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Anesth Analg. 2019 Nov;129(5):1401-1407. doi: 10.1213/ANE.0000000000004268.

Association Between Participation and Performance in MOCA Minute and Actions Against the Medical Licenses of Anesthesiologists.

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From the The American Board of Anesthesiology, Raleigh, North Carolina.
Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California.
Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
Department of Anesthesiology, Emory University, Atlanta, Georgia.
Department of Anesthesia & Critical Care, The University of Chicago, Chicago, Illinois.



In January 2016, as part of the Maintenance of Certification in Anesthesiology (MOCA) program, the American Board of Anesthesiology launched MOCA Minute, a web-based longitudinal assessment, to supplant the former cognitive examination. We investigated the association between participation and performance in MOCA Minute and disciplinary actions against medical licenses of anesthesiologists.


All anesthesiologists with time-limited certificates (ie, certified in 2000 or after) who were required to register for MOCA Minute in 2016 were followed up through December 31, 2016. The incidence of postcertification prejudicial license actions was compared between those who did and did not register and compared between registrants who did and did not meet the MOCA Minute performance standard.


The cumulative incidence of license actions was 1.2% (245/20,006) in anesthesiologists required to register for MOCA Minute. Nonregistration was associated with a higher incidence of license actions (hazard ratio, 2.93 [95% confidence interval {CI}, 2.15-4.00]). For the 18,534 (92.6%) who registered, later registration (after June 30, 2016) was associated with a higher incidence of license actions. In 2016, 16,308 (88.0%) anesthesiologists met the MOCA Minute performance standard. Of those not meeting the standard (n = 2226), most (n = 2093, 94.0%) failed because they did not complete the required 120 questions. Not meeting the standard was associated with a higher incidence of license actions (hazard ratio, 1.92 [95% CI, 1.36-2.72]).


Both timely participation and meeting performance standard in MOCA Minute are associated with a lower likelihood of being disciplined by a state medical board.

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