Ultimate Guide to the MOCA-Peds Assessment

The MOCA-Peds Assessment is an alternative to the American Board of Pediatrics’ traditional 4-hour pediatric MOC exam. Standing for “Maintenance of Certification Assessment – Pediatrics,” MOCA-Peds is an option that many practicing pediatricians find preferable to the standard Maintenance of Certification exam. There are advantages and disadvantages to each, but we believe that the advantages outweigh the disadvantages. PBR can prepare you to take the MOCA-Peds test in an easy and painless way by providing you with guidance on how to navigate the MOCA-Peds experience and by giving you one-page summaries of the exact topics you will be tested on.

But first of all, what is the MOCA-Peds, and why is it preferable to the MOC?

What’s the Difference Between the MOC Exam and the MOCA-Peds Assessment?

MOC Exam

The Maintenance of Certification Exam is a 4-hour examination offered by the American Board of Pediatrics to board-certified pediatricians once every five years to help maintain board certification. It is a standardized, proctored test that lasts for five hours and is similar to the Initial Certification board exam for pediatrics. It can be on any topic related to pediatrics.

If you’re good at standardized tests and have been at low risk for failing (meaning you usually pass these types of tests with flying colors) then it might be a good option for you. The benefits are that it’s only once every five years, so you don’t have to worry about it the rest of the time. Because of this alone, we estimate that approximately 10-20% of pediatricians prefer to take the MOC Exam.

A related reason why some pediatricians might prefer the MOC exam has to do with subspecialties. For subspecialists who decide to maintain their subspeciality board certification and their general pediatric board certification, it’s preferable to only focus on their specialty most of the time and then shift their attention to general pediatrics only once every five years as they prepare for the MOC exam. 

MOCA-Peds Assessment

The MOCA-Peds exams are much shorter and the time commitment can be tailored to suit your needs. These mini-exams have many advantages over the MOC exam. In the MOCA-Peds exams you:

  • Answer 20 questions per quarter, every quarter, for four years. If you pass within your first 3 years, you get the fourth and fifth years off.
  • Answer one question at a time and get an instant result (answer and explanation).
  • Have five minutes per question.
  • Take the test at home, in the office, or any place with internet access without a proctor.
  • Take the test as an open-book, open-computer exam with the freedom to access the MOCA-PBR Study Guide & Test Companion, UpToDate, Peds in Review, or any other online resource.
  • Can fail up to four quarters in the five-year cycle and still maintain your certification.
  • Study only a limited number of topics to prepare for the exams. Instead of studying everything in the world of pediatrics, you only have to study the 40 Learning Objectives and 4 Featured Readings laid out at the beginning of each year by the American Board of Pediatrics (ABP). The 80 questions per year come from those topics and a new MOCA-PBR Study Guide & Test Companion is created every year to cover the new Learning Objectives and Featured Readings.

What are Learning Objectives and Featured Readings?

The American Board of Pediatrics provides 40 Learning Objectives which are somewhat vague. But, even 40 vague topics are much better than having to study every little thing that might show up on a pediatric board exam. The Learning Objectives and Featured ReadingsLearning Objectives are typically released on the ABP website one to two months prior to the new year. Some recent examples of MOCA-Peds Learning Objectives include:

  • Counsel parents regarding circumcision
  • Differentiate between normal and abnormal variations in head growth and manage appropriately
  • Evaluate and manage a child with an inguinal mass

The Featured Readings are articles published in medical journals. Some examples of recent featured Readings include:

  • Management of Infants at Risk for Group B Streptococcal Disease. Pediatrics. 2019.
  • Acute Treatment of Migraine in Children and Adolescents: Report of the Guideline Development, Dissemination, and Implementation Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology. 2019.

What Happens if You Fail the MOC or Fail the MOCA-Peds?

If you fail the MOC, it is a complete fail and you have to take the entire exam again. The exam is administered four times per year. 

