Why MOCA-Peds?

Science and medical care are advancing at previously unseen rates, with no signs of slowing anytime soon. There are also more demands on physicians’ time than ever before. A web-based survey conducted in 2008 with a random sample of adults found that most believe it is important for doctors who care for children to be assessed on their quality of care (95 percent) and pass a written test at regular intervals (88 percent).1

So, how does assessment of clinical knowledge and judgment fit into the world in which we live today?

The American Board of Pediatrics began to explore new assessment options back in 2015. Three years of extensive research, building, and pilot testing later, the ABP officially launched the Maintenance of Certification Assessment for Pediatrics (MOCA-Peds) as an assessment option in January 2019.

MOCA-Peds is a web-based, non-proctored exam platform that allows test takers the flexibility to answer questions on their computers, tablets, or smartphones. They also can use resources (e.g. the internet, books, etc.) to help answer questions.

Linda Althouse, PhD"MOCA-Peds allows us to assess the most current and relevant information to pediatricians on a continuous basis rather than once every 10 years or so,” says Linda Althouse, PhD, ABP Vice President for Psychometrics and Assessment Services and the executive sponsor of the platform. “It also combines learning with the assessment process.”


The ABP piloted MOCA-Peds for General Pediatrics for two years, beginning in January 2017. By the end of 2018, more than 11,000 pediatrician volunteers had participated in the pilot. Many of the volunteers also chose to participate in focus groups and answer surveys about their experiences. The Board found the feedback invaluable.

“Happily, we learned that pediatricians like the new platform,” Althouse says.

MOCA-Peds Task Force members

One pilot participant noted in a survey, “MOCA-Peds is clear and straightforward.” Another added, “I can do this at my own pace over time. It helps me learn.” Yet another commented, “It’s so much better than having to go to a testing center.”

Feedback from the pilot participants also identified areas the ABP needed to enhance.

“We learned that because MOCA-Peds is continuous, we needed to build in flexibility,” Althouse says. “For example, the scores from the four lowest-scoring calendar quarters [in a five-year cycle] are not counted toward the final score to allow for circumstances in one’s life where they may not be able to answer questions. We also allow those taking the assessment the flexibility to answer questions whenever they want during the quarter.”


From 2019 on, pediatricians will not be required to take the proctored exam at a secure testing center unless they choose to or if they do not pass MOCA-Peds. Also, the MOC Part 3 (Exam) requirement is now aligned with the five-year MOC cycle.

Once pediatricians earn a passing MOCA-Peds score, they are not required to answer questions for the rest of their MOC cycle. They may choose to continue participating to earn five points of MOC Part 2 (Lifelong Learning and Self-Assessment) credit for each year of continued successful participation.

Participating physicians who do not pass MOCA-Peds during the first four years of the cycle will need to take the proctored exam in the fifth year. There are no penalties to pediatricians’ certifications if they don’t pass or if they stop doing MOCA-Peds as long as they successfully pass the proctored exam by the end of their MOC cycle.


MOCA-Peds is now available for General Pediatrics and some subspecialties. Subspecialty exam due dates (for exams administered by the ABP only) have been postponed until MOCAPeds is available (see chart below). Pediatricians will have the opportunity to start MOCA-Peds for their area when they enroll in their next MOC cycle. Pediatricians can log into their ABP Portfolio to find out when their specific start dates based on their MOC cycle and MOCA-Peds availability.



General Pediatrics, Child Abuse Pediatrics, Pediatric Gastroenterology, Pediatric Infectious Diseases


Developmental-Behavioral Pediatrics, NeonatalPerinatal Medicine, Pediatric Nephrology, Pediatric Pulmonology


Pediatric Critical Care Medicine, Pediatric Endocrinology, Pediatric Hospital Medicine, Pediatric Rheumatology


Adolescent Medicine, Pediatric Cardiology, Pediatric Emergency Medicine, Pediatric Hematology-Oncology

Visit MOCA-Peds: Research and Evaluation for 2017 pilot results.


Dr. Lewis First

“Being part of the creation of an assessment for learning rather than learning for an assessment is the best way to ensure that recertification not only means you are highly qualified to care for children, but that you are up to date and skilled in the key areas that pediatricians need to be aware of on an ongoing basis. Seeing the satisfaction metrics of those who are enrolled in MOCA-Peds in terms of how helpful this method is to improve their clinical knowledge of timely issues in child health is a particularly meaningful return on the investment of time and effort I have made as a volunteer for the ABP and its Research Advisory Committee.”

Lewis First, MD
Professor and Chair
Department of Pediatrics
University of Vermont
Larner College of Medicine
Chief of Pediatrics
University of Vermont Children’s Hospital
Editor-in-Chief, Pediatrics

Dr. Rachel Dawkins“I was in the initial pilot for MOCA-Peds in 2017. Despite writing exam questions for [initial certification] the past three years, I hate taking exams! I loved the idea of having an ‘open book’ test because it was truer to what I experience in practice: if I am unsure of something, I can look it up. The other thing I loved was that I could do a few questions at a time when I had time. I had previously heard about MOCA-Peds during our certifying exam  committee meetings and knew members of the group who were responsible for not only writing the questions but also writing the explanations of the answers. It was great to see their hard work in action!”

Rachel Dawkins, MD
General Pediatrician
St. Petersburg, FL

Dr. Jeffrey Snedeker“I think the most eye-opening event that I can recall was an ABP conference that I was invited to participate in a few years ago, called ‘The Future of Testing.’ What was truly remarkable about the meeting was that it soon became apparent that the whole model of a 10-year test cycle was problematic and didn’t meet the needs of either the public at large or the pediatricians that the ABP serves. We came out of that conference with a completely new direction, which ultimately resulted in the MOCA-Peds model that is now being so successfully implemented. It was amazing to see the openness and willingness of this organization to fundamentally change direction so radically in such a
short time.”

Jeffrey Snedeker, MD
General Pediatrician and Infectious Disease Subspecialist
Ithaca, NY

Dr. James Callahan“Writing questions is not easy, but I’ve learned so much from the process. You learn by writing the questions and answers, and you learn even more from others on the subboard. The Board has thoughtfully approached the idea
of a different way to assess knowledge that also promotes learning. They’ve shown that if there’s proof that an innovation will work, then they’ll make a change.” 

James Callahan, MD
Associate Medical Director, Division of Emergency Medicine
Children’s Hospital of Philadelphia

Dr. Evelyn Hsu“Certification exams for pediatricians must be clinically relevant, up to date, and applicable to their practice. The only ones who can do this work are those who practice among us … I love my profession and the peers I work with.”

Evelyn Hsu, MD
Associate Professor of Pediatrics
University of Washington School of Medicine
Director of the Hepatology Fellowship
Medical Director of the Liver Transplant Program
Seattle Children’s Hospital

1Freed GL, Dunham KM, Clark SJ, Davis MM; Research Advisory Committee of the American Board of Pediatrics. Perspectives and preferences among the general public regarding physician selection and board certification. J Pediatr. 2010;156(5):841-845. doi: 10.1016/j.jpeds.2009.11.055.