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Niels F. Jensen, M.D. Dr. Jensen Board PREP 800-321-7737 MOCA: Proactive or Reactive? Recertification is
here. A review of strategy is
reasonable. The ABA is replacing
Recertification in Anesthesiology with MOCA (Maintenance of Certification in
Anesthesiology). Currently, either
program is available to those certified before January 1, 2000. However, Recertification will close in 2009
and only MOCA will be offered as a path to recertification. Those certified after
January 1, 2000, have time-limited certifications valid for 10 years. Anesthesiologists in this group need to
complete MOCA before their time-limited certificates expire in order to
maintain their diplomat status. The same test is
administered to those in the Recertification pathway and the MOCA pathway; the
Recertification exam and the MOCA exam are the same set of questions generated
from the same key words. For those certified after
January 1, 2000 there’s no choice about taking the MOCA-Recert exam if one
wants to maintain certification. While
letting one’s diplomat status elapse would not constitute professional suicide,
it probably isn’t the right approach, either.
Given the time, trouble, and difficulty of becoming certified and given
the growing importance of certification, I doubt very much that many will
choose to let their Board certification expire. Those certified prior to
January 1, 2000 currently have an option of not recertifying. Among this group, one of the most common
questions I receive is, “Why recertify?
I don’t want to, unless I have to.”
One problem with a
“head-in-the sand” strategy is that the Board has a history of changing its
mind about such things and if and when they do other factors can also change,
namely and most importantly pass rates.
Recall when
recertification first came along there was considerable resistance and, in
fact, the stated position of the Board until two or three years before the test
was instituted was that we were NEVER going to have recertification in our
specialty. After less than a year of
“full discussion and debate” it was decided that recertification does in fact
have merit and would proceed on a voluntary basis only. Another year or two
passed and recertification went from never, to voluntary (for some), to
mandatory (for all). To avoid
full-scale revolt among its membership, the Board decided mandatory
recertification would only apply to some of us, namely our junior colleagues
(those certified after January 1, 2000).
One can speculate about how and why this date was chosen, but the
arrival of a new millennium does not change the fact that this has an
appearance to many (especially those affected) of being arbitrary and
capricious. With all due respect, the
Board has a history of changing its mind in this arena and this is precisely
why it’s probably best to complete recertification while it is fairly
straightforward and before additional stipulations, rule-changes, and scoring
modifications. By getting it done, one
moves beyond the controversy and flip-flops which are have characterized the
recertification process. In the final analysis, as
usual, perhaps Churchill says it best:
“Very fine arguments are always given for doing nothing.” While doing nothing is an option for many at
the present time, this will likely change.
I believe that the impetus for such change will come from our junior
colleagues and, objectively, they have a strong argument. Specifically, they question why
recertification is required for them but not for their more senior peers who,
it could be argued, are in just as much need of it (if such a need exists at
all). In the years ahead, this
argument will be advanced with more force, more vigor, by more people in
increasingly powerful positions and will eventually carry the day. To do otherwise, raises the specter of the
very sort of double standards, for example in passing percentages, which the
Board has always vigorously denied. It
seems very unlikely that anesthesiology will be one of the few Boards which
rejects recertification. What seems
more likely is that everyone who has not recertified will be required to. Perhaps to blunt
criticism, at least for the time being, the solution seems to be frequent
rules, eligibility, and even name changes (“Continued Demonstration of
Qualifications” became “Recertification” only to became “MOCA”) while
maintaining high pass rates on the recertification exam. The problem, as all of us instinctively
know, is that if the janitor, with all due respect, can take and pass the
examination how much validity does the entire process have? This, in my view, will not forever be lost
upon the ABA nor upon the American Board of Medical Specialties, which governs
the ABA, and more changes are inevitable.
Specifically, this exam is bound to get tougher so it can legitimately
be called a valid, reputable examination.
Given these
considerations, what is the best approach to recertification? To meet the challenge we know is there, I recommend
and personally followed the very same strategy we embrace every day in our
daily lives to get through massive work and meet major responsibilities: “get in, get it done right, get out, and go
home.” (I took this examination, I took
it as soon as I could, I have no regrets, and I’m proud to hold Recertification
Certificate #00191.) If this is your strategy,
to proceed, your best bet for MOCA-Recertification preparation is MOCA Blue and
a course. MOCA Blue is derived from Big
Blue and is adapted to the MOCA examination.
Specifically, MOCA Blue is key word correlated to the MOCA
examination. These key words are
reviewed within the text of MOCA Blue and the pertinent information is
covered. Many have worked with Big
Blue, and there is clear overlap. In
fact, Big Blue served as the core basis, the foundation, for MOCA Blue. However, there are also significant
differences and MOCA Blue is much more tailored for this particular test. Further, it’s often been several years since
I worked with many of you for the Written and important things have changed—for
example CPR standards, to name just one example. There are many other important changes and important
differences. Perhaps many of you share
my sentiment: if I’m going to do
something, I’d just as soon do it right. Doing it right also
probably entails coming to course, if possible. The Written review course is excellent for the
MOCA-Recertification exam and this will apply to all but those taking the
January examination. For those taking
the MOCA-Recertification test in January a special course will likely be
necessary. The dates will be posted on
the site. Being proactive rather
than reactive, aggressive rather than passive, and changing before being forced
to change are strategies we have always employed. These strategies may be old and they may seem tired (wasn’t this
what our parents always preached?), but they are central to our success and
therefore to who we are. Most
importantly, they work. I therefore urge you to
be proactive and don’t fight battles which cannot be won. Rather, embrace the MOCA-Recertification
process as a way to refresh and renew your knowledge base and as a point of
pride. How this has come about and some
of the rules surrounding it are wrong but the concept of on-going education is
not wrong and this concept will ultimately prevail. By embracing rather than fighting it, you will be enthusiastic
and energetic and be more fun to teach and interact with. More importantly you will learn more and
therefore take what you derive where it counts most—to the operating room and
to the care your patients. In this spirit and
specifically with regard to the MOCA-Recertification examination, “Onward to
Victory!” Sincerely, Niels F. Jensen, M.D. |