If you fail a MOCA-Peds quarterly assessment, nothing happens at that time. You only have to pass twelve quarterly assessments within the first four years of your five-year cycle to maintain certification. If you do not pass at least twelve quarters by the end of your fourth year, then you must pass the proctored MOC exam by the end of the five-year cycle.

MOCA-Peds is built into your recurring ABP dues. You must pay extra to take the MOC exam. Failure to meet your recertification requirements will result in additional fees and can result in the loss of your job (many hospitals and clinics will only employ board-certified pediatricians).

You can see why it is so important that you do well on the ABP MOCA-Peds assessments or the MOC exam.

How Do You Prepare For MOCA-Peds?

The good news with the MOCA-Peds is that the ABP gives you the 40 Learning Objectives and Learning Objectives4 Featured Readings in advance. This gives you a great place to start your studies. Therefore, your options when taking the MOCA-Peds exam are:

  1. Wing it! Use Google, UpToDate, Peds in Review, and other online resources to hopefully find the answers within the five-minute window that is allowed per question. This is not recommended since it can result in anxiety and failure. 
  2. Find resources on your own that allow you to prepare for the topics and subtopics related to the 40 Learning Objectives and Featured ReadingsFeatured Readings. This is doable but requires a lot of work and research on your part–and most of all, a lot of time.
  3. Get the MOCA-PBR Study Guide & Test Companion in an online format and/or hardcopy format. Every year, we do the hard work for you. When the ABP publishes the Learning Objectives and Featured ReadingsLearning ObjectivesFeatured Readings, we do a deep dive into those topics and create concise study guides to capture the common, and uncommon, information that may be covered on the exam. Use Study Guide and Test Companion as your open-book and open-computer tool. Even if you’re not tech-savvy, our online resource makes it easy to search, efficiently answer questions and PASS your MOCA-Peds exams.


Are you ready to take on MOCA-Peds?

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How to Prepare For the Pediatric Boards

Getting to the pediatric boards is a major step in your career, but passing isn’t a walk in the park. You’ve worked your way through test after test, through medical school and residency, and now comes the time to take your boards–are you going to lose it all now?

Pediatrics Board Review is here to make sure that you don’t. We’ve helped thousands of pediatricians get through the initial certification exam, including those who have failed it many times before. PBR offers focused, easy-to-use resources that will get you across that finish line. Don’t believe us? We back it up with a Money-Back First-Time Pass Guarantee. And of the thousands who have utilized our resources, less than 0.5% of pediatricians have had to ask for their money back.

We’ve helped them, and we can help you.

The Three Pillars of Passing the Pediatric Boards

Passing the pediatric boards isn’t easy. We know that; we’ve taken them ourselves. We’re not just a testing company: we’re board-certified pediatricians who know what it’s like to go through these exams and we have the knowledge base and continuing education to help you pass.

There are three must-have ingredients for passing the pediatric board exams. They are content, technique, and commitment. Each one is important in its own way, and you won’t get far into the exam if you’re lacking in any of these three areas. Let’s look at them each in turn.


Content refers to the development of your fund of pediatric knowledge as you prepare for the pediatric boards. You may think that this is a time when you need to gather all the resources possible, read countless books, and spend agonizing hours flipping from one cross-reference to another. But the truth is, more is not better when it comes to taking this board exam. Turning to other textbooks and medical journals and notes can be a recipe for disaster. What you need is a single source that is comprehensive, focused on board-relevant information, and allows for repetition in order to guarantee reinforcement of the concepts.

Using the PBR Core Study Guide and Q& A Book, in both online and hardcopy formats, as well as audio and video courses and virtual atlas (the PBR All-Access Pass), will get you on the pathway to success faster than turning to every resource under the sun. The reason is congruence. Looking at every available text will result in the cardinal sin of “information overload.” In fact, we recommend that after you get the PBR study guides you don’t consult outside information at all. Resist the urge. Having a single signpost pointing you in the right direction will give you better information than trying to listen to a hundred voices.[1] [2]

“Content is king.” So, getting the right content in hand is the single biggest thing you can do to change your FAILED pediatric board experience into a PASS.


