No, your requirements and fees are not doubled if you hold two time-limited certificates, nor tripled for three. The MOC program is designed so that your overall participation requirements and fees remain the same, regardless of how many certificates you hold.

The first thing to understand if you hold multiple time-limited certificates is while each certificate will continue to have its own 10-year cycle, the first one that you earned will define your "governing cycle." The governing cycle, in turn, sets the schedule for (1) your PQI participation (4^th MOC component), (2) when you are eligible for examination (3^rd component), and (3) your annual fee amount.

Regarding lifelong learning (2^nd component), the credits you earn will be counted toward the requirement for each of your certificates. Credits you earn for any state licensure CME requirements may also serve to meet your MOC requirement. You only need to make sure that you pace your credits at about 25 per year, so that each 10-year cycle that you are involved in has a total of 250 credits upon finishing. All SAMs you take are counted toward each of your certificates. There is one caveat for SAMs: at least 6 of your required SAMs must be in the relevant subspecialty category for every subspecialty certificate you have. For example, a diplomate with subspecialty certificates in both neuroradiology and pediatric radiology should make sure his/her SAMs follow this pattern:

Your cognitive exam (3rd component) will be practice-profiled to reflect your areas of practice and subspecialty. You will meet the cognitive expertise requirement for all your certificates by taking, on one occasion for all your certificates, a number of exam modules with content related to each of your certificates.

No. The MOC process is an integral process that encompasses all the certificates you hold. Neither fees nor requirements increase if you participate in MOC for multiple certificates. Only the proportional distribution of content for your learning activities and your exam may change, depending on the certificates for which you are participating.

You may coordinate the fulfillment of your requirements as follows:

Component 1: The professional standing (licensure) requirement must be fulfilled on a continuous basis, by keeping all state medical licenses current and unrestricted.

Component 2: The lifelong learning requirement must be fulfilled within each of your cycles. However, all credits you take can be counted twice - once for your neuro and again for your peds certificate. As you come to the end of each cycle, monitor to make sure that your total within the cycle will equal or exceed the stated requirements. Specifically for SAMs, make sure that you have taken at least 6 in the area of the certificate that is ending.

The following chart illustrates how you can simultaneously fulfill SAM requirements for 2 certificates:

Component 3: The cognitive expertise requirement is fulfilled by taking and passing a computer-based examination in the last 3 calendar years of your governing cycle (in the example, this would be the Peds 2007 - 2017 cycle). You need come on only one occasion, every 10 years. When you register for the exam, in addition to selecting date and location, you will indicate your practice profile to determine the categories in which you will receive clinical content modules. In addition to the clinical content modules (at least 2 per subspecialty certificate area are required to maintain a subspecialty certificate), you will receive 1 general content module, as do all diagnostic radiologists.

Component 4: The practice quality improvement project must be completed along the timeline of your governing cycle (in the example, this would be the Peds 2007 - 2017 cycle). The sequence of steps is defined in the "PQI Timeline and Milestone Tracking Chart". As long as you are participating in PQI on that schedule, your requirement will be considered fulfilled for your other cycle as well.