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MOC Part IV Information

MOC Part IV Information


What is MOC Part IV?

Since the inception of the Maintenance of Certification (MOC) principle in 2001, the American Board of Medical Specialties (ABMS) has led and overseen the development of MOC programs for all 24 of its member boards. The development of MOC programs by member boards was not an option and was a prudent decision to ensure the integrity of all medical specialties and, most importantly, make certain the public has confidence they are receiving high-quality medical care from physicians who are well-trained and knowledgeable in the latest advancements, research and technologies in their chosen specialty.

Part IV of MOC process is practice performance evaluation. In the past, physicians were given a cognitive exam to determine the extent of their knowledge. The goal of Part IV is continuous quality improvement. Now in addition to gaining new knowledge and evaluating whether or not they "know it," they must now evaluate whether or not they "do it" and determine if it makes a difference in their quality of practice and patient outcomes. This more direct measure of quality of nuclear medicine performance would involve metrics on such topics as over- and underutilization, accuracy of interpretation, appropriateness of therapy, and clarity and timeliness of communication.

For more information on the history and development of MOC, visit the ABMS Website at


MOC Part IV Projects and Templates

Interpretive Accuracy and Diagnostic Certainty of Myocardial Perfusion Imaging

Implementation of Practice Guidelines:  Pediatric Radiopharmaceutical Administered Doses

Diagnostic Accuracy of 18F-FDG PET/CT in Patients with Cancer

Report Turn-Around Time Quality Improvement (PQI) Template

Patient Experience of Care Survey

SNMMI Project Template

How to Select a Project:
     • Instructions 
     • Project Measurement/Re-Measurement Sheet


MOC Part IV Resources



How Will Part IV Be Implemented in Nuclear Medicine?

Physicians will be expected to participate in local quality improvement initiatives. The basic idea is to:

  1. Make a quantitative measurement of how the practice is doing.
  2. Assess the data to identify what things could be done better, come up with an improvement plan, implement the improvement plan.
  3. Re-measure to determine if the practice has improved.

All projects are divided into these three activities; each activity provides one Practice Performance Assessment (PPA) credit. ABNM diplomates must log into the ABNM web site and attest to the activities that have been completed.  The diplomate must complete one activity (one credit) each year.  To ensure compliance with Part IV, the ABNM will audit a small percentage of diplomates.  During teh audit, diplomates will be asked to provide documentation for the project.   For Board qualified projects, the design of the project will not need to be documented, only the measurement and re-measurement.


AMA PRA Category 1 Credit™

The AMA has provided criteria to accredited providers for offering CME credit to MOC Part IV project participants. Three stages have been identified for credit-reporting purposes:

  • Stage A - learning from current practice performance assessment
  • Stage B - learning from the application of performance improvement to patient care
  • Stage C - learning from the evaluation of the performance improvement effort


Types/Levels of Part IV Projects

Three levels of practice performance assessment projects (PPAs) are available for diplomats:

  • Individual - must follow criteria identified by ABNM as individual-centered projects or by ABR as Type 1 projects to pass random audits by ABNM or ABR
  • Center- or group-based - must follow criteria identified by ABNM as group-centered projects or by ABR as Type 1 projects to pass random audits by ABNM or ABR
  • Society-based projects - pre-approved by ABNM and ABR (Type 2) so no random audits will be implemented. Projects can be either individual-based or group-based.