Technique refers to how you process board-style questions and how you take the exam. Exams are different from clinical work, different from laboratory work, different from hands-on skills. Taking a standardized test is a challenge all its own and it requires a certain set of skills. Some people are born great test-takers. Others may be brilliant clinical physicians but struggle to tackle the format and code-breaking that is a standardized pediatric board exam.

The thing is, there are “rules to the board game.” Medical board questions cannot be viewed as miniature patients. They have to be viewed as silent puzzles with rules that can help you solve the puzzles, oftentimes even without the supporting clinical knowledge in place. This has to do with understanding the various styles of pediatric board exam questions, how to navigate those different styles of questions, and how to process the answer choices in a way that leaves only the answer that the test makers want.

We’ve noticed that the test-taking technique is especially difficult for non-U.S. trained pediatricians (aka International Medical Graduates). They may have the content nailed, but if they don’t know the technique of answering questions, they’ll get eaten up on the test. This is often because standardized tests in this country are different from the types of exams used in their home countries: some had essay questions and others had oral exams. This is an entirely different world.

A good example of this is the time of test questions: you’re only expected to spend 75 seconds per question. What do you do when time gets running into two or three minutes and you’re still not done? Do you pass the question by or keep at it? You might waste a lot of time on a single question and blow five questions at the end of the test–that you knew the answer to–because you were out of time. (This is a particular issue when it comes to international students, who may be used to different test formats: some tests penalize you more for leaving a question blank whereas some penalize you more for entering a wrong answer. Learning the right way to answer the right test is essential.)

Time management is only one of the many test taking strategies we teach you in the technique section of our PBR Test Taking Strategies and Coaching course. [3]


Commitment is a huge reason why pediatricians fail the board exams. It takes a lot of effort and time to prepare yourself for the test, and if you’re an intelligent physician who is confident in your abilities but doesn't take the time to devote to studying, you will fail. We recommend that low-risk, first-time test takers should have a minimum of 300 dedicated study hours. For moderate and high-risk test-takers, at least 500 hours should be set aside.

PBR dives deep into what is required to develop the study habits that you’ll need to get to where you want to be. This is done in our Live Test-Taking Strategies & Deep Study Course. The lectures around PBR’s concept of “Deep Study” are so impactful in multiple areas of life, that they are often described as life-changing. They won’t be easy; but with the study skills gained through PBR, this may free up time for you to spend with your family and doing things for yourself. The key is to have high-quality study time or deep study, you won’t have to waste time spinning your wheels later on. Make the time that you’re spending in front of the books more impactful and important, so you can spend time on other things as well.

We offer three 90-day personalized schedules, which are customized to you, your personal schedule, and your learning style, and those personalized schedules come free with the package.

You can do it. We can help you.[4]

High Risk vs Low Risk for Failing Your Pediatric Boards

Are you at high risk or low risk for failing your pediatric boards? That’s something you’d want to know, right? Even though absolutely everyone needs to study and get ready for the exams, if you’re at high risk then you know that you have to put in that extra effort, and do so in the right way, to pass. We can help you get there, and we can even help you identify whether you’re a high risk or low risk.

What Makes Someone High Risk?

A physician, or resident, who is “high risk” would be anyone who:

  •       Struggled to pass (or failed) ANY board exam
  •       Classifies themselves as having difficulty with standardized board exams
  •       Is an International Medical Graduate
  •       Was told they are “at-risk” of failing the boards based on In-Training Exam scores
  •       Comes from an “at-risk” residency program with a pass rate of less than 90% – click here to see where your residency program stands
  •       Has taken a year off from studying for the exam
  •       Scored less than a 222 on the USMLE Step 1

What Makes Someone Low Risk?

