Diplomates are expected to satisfactorily complete all four parts of MOC. Those whose performance is below ABP expectations will be required to submit to the ABP an implementation plan to improve performance. Such a plan must include objective measures of improvement (i.e., examination performance, improved survey performance) or letters of attestation of improvement in areas that do not lend themselves to objective assessment, such as communication and professionalism. Those who fail to show significant improvement could be subject to intensified practice review by the ABP. Such review might include submission of detailed information regarding the area of practice in question (i.e., additional reports, quality assessment plans).
Diplomates who fail to satisfy performance criteria by December 31 of the year in which the time-limited certificate expires will no longer be recognized by the ABP as a diplomate of the ABP in the area in question. These physicians may continue to participate in MOC activities and may request to be recertified when the MOC requirements have been satisfied. Such a request must occur within five years of loss of certification. If a diplomate wishes to regain certification after five years, he/she must retake the initial certification examination. If the diplomate has remained in active practice since losing certification, the requirement for an additional year of training in an ACGME-approved pathology training program before sitting for the primary examination will be waived. However, the diplomate will always have the option to satisfactorily complete a period of additional training or a course of remedial education as a part of his/her attempts to complete the MOC requirements. The diplomate may appeal to the ABP according to the standard appeals procedure at any point in the MOC process if he/she believes that the MOC standards have been unfairly or inappropriately applied.