Longitudinal Assessment for PM&R

Assessment For Learning

The ABPMR implemented Longitudinal Assessment for PM&R (LA-PM&R) in 2020 to replace the now retired Maintenance of Certification (MOC) Examination following a successful pilot. This page provides an overview of longitudinal assessment, the rationale and evidence for making the change, and the design of LA-PM&R including customization, scoring, and the implementation plan for all ABPMR diplomates.

LA-PM&R is designed to be a learning tool to help you grow in your PM&R knowledge, so do not think of it as a “study-then-test” process. LA-PM&R is the study tool—throughout your participation, it will show concepts and ideas you have previously missed to reinforce learning and provide resources for improvement. The assessment covers general knowledge in PM&R, and you are able to customize your assessment content areas to see more questions based on your practice. You can then create your own ‘study’ plan for future questions according to your knowledge gaps and customization preferences. Remember, this is not a high-stakes examination, and you do not need to answer every question correctly to pass. What matters is continuous learning and improving over time that the platform assists you in doing.

Diplomates must enroll every year to complete customized questions and meet the performance standard. LA-PM&R questions are delivered quarterly through an online platform and answered at your own pace. Questions answered incorrectly will be delivered again in the following quarter to aid in retention and bridging knowledge gaps.

Why Longitudinal Assessment?

Real-Time Assessment For Learning

Why are we implementing longitudinal assessment, and why now?

  • We Heard You

    You told us you wanted a certification process that was more meaningful and relevant, less burdensome, and added value. The way we’re implementing longitudinal assessment offers a convenient, customizable product that is backed by research as a valuable learning tool. Learn more about how the program works.

  • Increased Value of Board Certification

    Longitudinal assessment uses a learning platform to both assess knowledge and improve memory retention. With immediate feedback, identification of knowledge gaps, and resources to help you learn and improve, 93% of ABPMR’s LA-PM&R pilot participants agree: this program adds tremendous value to certification.

  • Improved Relevance

    The physiatrist-designed customization system allows users to dial their question content concentrations up or down according to their practices – or their learning objectives. Learn more about the customization system here.

  • Decreased Burden

    Most ABPMR LA-PM&R pilot participants reported spending two hours or less of total time on the platform every quarter – including answering questions, reading critiques, reviewing performance, and making any plans to close knowledge gaps. This, coupled with the elimination of the MOC Examination along with accompanying costs of study materials and time off work, means longitudinal assessment decreases diplomate burden in several ways.

  • Data-Driven Assessment and Learning

    The results of the ABPMR LA-PM&R pilot were clear: Participating in longitudinal assessment significantly increased performance on the secure MOC Examination and demonstrated that participants learned over time. See the full results here.

  • Integrated Parts of CC

    LA-PM&R goes a long way in tying parts of continuing certification together. Participation counts not only for knowledge assessment, but also earns you Category 1 CME and self-assessment CME. You could also use your knowledge gap data to create your next quality improvement project!

Check Out Your Personalized Timeline

What About Me?

How does LA-PM&R implementation affect you? Select your current certificate expiration year to find out. (Not sure when your current certificate expires? Find yourself on our Physician Search Tool or log in to your account.)

Participation vs. Assessment

Depending on your current certificate expiration date, you may have some LA-PM&R participation years before you begin your first 5-year assessment cycle. Below are key differences between the two.

Participation Phase-In

  • Must meet quota of meaningful participation by expiration year (see ‘What About Me’ for number of questions/quarters required)
  • Earn Category 1 CME and self-assessment CME (SA-CME) for every quarter of full participation
  • If less than five years from expiration, meaningful participation counts for your CC assessment requirement
  • If more than five years from expiration, we encourage you to participate in LA-PM&R for the learning and SA-CME benefits — but participation is optional before you enter your first assessment cycle (five years before certificate expiration and ongoing after recertification)
  • Passed the MOC Examination before 2021? Your minimum participation required is 0%, but we encourage you to participate for the learning and SA-CME benefits

Assessment Cycle

  • Your LA-PM&R performance assessment is based on four years of performance with a summative assessment occurring in the 5th year
  • The lowest four quarters are dropped from scoring, allowing built-in flexibility for time off, sabbaticals, or leaves of absence
  • In year 5, LA-PM&R participation is encouraged for learning and SA-CME benefits, but not required
  • Earn Category 1 CME and SA-CME for every quarter of full participation
  • Diplomates begin an assessment cycle after they have successfully closed out their current 10-year cycle, or five years prior
  • LA-PM&R performance assessment will occur every five years as an integrated part of your 5-year certification requirements

ABPMR Longitudinal Assessment Program

LA-PM&R Features and Scoring

Customization System

Before starting your assessment, you’ll be able to dial up or down the percentage of questions you get across five domains to customize your content to your preferences.