A physician, or resident, who is “low risk” would be anyone who:

  •       Has never failed any medical board exams
  •       Typically scores near, or above, the national average
  •       Self-identifies as someone who is a good test-taker and generally does well on standardized board exams
  •       Graduated from a US medical school
  •       Was never “at-risk” of failing the boards based on residency In-Training Exam scores
  •       Comes from a residency program with a pass rate of greater than 90% (click here and check your residency's pass rate)
  •       Will take the boards in the same calendar year as their graduation from residency
  •       Scored at least a 222 on the USMLE Step 1

Use Our Risk Calculator To Find Out Where You Are

Are the Study Plans Different if You Are High Risk Versus Low Risk?

For low-risk pediatricians, we recommend that you definitely set aside at least 300 hours of prep time. At a minimum, we recommend the All-Access Pass, which includes 100% of our Initial Certification exam educational resources. It primarily focuses on providing you with concise, board-relevant content presented to you in a multimodal manner.

But, the most common bundle for test takers of the Initial Certification exam is the No Brainer Bundle. It includes resources to support all 3 of the key pillars needed to pass the pediatric boards:

  •       All-Access Pass
  •       Full Online Test-Taking Strategies Course
  •       Three 90-Day Personalized Study Schedules created by Team PBR

The No Brainer is the best pediatric study package on the market, and it costs less than the price of a traditional video board review course.


Are you ready to take on the pediatric board exams?


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Pediatric Board Review Course 2021


2021 Pediatrics Board Review Course Books and Online Resources

In this article we’ll learn about pediatric board review courses being offered in 2021 and learn why live courses are broken. We'll also be sharing resources and recommendations for those looking into live board review courses, along with a review of the 2021 pediatric board review course created by Pediatrics Board Review (PBR).

PBR was created by me, Ashish Goyal. As a pediatrician, I excelled when I increased my score by 160 points on the American Board of Pediatrics (ABP) Initial Certification exam. I was then asked by the ABP to write questions for them.

Now, as an author, my mission is to provide the best pediatric board review materials to residents and pediatricians. And I’ve been doing this successfully doing so with PBR since 2011.

As physicians, we're trained to learn "everything” in our field, and we apply the same methodology to how we prepare for an exam. We start from the first sentence and take a top-to-bottom approach.

But these strategies do NOT work when you are studying for the pediatric boards.

That’s why at Pediatrics Board Review, we focus on creating a full, one-stop shop for you to focus your learning on three things:

  1. The specific topics that will be tested on the exam
  2. The strategy behind test taking, and how to deconstruct difficult questions with ease.
  3. The tools, schedules, and systems needed to promote efficiency and accountability

This article will be covering a LOT about what pediatricians just like you need to pass the pediatric boards (and how we have been providing that successfully for the past decade).

The system that we’ve created has been proven to be much more effective (and cheaper) than attending a 4-6 day long course where you're expected to learn everything about pediatrics. And if the thousands of happy pediatricians are any indication, using the PBR Retention Methodology is the way to go (but more on that later).

If you are set on finding a traditional, live pediatric board review course, we do offer some advice and resources to help. Keep reading below to find a list of companies we've compiled who are offering live pediatric board review courses and the cost of attending.

But, if you have 5 minutes, take the time to read this article because it will likely save you time, money, and energy.

Through this article, and through videos like the one below, you will begin to quickly understand why a "traditional" pediatric board review course can lead to failure. PBR is not a traditional board review company, and we focus on helping physicians in ways that have never been done before. In the video below, I share with you the arrival of the NEW 2021 Edition of the PBR Core Study Guide, the NEW 2021 Edition of the Question & Answer books, our NEW Test-Taking Strategies Course, and information around the differences that allow PBR to excel.

My 2021 book "unveiling" video below will give you an excellent understanding of what makes PBR different than any other medical board review program.

Click here to get the full Pediatric Dermatology and Pediatric Gastroenterology chapters from THIS YEAR's EDITION of the PBR so that you can TRY BEFORE YOU BUY!


