Ultimate Guide to the MOCA-Peds Assessment

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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.


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Pediatric Board Exam Time Per Question, Number of Blocks & More
Pediatric Board Review Course 2022
Ashish Goyal, M.D.

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