Preparing for the Process of Recertification

Practical advice for recertification sometimes slips through the cracks.

By R. V. Paul Chan, MD, FACS; Pravin U. Dugel, MD; and Tarek Hassan, MD

The Maintenance of Certification (MOC) requirements of the American Board of Ophthalmology (ABO) mandate that ophthalmologists complete the process of recertification by submitting a catalogue of patient records for the Office Record Review (ORR) and by taking 2 at-home periodic ophthalmic review tests (PORTs) and 1 closed-book demonstration of ophthalmic cognitive knowledge (DOCK) examination. In this edition of Road to Recertification, R. V. Paul Chan, MD, FACS; Pravin U. Dugel, MD; and Tarek Hassan, MD, share with those seeking recertification practical advice addressing the elements of the MOC requirements that young ophthalmologists often overlook.

—Diana V. Do, MD

Give Yourself Plenty of Time to Complete the MOC Process

R. V. Paul Chan, MD, FACS

The best piece of advice I can offer is to realize that the MOC is more than just taking a test, it is a process. It takes time, and there are many steps you must finish before you can sit for the DOCK examination. Being aware of the requirements—their due dates, details, and orders of operation—will help you improve the likelihood that your recertification process is not too stressful.

The ORR requires you to submit a number of anonymized patient charts that reflect a spectrum of conditions and diseases. If you are aware of the number of charts you need to submit, you can think about it prospectively. Such preparation can pay large dividends: It ensures that you will not scramble at the eleventh hour to find charts that fulfill ORR requirements, and it leaves you more time to focus on the PORTs and the DOCK examination.

The examination portions of the MOC process complement each other. The ABO requires you to finish PORTs as well as sit for the DOCK examination. I think the PORT is a good way of preparing for the DOCK. Taking the PORT prior to sitting for the DOCK will give you an extra step of preparation that you can complete on your own time in the comfort of your home. The PORT will make you more comfortable with the DOCK format, which in turn can increase your likelihood of success. I would suggest taking the PORTs closer to the time you sit for the DOCK and if you need additional study materials, you can purchase additional PORTs. The American Academy of Ophthalmology (AAO) also provides live and online material to prepare for the DOCK.

Many retina specialists worry that their commitment to their subspecialty, which comes at the expense of experiencing other ophthalmic disciplines, reduces the likelihood that they will pass their DOCK examination. The DOCK examination requires diplomates to take 3 sections of 50 questions. The first set of questions concerns core ophthalmic knowledge and covers the basic understanding of the discipline that all ophthalmologists share. The other 2 modules can be specific to subspecialties. Retina specialists have the option to take 2 retina/vitreous modules, which reduces the chance that the exam will cover topics with which retina specialists might be unfamiliar.

R. V. Paul Chan, MD, FACS, is an associate professor of ophthalmology and the St. Giles Associate Professor of Pediatric Retina at Weill Cornell Medical College. Dr. Chan may be reached at

Manage Your Time Effectively

By Pravin U. Dugel, MD

Retina specialists going through the recertification process for the first time need to have realistic expectations about the amount of time they will have to prepare for the examinations. At this point in their careers they will have myriad professional, familial, and social obligations. The hectic lifestyle differs vastly from the lifestyle enjoyed as a full-time and focused student. Studying for tests—from the SAT to the MCAT to the Boards—is easy when one dedicates all of one’s time and energy to being a professional student. For the busy professional, finding time to study for a recertification examination may be more difficult than the examination itself.

Those who fail to adequately manage their expectations will be frustrated. With realistic expectations come manageable study strategies, and with manageable study strategies come positive results. Dedicating a few weekends to studying for the examination or enrolling in the AAO’s MOC review course will yield positive results during the recertification process without creating the undue disruptions that old study habits could have on a professional life.

It is important to remember that the recertification process is not designed to trick you. It is not punitive. Rather, recertification is designed to keep both patients and the profession safe. It is unwise to waste time worrying about arcane or obscure details. The recertification process will be less stressful for prepared, well-rounded retina specialists than for those who spend their time focused on esoteric details. Enroll in the MOC course and trust that the topics discussed are likely to appear on the written recertification examination.

Pravin U. Dugel, MD, is managing partner of Retinal Consultants of Arizona in Phoenix; a clinical associate professor of ophthalmology, Keck School of Medicine at the University of Southern California, Los Angeles; and founding member of the Spectra Eye Institute in Sun City, Arizona. Dr. Dugel may be reached at

Maximize the Potential of Your Study Materials

By Tarek Hassan, MD

Proper time management and identification of study materials are the keys to being able to complete the recertification process with minimal stress and a high likelihood of success. The recertification process is a several-year endeavor, so you can complete some of the steps early. The ORR requires you to review your charts and follow a self-directed online program to evaluate your own practice patterns and identify areas that may need improvement. This can be done early in the process to free more time and help identify particular strengths and weaknesses, thereby allowing better preparation for the written examinations.

Taking the PORT examinations is another way to identify weaknesses and to help identify portions of the DOCK on which you should focus. These pretests are taken online, on your own schedule, and they prepare you for the DOCK examination’s content and format. The AAO provides study materials that offer comprehensive coverage of the material to be tested. Although some people are reluctant to believe that the AAO study materials cover everything you need to know, I suggest that you use them to prepare for both the PORT and MOC exam. They have served my colleagues and me well in the past, and I am confident that they will do so for you as well.

Often we feel that study preparation for Board examinations is tedious and of low yield, particularly when going through material that is felt to be intellectually interesting and challenging but esoteric and irrelevant to clinical practice. Fortunately, I have not found this to be the case during the MOC preparation process. I felt it to be much less cumbersome, and much more rewarding, as the material learned and reviewed is very clinically relevant and applicable to most practices. I have now recertified twice, and, each time, I felt that I not only completed a requirement but also improved myself as an ophthalmologist.

Tarek S. Hassan, MD, is a partner with Associated Retinal Consultants, PC, a professor of ophthalmology at Oakland University William Beaumont School of Medicine in Royal Oak, Michigan, and the current president of the American Society of Retina Specialists. Dr. Hassan may be reached at

Diana V. Do, MD, is an associate professor of ophthalmology and Vice Chair for Education in the Department of Ophthalmology and Visual Sciences at the University of Nebraska Medical Center in Omaha. She is also the director of the Carl Camras Center for Innovative Clinical Trials in Ophthalmology and the director of the ophthalmology residency training program. She is a member of the New Retina MD editorial board. Dr. Do may be reached at


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About New Retina MD

New Retina MD delivers cutting-edge content to retina specialists in their first 15 years of practice. Each issue provides fresh insight from younger physicians plus established mentors on clinical and nonclinical issues affecting ophthalmologists in the earlier stages of their careers. NRMD features surgical pearls, clinical research endeavors, practice management, medical reimbursement and policy, continuing educational requirements, financial planning, innovations, and more.