, Orlando. She is a member of the CAP Cytopathology Committee and a trustee of the American Board of Pathology.