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Anesthesiology APPLIED Exam › Ambulatory, non-OR and special populations

Licensure, board certification and MOCA

Ambulatory, non-OR and special populations·~5 min read· Physician-reviewed✓ Sourced · 10

Stem

Dr. Lee finished residency last year and passed the APPLIED Examination this spring. Her hospital requires current ABA certification for anesthesia privileges, and her state medical license renews every two years with its own continuing education rules. She holds a second, inactive license in a neighboring state. She asks you, her department chair, what she must do to keep her certificate and whether a certification lapse would touch her license.

Question

What do you tell her?

Ideal answer

HeadlineThey are separate: the state license is required to practice; certification is voluntary, but her hospital requires it. MOCA keeps it current.

  1. Keep every medical license unrestricted. MOCA needs one active, unrestricted U.S. or Canadian license, every other license unrestricted, and restrictions reported within 60 days.1
  2. Answer all 30 MOCA Minute questions each quarter. That is 120 a year, or a steady performance standard, and each completed quarter earns 2.5 CME credits.2
  3. Earn 125 CME credits per five-year cycle. Including 10 in patient safety.2
  4. Complete 25 quality-improvement points every five years. A simulation course, registry feedback plan or leading department QI counts.3
  5. Register and pay each year, early. Registering in the first quarter keeps every quarter's MOCA Minute credit.2

Watch for: her cycle began the day after certification; year one is voluntary, then she registers each January.4

Breaking down the answer

  • License versus certificate — state boards license physicians for minimum competence in general practice, renewed every one or two years; one of 24 ABMS boards certifies specialty proficiency.5 Changes if: an employer requires certification; then a lapse costs privileges despite a valid license.
  • What the outline tests — professional standing, lifelong learning, cognitive knowledge, clinical practice assessment and systems-based practice.6 Changes if: asked to map them: license, CME, MOCA Minute, quality improvement.
  • MOCA Minute, not a 10-year exam — launched in 2016 as an alternative to one high-stakes examination every 10 years; more than 40,000 anesthesiologists take part yearly.7 Changes if: she misses questions; a performance p-value of at least 0.10 also satisfies.2
  • The cycle — ABMS continuing certification standards took effect January 1, 2024; ABA diplomates on 10-year cycles switch to five years automatically when their current cycle ends.8 Changes if: still on 10 years: 250 CME with 20 in patient safety, and 50 QI points.2
  • 2026 changes — MOCA Minute CME is reported quarterly; ASA members pay nothing extra, non-members $40 for each fully completed quarter.2 Changes if: she skips the opt-in at registration; the credit is not reported.2
  • Points per activity — a MOCA simulation course at an ASA-endorsed center earns up to 25; case evaluation or M&M up to 15; she attests in her ABA account, subject to audit.3 Changes if: audited; she keeps evidence.

Follow-up question

A year later her colleague's privileges are restricted for 90 days after a peer-review action for repeated documentation failures. He asks whether this touches his board certification, and who will find out. What do you tell him?

Follow-up answer

HeadlineProbably reportable: over 30 days, it goes to the Data Bank if tied to competence or conduct affecting patients. Certification follows his licenses.

A professional review action limiting privileges for more than 30 days is reported,9 and for incomplete records only if the hospital links the failure to his competence or conduct and to possible patient harm; an automatic administrative suspension is not.10 The ABA's professional standing rule concerns licenses: all must stay unrestricted, and any restriction is reported to the ABA within 60 days.1 So if his state board acts on the same facts, his certificate is at stake. I advise him to answer every credentialing question truthfully, complete the remediation, and document it.

Pitfalls that cost points

  • Calling board certification a legal requirement to practice; it is voluntary.5
  • Telling her the state's license CME and MOCA are one requirement; each body sets and audits its own.
  • Letting the neighboring-state license drift; discipline there still reaches her certificate.

Rapid-fire

Q: What if she misses a quarter? A: The yearly requirement is 120 questions or the performance standard; only finishing all 30 within their quarter earns that quarter's 2.5 credits.2

Q: Who runs licensing? A: State medical and osteopathic boards; the Federation of State Medical Boards represents 70 of them.5

Q: Does an ABMS board other than the ABA count for QI points? A: Yes; other ABMS Member Board QI activities earn up to 25 points.3

Q: Does registry feedback count? A: Yes; acting on MPOG ASPIRE feedback emails or an AQI NACOR measure review earns up to 25 points.3

Numbers to know

Item Value
MOCA Minute 30 per quarter, 120 per year2
CME, five-year cycle 125, including 10 patient safety2
CME, 10-year cycle 250, including 20 patient safety2
Quality improvement 25 points per five years2
Report a license restriction Within 60 days1
MOCA Minute CME 2.5 credits per completed quarter, up to 10 a year2
Five-year cycle standards Effective January 1, 20248

Sources

  1. 1.Medical License: 10-Year Cycle · ABA · theaba.org
  2. 2.2026 MOCA Registration Now Open · ABA, 2026 · theaba.orgJanuary 15, 2026 announcement: MOCA Minute, CME and QI requirements for 10-year and 5-year cycles; quarterly CME reporting and the $40 per-quarter processing fee for non-ASA members.
  3. 3.MOCA Quality Improvement Activities · ABA · theaba.orgUndated activity list; maximum points per activity over five years.
  4. 4.Digital Diplomate Welcome Kit · ABA, 2023 · theaba.orgMOCA cycle begins the day after certification; participation in the certification year is voluntary and free; register and pay from the next January. Fee figures in the kit are 2023 values and are not used.
  5. 5.Clarifying the Difference Between Medical Licensure and Board Certification · Academic Medicine blog (Price, ABMS), 2016 · academicmedicineblog.org
  6. 6.Initial Certification Content Outline · ABA · theaba.orgSection II.E.4.d: primary certification, recertification, maintenance of certification and related issues (professional standing, lifelong learning, cognitive knowledge, clinical practice assessment, systems-based practice).
  7. 7.Celebrating 10 Years of MOCA Minute · ABA, 2026 · theaba.org
  8. 8.Five-Year Certification Cycle · ABA, 2025 · theaba.orgPage last modified May 15, 2025.
  9. 9.Hospitals: NPDB querying and reporting requirements · HRSA National Practitioner Data Bank · npdb.hrsa.gov
  10. 10.NPDB Guidebook, Chapter E, Clinical Privileges Actions, Question 14 (suspension for failure to complete medical records) · HRSA National Practitioner Data Bank · npdb.hrsa.gov

Facts on this page were checked against these sources on Oct 25, 2026. Guidelines change; confirm doses against current institutional protocols.

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