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Performance Pathway

When you apply for MOC in Year 6, your Performance Pathway eligibility is displayed on your application. Performance Pathway is an optional way to meet your Year 6 exam requirement. If eligible, you have to enroll in the pathway program. You do have the option to decline participation in the pathway program and to go ahead and take the MOC exam.


ABOG introduced Performance Pathway (the "Pilot" program, which was approved for permanent adoption by the American Board of Medical Specialties in May 2018) in 2016 to enhance and streamline the continuing certification (MOC) process. The program integrates the self-assessment and external assessment requirements to encourage you to continuously demonstrate your knowledge of the specialty.


The program maintains a rigorous and relevant continuous professional development process that is critical to providing high-quality patient care. Performance Pathway emphasizes demonstration of knowledge throughout the entire MOC cycle. ABOG believes that this program helps ensure that you're maintaining a high level of current medical knowledge and are able to apply that information in your practice.


Watch this video to learn more about Performance Pathway.





To be eligible, you must have scored an aggregated average of 86% or higher on your Part II article assessment questions over Years 1-5 of your current MOC cycle and maintain that threshold in Year 6 as well. Current running average and historical year-by-year scoring information is available on your portal.


You will be ineligible to participate in the Performance Pathway if you have any of the following:

  • A probationary certification status
  • A current state board disciplinary action on your license, such as revocation, suspension, probation, denial of renewal, or surrender
  • A felony criminal charge, conviction, or pleading


If you decline to participate in Performance Pathway, or you're ineligible to participate, you must pay the MOC exam fee in addition to the annual MOC fee, and you must take and pass the MOC exam in your MOC Year 6.


If you are eligible and choose to participate in Performance Pathway, you will not pay the additional MOC exam fee. But, you must meet the MOC Part I Professionalism and Professional Standing requirements. You must have completed the MOC Part IV Improvement in Practice requirements for the cycle. You must also meet or exceed the required 86% threshold in MOC Part II Lifelong Learning and Self-Assessment.


  • If you're in Year 1-5 of your MOC cycle, you should be aware of the initial answer threshold of 86% used to determine Performance Pathway eligibility.
  • You're encouraged to maintain a high-performance threshold to ensure Performance Pathway eligibility.
  • ABOG may choose to use different eligibility criteria for Performance Pathway in the future.

If you don't qualify for Performance Pathway, or elect not to participate, you must pass the MOC exam by mid-December. Check Dates and Fees for this year's exam date requirement.

  • You'll be required to pay $200 to cover the administrative costs of preparing the exam (in addition to paying the MOC application fee). This cost is exclusive to the annual $275 fee to participate in MOC.
  • When your application has been approved (usually taking fewer than 72 hours), information will be sent by email explaining the process to schedule a test at a Pearson VUE test center. Reservations at each test center are scheduled on a first-come, first-served basis. You are encouraged to schedule your examination as soon as possible after receiving the notice of approval.
  • If you don't pass the MOC exam, it may be retaken up to four more times during the MOC year. The original test fee of $200 covers the cost of all repeat exams. The last day a repeat exam can be taken is in December. Check the dates and fees for this year's date.
  • If you don't pass the MOC Part III exam by the ABOG-assigned date in December, your certificate will expire. If you want to regain certification, you must apply through the Re-entry process to reinstate your board certifications.
  • In addition to passing the MOC exam, if you're in MOC Year 6, you must also complete the Part I Professionalism and Professional Standing; Part II Lifelong Learning and Self-Assessment; and Part IV Improvement in Medical Practice assignments.

An MOC practice test is available in the "Assessment of Knowledge, Judgement, and Skills" section of your portal, just look for the words "Practice Test." The exam structure including exam content, grading, and test selectives can be found in Assessment of Knowledge, Judgement, and Skills.