What Makes a Great Pediatric Board Review Course?

Having been around pediatric board materials (and helping pediatricians pass!) for almost 10 years, I have found the key to any successful pediatric review course boils down to 5 key elements:

  1. CONTENT CONGRUENCY: Having materials that work cohesively together has been proven to better reinforce knowledge in our brains. This is compared to having several disjointed study materials with competing methodologies. Congruency promotes a smarter, not harder, studying experience.
  2. BOARD RELEVANT MATERIAL (NOT ALL MATERIAL!): No course should try to shove as many topics as possible into your brain; that will only lead to overload! Pick a course that provides a laser focus on the topics that are known to be tested, and curates your study experience around those topics.
  3. A FOCUS ON THE TEST-TAKING STRATEGY (JUST AS MUCH AS THE TOPICS): Everyone has a colleague, a friend, or a family member who is very intelligent, but tests poorly. When it comes to standardized tests, knowing how to test is just as important as knowing about the subject being tested! So, your chosen course should place a high emphasis on teaching you how to TEST well.
  4. INTERACTION: A course that promotes interaction with both your peers and the instructor can lead to a better study experience. Trying to study in isolation for hours on end, with an instructor just talking at you, will only limit the amount of information you retain. It will also provide zero opportunity for you to gain clarification on the difficult topics you struggled with.
  5. MULTIPLE RETENTION TECHNIQUES: Everyone learns at a different pace, so finding a course that utilizes several retention techniques to help you solidify what you are studying is key.
Click Here And Continue Reading...


Pediatric Board Exam Results – 2020!

Well, friends, results of the 2020 pediatrics board exam have been announced! This is always an emotional time for pediatricians. For us here at PBR HQ, it's also overwhelming because we get flooded with emails from the members who have worked so hard over the past year, and have now FINALLY passed the boards!  
The stories from our 2020 members have been wonderful. To have members say that we have changed their lives has been nothing less than humbling. Our members are also providing feedback on making the resources we have even better so that the PBR system continues to be the best pediatric board review available. While we are known for being the premier resource for anyone at moderate to high risk of failing the pediatric boards, the results below will help you see that if we can help pediatricians pass after SIX failed attempts, then helping you pass the pediatric board exam should be easy. 

In this article, I’ll be covering: 

  • The pass rate for PBR members and first-time test takers 
  • Feedback from our board-certified alumni on how to pass the pediatric board exams 
  • Next Steps if you FAILED the boards (and common mistakes to avoid to make sure you pass next year) 
  • Free upcoming webinar on how to ensure you pass the 2021 pediatric boards

Click Here And Continue Reading…

Test-Taking Strategies for Medical Board Exams


Test-taking strategy is often overlooked when you are preparing for your board exams, yet it can be the difference between passing or failing. Since there is no question that physicians are extremely bright, why is it that even great physicians often fail their board exams?

Answer: A good clinician is not the same thing as a good test-taker.

When I failed the boards the first time, I was confused. I felt like I had a good handle on the material, but I quickly realized that how you treat a board style question is very different than how you should treat a patient. But it was too late. I had the “standard” top to bottom approach to answering board-style questions, and I ultimately failed the board exam.

I simply did not know how to approach the questions on the test effectively.

And this isn’t uncommon.

However, during my 2nd attempt at the pediatric board exam, I had a strong focus on pacing and a strategic approach to questions. That led to me not only passing my boards, but I increased my score by 160 points! I scored above the national average, and after failing the previous year, the American Board of Pediatrics asked me to write questions for them.

The skill set needed to be a master clinician is completely different than the skill set needed to be a master test-taker and win this “board-game”. Developing this strategy requires training and education like any other skill that you have had to practice. But with practice, you can have dramatic increases in your score like this member of our test-taking strategy course.

Learn Test-Taking Strategies for Medical Board Exams


While having a strong knowledge base is important to pass the pediatrics boards, it will mean nothing if you are unable to apply what you know to the test.

