MAINTENANCE OF CERTIFICATION
Starting in January 2008, the American Board of Thoracic Surgery (ABTS) replaced its Recertification process with Maintenance of Certification (MOC) process. MOC is intended to give the public assurance that certified specialty physicians are maintaining high standards of clinical care throughout their career. For that reason, the Board requires that all Diplomates, including those who were certified before 1976 and hold life-time certificates, participate in MOC. The only exception is for those Diplomates who have notified the Board of their retirement and/or disability.
The ABTS MOC process is based on a 10-year cycle with a 5-year benchmark that Diplomates need to meet. During the fifth year, verification of licensure and hospital credentialing will be required. In addition, Diplomates are expected to take and complete the SESATS exercise. By the tenth year, Diplomates are expected take and pass a secured exam. In addition, Diplomates will need to provide documentation of practice improvement and references, along with verification of licensure and hospital credentialing.
A summary of the 4 MOC components can be found below and specific MOC requirements for each Diplomate based on certificate year can be found in the right-hand column box on this page.
Part I - Professional Standing
Diplomates must hold a currently valid, full and unrestricted license to practice medicine. Diplomates must provide delineation of privileges at a hospital(s) accredited by the JCAHO or other institutions judged acceptable by the Board. Diplomates must also submit letter(s) of reference documenting their level of clinical activity and stature within the surgical community from the VP of Medical Affairs and one other responsible member on staff at their principal hospital.
Part II - Lifelong Learning and Self-Assessment
Diplomates must complete 150 hours of AMA Category I CME over each 5-year period (an average of 30 hours per year). Half of the CME (75 hours) need to be in the broad category of cardiothoracic surgery. In addition, each Diplomate must complete the SESATS exercise during the fifth year of their MOC cycle. The Board reserves the right to randomly audit Diplomates and request copies of the CME certificates issued by a third party.
Part III - Cognitive Expertise
Diplomates must take and pass a secure, comprehensive written examination that will test fundamental and practice-related knowledge. Diplomates may take the exam starting in the eighth year but must pass it by their tenth year. The content of these exams will be derived from recent editions of SESATS and will include all areas of thoracic surgery.
Part IV - Evaluation of Performance in Practice
Diplomates who want to maintain their Certified-Active Status must complete Part (IV) of MOC; however, Diplomates on Certified-Inactive Status do not need to complete this component.
A. Peer Evaluation - The Board reserves the right to randomly audit Diplomates and request additional letters of references from referring physicians, colleagues, staff and patients.
B. Performance Improvement - The Board has voted to replace the requirement for mandatory database participation by July 2014 with Performance Improvement. The Board is considering the appropriate start date for the Performance Improvement process, but it will not be earlier than January 2016.
Until the Performance Improvement Initiative is initated, Diplomates will be expected to provide the name of the clinical outcomes database that they use to improve their practice. If a Diplomate does not belong to an outcomes database, the Board requires Diplomates to participate in the free Professional Portfolio on the Board’s web site (www.abts.org) or the ACS Operative Logs.
The Board has already approved the following outcomes databases as meeting our requirements:
- STS Databases (Adult Cardiac, General Thoracic and Congenital);
- VA CISCP
- Northern New England
- California State Database
- Massachusetts State Database
- Michigan State Database
- New York State Database
- Pennsylvania State Database
- Washington State COAP
- American College of Surgeons
- ACS Operative Logs
The Board is willing to approve and accept additional outcomes databases than those listed above. In order to be approved by the Board, outcome databases should include the following criteria:
- Large, multi-institutional recognized database;
- Database elements and results published;
- Collects important demographics, diagnosis, procedures(s), pre-operative risk factors, intra-operative events, postoperative events, and morbidity measures as well as mortality;
- Risk adjusted;
- Covers core elements of adult cardiac surgery, thoracic surgery, or congenital cardiac surgery; and
- Outcomes benchmarking.