In 1990, the American Board of Internal Medicine (ABIM) moved from lifetime board certification to time-limited, 10-year certification. Subsequently, in 2014, ABIM announced the maintenance of certification (MOC) examination, which was proposed to allow the physician to stay up to date with the current medical knowledge. The ABIM has recently imposed new MOC requirements to maintain board certification. Physicians seeking continuation of initial ABIM certification must fulfill MOC activity, which can be obtained from specific continuing medical education activities, a limited range of activities developed by ABIM, and quality improvement/practice improvement projects, every 2 years, with a threshold of 100 MOC points required during 5-year intervals.