If you consider yourself to be a test-taker with average (or below average) scores on standardized tests, then learning test-taking strategies can QUICKLY give you an advantage to increase your score, and pass the boards.

Plus, unlike studying for a single chapter that may be applicable to 5% of your exam, test-taking skills can be leveraged throughout 100% of this exam (and every future board exam that you ever take).

Study a ton, remember none. Sound familiar?

If you've previously done well on standardized exams, just follow the PBR “Roadmap to Success” and you will do great.

BUT, if you:

  • Struggle with standardized tests,
  • Get test anxiety,
  • Find yourself running out of time on exams,
  • Were told that you were “at-risk” of failing the boards based on IN-Training Exam scores,
  • Have taken a year off from studying for the exam, or
  • Scored less than a 222 on the USMLE Step 1

… then improving your test-taking technique is just as, if not MORE, important for you to study than the actual material.

Below you’ll find some of my top strategies I teach our PBR students to sharpen their test-taking skills before the board exam.


  1. NEVER process a question in a top to bottom manner. Processing the information in a different order will give you much more control and clarity over the question
  2. Do not try to predict the question or answer. When you try to guess what will be asked, or what the answer will be, you waste time and energy as you think through hundreds of possibilities.
  3. Start by reading the question being asked of you, and then reading the vignette. This narrows your focus and gives you tremendous insight into what information from the vignette will be crucial to extract in order to answer the question correctly.
  4. Find your answer through the process of elimination. It’s easier, less stressful and more appropriate to eliminate weaker answer choices rather than choosing the first answer that seems to be correct.
  5. Skip “data blocks” and come back to them if needed. Most vignette-style questions can be answered by just using the text, so try that before reviewing tables of data, x-rays or images.

Click Here And Continue Reading…

A Pediatric Board Study Schedule with Step-By-Step Instructions

Why You DO Need A Study Schedule for the Pediatric Boards

Map out Your Study Schedule

I often get asked questions along the lines of…

Can you give me a general pediatric board study schedule?”

I'm in practice and very busy. Can you provide me with a pediatric board study plan that's going to work for me?

Can you provide a pediatric board study schedule for those of us with an erratic schedule because we're in fellowship?

The answer to all of these questions is "yes." But, when you’re preparing for your pediatric board exam, the most essential first step is to map out a dedicated amount of time for your studying based on your personal availability and the recommendations in this article. If you are a first-time test taker, and you:

  • Graduated from a US medical school
  • Have done well on prior board exams
  • Scored above a 222 on the USMLE Step 1
  • Come from a residency program with a high passing rate, and
  • Have done well on your most recent In-Training Exam

Then you are likely at low risk for failing the pediatric boards, and this is the study plan for you! For low risk test-takers, I recommend finding a MINIMUM of 300 hours to block out in your schedule, with plans to go through your Pediatrics Board Review material at least THREE times.

Click Here Now & Go Through the Full PBR Risk Calculator

Please remember, though, a schedule is only as valuable as your DETERMINATION to follow it. In this article, I break down those 300 hours into a manageable, concrete schedule that you can use to guide your studies and PASS the pediatric boards

I Recommend 300 Hours

Since it’s impossible for me to know exactly what your commitments are, what I’ve tried to do below is map out 14 weeks of study time based on the goal of studying approximately 300 hours.

Even if you do not agree with everything I recommend, keep reading to get some ideas that you can incorporate into your own board preparation plan. At the end of this article, I also share some pearls of wisdom towards to help you manage all of the study time that will be needed to pass your boards!

What If I'm at "Moderate to High Risk" of Failing the Pediatric Boards?

If the risk calculator helped you realize that you are at moderate or high-risk for failing the boards, don’t worry! I've created a 16-week study schedule to help you succeed on the boards! The recommendations in the other article are tailored towards graduates who were told that they were "at risk" of failing the boards based on their in-training exam scores, and those who have already failed the boards at least once.

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