Focus On MOC/OCC and MOL
Healthcare regulators and payers now require physicians to demonstrate continuous professional development and quality
patient care. Continuing Medical Education (CME) providers can assist physicians to meet the requirements of maintenance of
certification (MOC)/Osteopathic Continuous Certification (OCC) and maintenance of licensure (MOL) through strategic design of
What are MOC/OCC and MOL?
MOC/OCC: Physicians become certified by individual specialty boards to acknowledge mastery of their given medical or surgical
specialty. Board certification, while voluntary, is often required for credentialing by healthcare institutions and for inclusion in
insurance plans. Certifications are now time-limited and require documentation of continuous professional development. The
American Board of Medical Specialties and the American Osteopathic Association (AOA) Bureau of Osteopathic Specialists (BOS)
develop professional standards for medical specialty boards.
Both MOC and OCC requirements include four components:
• Part I Professional Standing (i.e., physician must hold a valid license in the U.S.);
FOCUS ON MOC/OCC AND MOL
• Part II Lifelong Learning and Self- Assessment (CME or equivalent);
• Part III Cognitive Expertise (i.e., a certification examination); and
• Part IV Practice Performance Assessment (i.e., performance improvement activity);
OCC includes an additional requirement for continuous membership in the American Osteopathic Association.
MOL: The Federation of State Medical Boards (FSMB) represents and supports the 70 state medical and osteopathic boards of
the U.S. and its territories. In 2010, the FSMB published a three-part model for maintenance of licensure that includes
(1) reflective self-assessment (2) assessment of knowledge and skills; and (3) performance improvement. One recommendation
of the FSMB is that physicians satisfying the requirements of MOC or OCC should be recognized as having substantially fulfilled
the requirements for all three components of MOL.
It is important to understand that the FSMB has no regulatory authority. That authority rests with the state/territory boards, and
requirements differ widely. For example, documentation of CME currently is required in 62 of 69 jurisdictions, and topic-specific
CME is required in 15 states. A number of state boards currently are addressing the FSMB recommendations through the
development of MOL pilot programs.
Why are MOC/OCC and MOL important with regard to CME?
Continuing education is a vital component of both MOC/OCC and MOL for nearly all physicians. These new regulatory
expectations for continuous quality and performance improvement require physicians to do more than simply participate in
traditional CME programs. Physicians now must engage in critical self-assessment, participate in CME that addresses identified
gaps, and monitor and improve their performance.
MOC/OCC requirements differ from specialty area to specialty area. Likewise, MOL requirements may differ from state to state
(or territory). Physicians must (1) understand which requirements are applicable to their professional situation;
(2) meet those requirements; and (3) record, track and report completion.
CALL TO ACTION
Addressing MOC/OCC and MOL requirements promotes the improvement of clinical judgment and skills necessary for high quality
patient care but may also pose a daunting challenge for physicians. Providers of healthcare education are encouraged to assist
1. Staying informed of MOC/OCC and MOL requirements.
2. Designing activities that measure performance, address identified gaps, and meet requirements for MOC/OCC and MOL
3. Clearly identifying credit that is applicable to MOC/OCC Part II and Part IV requirements.
4. Creating and identifying study opportunities consisting of relevant, practice-based and self-assessment-based CME to help
physicians pass MOC/OCC Part III certification exams.
5. Offering or identifying learner portfolios that document the results of self-assessments and performance improvement
activities, a plan for CME, and completion of MOC/OCC and MOL requirements.
American Board of Medical Specialties (ABMS): http://www.abms.org/
ABMS White Paper on MOC CME and Responses from the Alliance for CME; CMSS, AMA and SACME:
ABMS Multi-Specialty MOC Portfolio Program: http://www.abim.org/quality-improvement-program-providers/moc-
American Osteopathic Association: Osteopathic Continuous Certification http://www.osteopathic.org/inside-
Federation of State Medical Boards (FSMB): http://www.fsmb.org/
FSMB Summary of CME Requirements by State: http://www.fsmb.org/pdf/GRPOL_CME_Overview_by_State.pdf
Humayun J. Chaudhry, et al. Maintenance of Licensure: Protecting the Public, Promoting Quality Health Care. Journal of
Medical Regulation (96)(1). Federation of State Medical Boards: http://www.fsmb.org/pdf/mol-bg.pdf
Jackson, Marcia et al. The Need for a Specialty Curriculum Based on Core Competencies: A White Paper of the Conjoint
Committee on Continuing Medical Education. The Journal of Continuing Education in the Health Professions. Volume 27,
Issue 2, Spring 2007: http://www.jcehp.com/vol27/2702_jackson.asp
McKenna, Mindi, Implications of MOC / MOL for CME Collaborations. 22 Annual Conference of the National Task Force
on CME Provider/Industry Collaboration. September 22, 2011: http://www.ama-assn.org/resources/doc/cme/2011-
The Alliance for Continuing Education in the Health Professions is a community of
professionals dedicated to accelerating excellence in healthcare performance through
education, advocacy, and collaboration.