Do doctors have to take boards every 10 years? For many specialists the answer used to be yes, but it isn’t a universal rule anymore. Whether a physician still faces that once-a-decade exam depends on three things: the year they were first certified, which of the 24 specialty boards governs their field, and whether they’ve enrolled in a newer continuous-testing option that replaces the single high-stakes test. Board certification is also a voluntary professional credential, not the state license that legally allows a doctor to practice.
The Old 10-Year Rule and Why It’s Changing
For decades, each member board of the American Board of Medical Specialties (ABMS) required its diplomates to pass one secure, proctored exam at the end of a 10-year cycle. That exam sat inside a broader framework called Maintenance of Certification (MOC), which also asked physicians to hold an unrestricted license, complete continuing medical education, and participate in quality-improvement activities.1American Board of Orthopaedic Surgery. Maintenance of Certification Failing the exam could flip a doctor’s public status to “not certified,” which hospitals and insurers check when granting privileges or network participation.
The 24 ABMS member boards cover 38 specialties and 89 subspecialties, from cardiology to sleep medicine.2American Board of Medical Specialties. Member Boards Each board sets its own rules, and in recent years several have moved away from the once-a-decade exam entirely. So the traditional 10-year cycle is still the model in some specialties, but it’s no longer the default answer for every certified physician.
Doctors Who Never Have to Retake the Boards
A large group of certified physicians will never sit for a recertification exam, because their certificates don’t expire. Each ABMS board transitioned to time-limited certificates on its own timeline during the 1970s and 1980s. The American Board of Internal Medicine (ABIM), one of the largest boards, made the switch in 1990. Anyone ABIM-certified before that date holds a lifetime credential and participates in MOC only voluntarily; they cannot lose certification for skipping it.3ABIM Blog. Did You Earn Your ABIM Certificate Before 1990 Heres What You Need to Know for 2023
The result is a two-tier system inside the same specialty. A physician certified in 1988 is board-certified for life. A colleague certified in 1992 is on the 10-year clock. Hospitals and insurance networks generally recognize both types of certificates as valid, and boards can’t retroactively impose exam requirements on the older group.3ABIM Blog. Did You Earn Your ABIM Certificate Before 1990 Heres What You Need to Know for 2023
The Longitudinal Assessment That Replaces the 10-Year Exam
Several boards now offer a longitudinal assessment: shorter question sets answered online over the course of the certification cycle instead of a single day at a testing center. Doctors can typically use clinical references while answering, which mirrors how medicine is actually practiced.
The ABIM’s Longitudinal Knowledge Assessment (LKA) runs on a five-year cycle. Diplomates answer a small number of questions each quarter, spending on average less than an hour per quarter and under two minutes per question. If they meet the participation requirement and other MOC obligations, their public status stays “Certified” throughout the cycle. The LKA is included in the annual MOC fee. If a doctor fails at the end of the five-year cycle, they must pass the traditional 10-year exam the following year to keep their certification.4American Board of Internal Medicine. Longitudinal Knowledge Assessment
The American Board of Family Medicine offers a similar option: 25 questions per quarter across three to four years, 300 questions in total, held to the same passing standard as the one-day exam.5American Board of Family Medicine. Longitudinal Assessment The American Board of Pediatrics runs MOCA-Peds, and the American Board of Physical Medicine and Rehabilitation moved to longitudinal assessment on the ABMS CertLink platform.6American Board of Medical Specialties. ABPMR to Implement Longitudinal Assessment Replacing 10-Year MOC Exam Not every board has made the switch, so some specialties still rely on the proctored 10-year exam.
What Happens If a Doctor Skips or Fails Recertification
A lapsed certificate doesn’t end a physician’s career on its own, but it starts a chain of practical problems. Hospitals re-credential physicians every two to three years, and a lapsed certificate can trigger suspension or termination from a medical staff. Insurance networks run on a similar cycle, and losing network participation shrinks the patient base and the revenue that comes with it. Some malpractice carriers also offer a discount of around 5 percent to board-certified physicians, which disappears when certification lapses.
The Interstate Medical Licensure Compact, which offers an expedited multi-state license, requires current ABMS or AOABOS board certification (or a time-unlimited certificate) as an eligibility condition.
Getting certification back is possible but costly. The American Board of Surgery requires lapsed diplomates to complete outstanding requirements and pass an assessment, with an annual participation fee of $285.7American Board of Surgery. Lapsed Certificates The American Board of Psychiatry and Neurology charges between $1,750 and $3,100 for its continuing certification exam, depending on how many certifications the physician holds.8American Board of Psychiatry and Neurology. ABPN Fee Schedule
Failing a longitudinal assessment doesn’t automatically end certification either. Most boards build in a remediation window, and specific rules vary by board.
State Laws That Change the Answer
More than a dozen states have passed laws restricting how MOC can be used as a condition of licensure, hospital privileges, or insurance network participation. Some are broad, covering state licensing boards, insurers, and hospitals; others target only one or two of those areas.
These laws don’t eliminate board certification itself. They stop institutions from penalizing a doctor solely for not completing MOC, especially when the physician holds an initial certification or a lifetime certificate. A hospital in a protected state can still consider board certification during credentialing, but MOC participation generally can’t be the deciding factor for privileges or network status. That’s why the answer to whether a doctor must recertify every 10 years also depends on where they practice.
Certification Is Not the Same as a License
One boundary worth naming, because it’s often confused. A state medical license is the legal permission to practice, issued by a government board under the state’s medical practice act.9FSMB. About Physician Licensure Every physician needs one, and it typically renews every one to two years with CME requirements set by the state. Board certification is a separate private credential from an ABMS or American Osteopathic Association board. A doctor can legally practice without it, and losing it does not automatically cost them their license. The 10-year exam question is only about certification, not about the underlying right to see patients.
How to Check Your Own Doctor’s Status
If you want to know whether a specific physician is currently board-certified, the certifying boards maintain public directories that show current status. Because the rules vary by specialty, certification year, and state, the directory listing is the most reliable answer for any individual doctor. What used to be a simple “every 10 years” rule now depends on all three factors working together.