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CME

What Is the Difference Between MOC and CME?

The MDProgress Team
Last updated June 11, 2026
6 min read
What Is the Difference Between MOC and CME?

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You hold a specialty certificate and a medical licence, and two organizations want proof you keep learning. Continuing medical education (CME) is the unit of learning credit. Maintenance of Certification (MOC) is your specialty board's program for keeping your certificate current; CME is usually one component of it. Your licensing body adds a third rule, and the same abbreviations mean different things in Canada and the US. Each tracks you separately.

In the US, CME is the credit and MOC is the program

CME credit comes from accredited providers. The Accreditation Council for Continuing Medical Education (ACCME) accredits the organizations that run CME programs. It accredits the organization, not the physician. Activities certified for AMA PRA Category 1 Credit, the American Medical Association's formal credit designation, must come from a provider accredited by ACCME or a recognized state medical society.

MOC belongs to your specialty board. The American Board of Medical Specialties (ABMS) sets the overall standards and leaves each member board to decide how to meet them. ABMS now calls this continuing certification and names CME as one input; the requirements you face depend on who certified you.

If your board is the American Board of Internal Medicine (ABIM), it asks for at least 100 MOC points every five years plus a knowledge assessment. If your board is the American Board of Family Medicine (ABFM), the program is called continuous certification. Its 5-Year Cycle requires 200 CME credits with at least half from Division I activities, 60 certification points, and either 25 quarterly questions or a one-day exam. An annual fee applies. Only your own board's list applies to you.

Your state board and your licence

Board certification and medical licensure are two separate obligations. Certification is a tier above the licence but does not replace it. Licence renewal is your state board's job, and CME comes with it. As of August 2026, the Federation of State Medical Boards counts 63 of 67 boards as requiring substantial CME, its threshold being 15 hours a year.

The numbers vary widely. Alabama requires 25 hours a year. Illinois requires 150 every three years. Alaska requires 50 every two years. Indiana, Montana, New York and South Dakota set no hour total, though New York still mandates training on specific topics.

MOC can substitute for CME. Rhode Island accepts ABMS MOC as meeting its full CME requirement; West Virginia accepts it for all but a 3-hour risk-assessment course. California grants four consecutive years of CME credit to any physician who passes or recertifies with a specialty board.

In Canada the words change

The Royal College of Physicians and Surgeons of Canada runs the Maintenance of Certification (MOC) Program for specialist physicians. Your Fellowship depends on it. The term used across all Canadian bodies is CPD (continuing professional development), not CME. Most participants follow a five-year cycle requiring 250 credits with at least 25 per year.

The credits fall into three sections. Section 1 (Group Learning) covers conferences, courses, rounds and other group activities, accredited or not. Section 2 (Individual Learning) covers reading, listening and watching, asynchronous courses and the preparation you do for teaching or writing. Section 3 (Feedback and Improvement) covers activities that measure your knowledge or practice performance; the cycle requires at least 25 Section 3 credits, including at least one feedback-received activity. Credits are reported annually, with a January 31 deadline for the prior year.

Family physicians answer to a different body. The College of Family Physicians of Canada (CFPC) runs Mainpro+, which requires 250 credits over five years with at least 25 per year and at least 125 as Certified or Certified Assessment credits. The remaining 125 can be non-certified activities. Up to 40 credits can carry over to the next cycle.

Enforcement is provincial. Ontario, British Columbia and Alberta require licensees to be enrolled in a recognized CPD program; MOC and Mainpro+ qualify in all three. Quebec operates through the Collège des médecins du Québec (CMQ), which requires 250 hours over five years under its own regulation, with changes coming into force on 1 January 2027. Canadian MOC and US MOC share a name. They are separate programs with different rules.

Cross-border recognition

The AMA has a conversion agreement with the Royal College of Physicians and Surgeons of Canada that lets some Royal College activities earn AMA PRA Category 1 Credit. Going the other way, the Royal College does not recognize AMA PRA credit as such. It does credit certain ACCME-accredited activities: live online courses from physician organizations count in Section 1, and self-assessment programs registered as CME for MOC count in Section 3. Completing one does not satisfy the other.

United States Canada
Licensure body State medical boards Provincial/territorial colleges
Specialist certification ABMS member boards Royal College of Physicians and Surgeons of Canada
Family medicine certification ABFM College of Family Physicians of Canada
Credit terms AMA PRA Category 1 Credit (accredited) or Category 2 (self-claimed) MOC Sections 1 to 3; Mainpro+ credits
Typical cycle From one year to five, by state and board 5 years
Tracking platform State/board-specific portals My MOC (Royal College); Mainpro+ (CFPC)

Which rules apply to you

Start from who can act against you. Your licensing body, the state board or provincial college, decides whether you keep practising. Its requirements come first, before any board's cycle. Your specialty board or national college decides whether you keep your certificate. When in doubt, ask the regulator.

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