All You Need to Know for the Internal Medicine Maintenance of Certification Exam (MOC)
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The practice of medicine is rapidly evolving. For board-certified internists, the American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) exam aims to ensure that physicians stay current with standard-of-care practice recommendations and to promote lifelong learning.
In this post, we’ll break down what to know about your testing options, how to prepare, and what makes this exam so important to providing great care to patients.
Two Testing Options: 10-Year Exam vs. Longitudinal Knowledge Assessment
ABIM offers two different Internal Medicine MOC assessment options so that physicians can choose what fits their learning and testing preferences best:
1. 10-Year MOC Exam
The 10-year MOC exam is a traditional one-day assessment taken every 10 years, starting 10 years after initial certification. This is a proctored multiple-choice exam, typically lasting 10 hours and split into four sessions.
The MOC exam is administered online at test centers, and use of the online reference UpToDate is allowed during the exam. You may prefer this traditional exam format to condense your preparation and testing time into a shorter (albeit more intense) period with a clear endpoint.
2. Longitudinal Knowledge Assessment (LKA)
The Longitudinal Knowledge Assessment (LKA) is a continuous alternative to the traditional 10-year MOC exam. Starting 10 years after initial certification, you’ll answer 30 multiple-choice questions every 3 months for a 5-year cycle online from home.
The exam is open-book, and you can use any resource (other than the help of another person) while answering questions. After answering each question, you will receive immediate feedback with detailed explanations (much like a Qbank).
The LKA emphasizes ongoing, longer-term learning rather than test-day performance, making it appealing to clinicians who prefer small amounts of steady engagement over time.
Internal Medicine vs. Inpatient Internal Medicine MOC Exams
The ABIM also recognizes that there is variation in the settings where general internists practice. To this end, they’ve created two versions of the Internal Medicine MOC exam to align better with one’s practice setting: the general Internal Medicine MOC exam and the Internal Medicine Inpatient MOC exam.
General Internal Medicine MOC Exam
The general Internal Medicine MOC exam covers the full breadth of internal medicine encountered in both outpatient and inpatient settings, including chronic disease management, preventive care, and hospital medicine. The exam tends to have a higher proportion of questions addressing care in the outpatient setting.
Internal Medicine Inpatient MOC Exam
The Internal Medicine Inpatient MOC exam, designed specifically for hospitalists, focuses heavily on inpatient and transitional care, consultative co-management, and patient safety. There is less emphasis on ambulatory medicine.
Selecting the correct exam version ensures that the content aligns closely with and is relevant to your clinical work. Both versions offer either the 10-year traditional MOC exam or the LKA testing option.
Using ABIM MOC Exam Content Blueprints to Prepare
The ABIM Internal Medicine MOC exam content blueprints can help you identify and hone in the most important concepts covered on the test.
The blueprint organizes content into categories which further break down into subcategories and topics. For example, the general Internal Medicine MOC exam content blueprint has 18 categories that correspond with specialty areas (e.g., cardiovascular disease, pulmonary disease, gastroenterology). Under each category, the content is then organized into subcategories. Then, the content in each subcategory is broken down further into specific topics.
Each question asks about the topic in light of specific tasks that a practicing internist is expected to perform or know about, such as making a diagnosis, ordering tests, recommending treatment, determining prognosis, or understanding pathophysiology.
How does the ABIM determine the topics on the exam content blueprints?
In order to ensure that ABIM blueprints represent the breadth and frequency of topics encountered in clinical practice, the ABIM performs regular surveys of its diplomates, asking them to rate the relative frequency and importance of blueprint topics in their practices.
Based on survey results, the ABIM blueprint designates each topic separated by task based on importance (high, medium, or low), with only those designated as high or medium importance appearing on the exam. Topics are also rated based on the frequency (high, medium, low) that they will appear on the exam.
Questions on topics designated as low frequency will comprise no more than 18–20% of the exam. In these ways, the blueprint helps learners identify topics of higher importance and frequency to prioritize when studying.
How to Prepare for Your Internal Medicine Maintenance of Certification Exam
Whether preparing for the 10-year exam or participating in the LKA, using the blueprint to guide topic review and answering practice questions will be helpful. There are multiple resources for studying for the MOC exam, such as MKSAP by the American College of Physicians and UWorld.
Blueprint/Rosh Review recently released an updated version of the Internal Medicine Maintenance of Certification Qbank was recently released, now featuring a recently reviewed and expanded 2,850-question general MOC Qbank covering both outpatient and inpatient topics.
For physicians practicing primarily in the inpatient setting, you’ll also have the new option to purchase the 950-question Inpatient MOC Qbank with only the questions geared towards inpatient settings.
In order to focus studying on what is most important, every question in the Blueprint/Rosh Review Internal Medicine MOC Qbank covers a topic designated as high or medium importance based on the ABIM general internal medicine blueprint. You’ll also have the ability to filter questions by high/medium or low frequency, thus maximizing your efficiency.
Every question comes with a detailed explanation, high-yield image to help master important teaching points, and an additional “One Step Further” question to reinforce important concepts.
Final Thoughts on the ABIM MOC
Studies have found that participation in and performance on the ABIM MOC exam may be associated with better patient care measures and outcomes. Preparing for and taking the ABIM MOC exam not only fulfills a requirement but also helps in staying up to date with practice recommendations and improving patient care.
Best of luck on this journey of lifelong learning!
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