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Getting Feedback on MOCA-Peds from Pediatricians Across the U.S.

By Adam Turner, MPH, PMP

Certified pediatricians – called diplomates of the American Board of Pediatrics (ABP) – have played a significant role in shaping the pilot of the ABP’s new approach to the Maintenance of Certification (MOC) Part 3 assessment, MOCA-Peds. 

The ABP has been working with an independent research institution, RTI International, to reach out to pediatricians and elicit their feedback. Contracting with a respected, external research organization was important to the ABP to demonstrate our commitment to transparency and fairness to diplomates.

In January 2016, more than 3,200 diplomates responded to RTI’s open call for pediatricians to participate in providing feedback about MOCA-Peds. RTI randomly selected diplomates who represented a range of ages, geographies, and practice types: 37 diplomates are serving as a user group that meets every 4-6 weeks to develop the model and test the IT platform. About 300 additional diplomates are participating in focus groups this year.

Based on feedback from these groups, a number of changes have been made to the pilot. For example:

  • Learning objectives on which questions are based will be released before the year starts.
  • If MOCA-Peds replaces the secure exam, flexibility will be built into the system to allow for personal circumstances in diplomates’ lives. 
  •  A specific MOCA-Peds Code of Conduct has been created that is easy to understand and specific to this platform.
  • Sample questions will be released prior to the pilot launch.
  • Questions on emerging issues (which will not be scored) will be offered in late 2017 and will let us try out an article-based system.

Additionally, modifications have been made to every major webpage of the MOCA-Peds platform based on user group feedback. This feedback has ranged from general design suggestions to specific ideas, such as adding a bookmark option to facilitate easy re-visiting of questions at a later time. 

These diplomates also have given us ideas for future changes we will consider, such as offering a broader array of questions that increasingly test reasoning and clinical judgment, as well as more frequently incorporating graphics and images into the questions. 

Diplomates also suggested that the assessment cycle for MOCA-Peds be five years and align with MOC cycles. 
Overall, the feedback and perspectives offered by diplomates have significantly molded the MOCA-Peds pilot. We look forward to additional suggestions during the pilot. These suggestions will be instrumental as we continue to build a more meaningful assessment and learning experience. 

Who is eligible for the MOCA-Peds pilot in January 2017? Certified pediatricians who are meeting the requirements of MOC in general pediatrics and who have a general pediatrics exam due in 2017. Instructions on how to apply for the pilot will be available beginning September 6, 2016.

About the AuthorAdam Turner, MPH, PMP

Adam Turner, MPH, PMP, joined the American Board of Pediatrics (ABP) in 2015 as Senior Research Associate. His work supports the newly-formed research department, as well as the Research Advisory Committee and ABP Foundation. Previous to joining the ABP, Adam has invested much of his career to international healthcare management and IT consulting. 


50 Responses


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Angela Stefan

MOC or MOCA ? ,

I was unable to register, called 919 929 0461 adviced to check my email and to try again to register for pilot as a voluntier.

I noticed the lack of respect , information and help.

Very nice job .

Thank you ABP.

Eneysis Pena

Please quit making this even more confusing. I'm so busy WORKING and trying to have a family that I didn't even have time to read this until today., imaging trying to keep up with all this MOCA deal to top it all off. After completing 2015 I do not feel I gain more knowledge,it didn't make me a better physician. It did cost me lot of money and time away from my kids. So what's the real point??

Kelly West

MOC is a waste of time and creates an undue financial burden. Yearly CME should suffice for an educational requirement for board certification. It is a complete waste of time to sit for an 8 hour test on obscure subjects which can easily be accessed in a textbook or an online site such as Up To Date. MOC is a scam to line the pockets of those who sit on the board.

Mark Deneau

Nothing but a cash grab. ABP should be ashamed. Takes time away from our patients and families with no proven benefits. A monopoly with no competition.

Free MOC credits for multiple choice questions on the relative risk of lupus in siblings? You know the disease incidence is 5 per one million, right? Yes, obviously ABP is in touch with general practice. This will help us prepare for irrelevant board questions on incredibly obscure diseases that general pediatricians and many subspecialists will never see.

Dear ABP members: quit now, cancel these wasteful programs, refund your salaries to all the pediatricians forced into your programs, and go use your degree to help some patients somewhere.

Reucar Quijada

I don't agree with the MOC; it is only about the money. I'm a 100% for open book exam. The daily practice of peditarics is the real test!!!!!

Sophia Yen MD MPH

As many have said above, the MOC as it currently is fails pediatricians and does not serve patients.

1. It is costly and stressful.

2. We want to encourage life-long learning, not cramming. The once in 10 year test does not. (it seems like a money making machine with the prep clasess and paying the test administration centers.) The continuing medical education does encourage life-long learning e.g. Question Of the Week.

3. To be a pediatrician, QI projects are nice but NOT necessary. My hospital and academic center already do QI that are much better than these random and limited ones that the ABP requires/has available.

4. As a sub-specialist, I have to take the ridiculous tests in artificial environments twice. Many of us are thinking of dropping our pediatrics certification and just sticking with the specialty.

5. It is hypocrisy that any members of the ABP that made up this requirement should be exempt from it. If you are subjecting us to it, you need to suffer it too.

6. Internal Medicine decided to DROP their tedious requirements. The ABP should follow suit. Per the rheumatologists "A secure, closed-book, high-stakes MOC examination is not an appropriate means of assessing clinical knowledge." "The study concluded that internists incur an average of $23,607 in MOC costs over 10 years--with doctors who specialize in cancers and blood diseases out $40,495. All told, the study concluded, MOC will suck $5.7 billion out of the health care system over 10 years, including $5.1 billion in time costs (resulting from 32.7 million physician-hours spent on MOC) and $561 million in testing costs. And remember--all that time and expense is for a program that has not been proven to accomplish anything."


Dr Nichols, as president of the ABP, I would like to know how come you are NOT participating in the MOC process for pediatrics yourself, since the ABP "strongly recommends" doing it? How come you have NOT taken a closed book examination yourself since 1982 when you probably completed specialty training? Could it be that it is too difficult for you to go sit 8 hours in a Prometric Testing Center? Could it be that it interferes with your family -life balance? Or maybe you feel is dreadful to have to review and memorize extensive material for months just for a test that you don't really need, because of course, you are "grandfathered"? Good for you! Congratulations on your career and on your onerous salary of more that a million dollars a year! You have failed us. You should be ashamed of yourself for what you are doing to hard working pediatricians!

Marc Frager

Time-limited certification/MOC was imposed unilaterally on pediatricians in 1989 with no input from diplomates. Asking for input now is cynical and sickening. Your moves to save worthless MOC smack of desperation. Let's just end this scam already

Lisa Wrau

As a pediatric subspecialist, I have the choice of whether or not to renew my certification in General Pediatrics. In the midst of my very busy and underpaid days, it serves neither my patients nor myself to participate in the MOC process as it currently exists. The proposed pilot seems vastly more appropriate to serve the needs of pediatric patients, their families, and providers. Lifelong study and learning should always be the goal as opposed to rote memorization and recall for a closed book (and massively expensive) test.


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