Component 4: Practice Performance Assessment & Improvement


Under Component 4 of the OCC process for the specialty of Surgery, physicians are required to participate in a practice performance assessment (PPA) process designed to evaluate performance improvement in surgical knowledge and surgical skills.

Through the process, diplomates demonstrate that they can assess the quality of surgical care they provide compared to peers and national benchmarks and then apply the best evidence or consensus recommendations to improve that surgical care using follow-up assessments.

Diplomates found to be deficient in the PPA process must provide documentation of appropriate remediation of the deficiencies.

A minimum of two PPA modules are required once every three years in the 10-year OCC cycle and must be completed by the end of each three-year cycle.

Once during each three-year PPA cycle, diplomates must select different PPA modules, ensuring that at the end of the 10-year OCC cycle, they will have submitted data on a minimum of six different case types.

An attestation form signed by the diplomate is required for each three-year PPA cycle.

PPA Module Collection

Diplomates are required to collect data from a minimum of 10 consecutive patient records extracted for a designated condition, disease or procedure. Data must be from patients treated by the diplomate and not by other physicians in a group practice. The AOBS will provide samples of the PPA modules with instructions.

Once the PPA data has been collected, the diplomate will have 30 days to enter the data into an online PPA module.

Limited scope: Diplomates who verify that 90% or more of their primary practice does not currently fall within the scope of their primary specialty board certification may propose an alternate Component 4 PPA project.

Dually-certified physicians (two or more AOA specialty certifying boards): Due to the unique nature of each specialty, diplomates holding two or more surgical certifications administered through the AOA must meet all criteria for each specialty certifying board’s OCC processes. However, CME earned will apply to each specialty certifying board, with the exception of the special CME requirements for each specialty and/or subspecialty certification.

Dually-certified osteopathic physicians (AOA and ABMS certification): Diplomates participating in the Maintenance of Certification (MOC) process through one or more ABMS-recognized certifying boards may petition to submit their practice performance assessment activities completed through MOC and apply them to their OCC Component 4 requirements. However, the specialty certifying board may also require an osteopathic component.