Read More

Longitudinal Assessment Overview

Check out this graph for a quick overview on how LA works, what dates questions are available each quarter, and how reattempt questions work.

View Infographic

Earn Category 1 and SA-CME

By participating in LA-PM&R, diplomates can fulfill another certification requirement: For every quarter you participate fully, you’ll earn three (3) Category 1 and self-assessment CME (SA-CME) credits, or up to 12 per year.

More about SA-CME

LA-PM&R Scoring

Your LA-PM&R performance will be scored over a four-year period, but we’ll be providing feedback along the way to let you know whether you’re on track.

How Scoring Works


The ABPMR is using the next few years to analyze our cost for maintaining the platform, developing questions, and supporting the new requirement. For now, diplomates will continue to pay the $350 annual fee for continuing certification. After careful analysis is complete, the ABPMR will set fees in line with costs to run the program, including periodic re-analysis. One significant benefit for diplomates is the elimination of the costs associated with taking a secure exam, including time off work, study materials, and travel.


Getting Back On Track

First, we want to emphasize that the purpose of LA-PM&R is to keep you up to date and in the process of continual learning that’s relevant to your practice. You’ve already earned your certification; longitudinal assessment is a research-backed tool to help you learn and continually improve over time. This is the philosophy and heart of this program, and to that end, we anticipate the primary reason for loss of certification will be non-participation or professionalism issues.

The purpose of LA-PM&R is to keep you up to date.

  • Our goal in switching to this assessment method is to make the certification process more formative, enhancing the value of your board certification by integrating a continual knowledge assessment and offering resources to improve.

Your LA-PM&R performance assessment won’t be a surprise.

  • The ABPMR will continually monitor performance and provide individualized updates on performance and whether you’re meeting the standard. The vast majority of diplomates will stay on track simply by using the platform, which helps you learn and improve over time. Diplomates who don’t participate or whose performance hovers near the assessment standard will get notifications and suggestions for remediation long before the final assessment.

We’ll offer help along the way.

  • One of the most exciting possibilities of longitudinal assessment is truly individualized learning – over time as you get a fuller picture of how you’re performing and where your knowledge gaps are, the ABPMR hopes to begin offering suggestions for educational resources and opportunities in relevant areas.

Re-Entry Pathways

For those whose certification has expired or those looking to get back on track, there are two pathways for fulfilling the assessment requirement as part of regaining certification:

Five-Year* LA-PM&R Assessment Cycle

  • *Answer questions over four years (final assessment occurs in year five), meet performance standard
  • Complete all other CC requirements
  • After LA-PM&R results are finalized, the status of physicians who are meeting the performance standard and all other CC requirements will change to "Certified, meeting requirements."

PM&R Re-Entry Exam

  • Apply, pay for, and pass the Re-Entry Examination, a secure examination administered in a computer-based testing center
  • The 250-item exam is based on the blueprint and difficulty level of the Part I Examination
  • Complete all other CC requirements
  • Upon passing the exam, status will be "Certified, meeting requirements"

Frequently Asked Questions

  • Why did ABPMR transition to this new assessment method?

    We heard loud and clear from ABPMR diplomates that the (now retired) MOC Examination was not relevant and did not add value to certification. But because the ABPMR’s mission is to serve and protect the public, the credential must include a periodic assessment of knowledge and skills—earning CME alone isn’t enough to offer an assurance of quality to the public.

    As the board explored options for increasing the value of post-certification assessment, longitudinal assessment quickly became the top contender: Not only is it backed by adult learning research, but it’s also convenient, customizable, and promotes learning over the long term. The ABPMR’s successful pilot confirmed these points, and the ABPMR Board of Directors enthusiastically embraced longitudinal assessment as a valuable assessment tool that will also help diplomates improve over time.

  • What is longitudinal assessment?

    Longitudinal assessment is a method that has been shown to enhance memory retention and facilitate new learning. The user completes shorter, more frequent assessments with spaced repetition (seeing similar questions repeated periodically). It can be likened to quizzing, learning your knowledge gaps, then re-quizzing a little while later to see if you've retained or learned the information.

    Research on this method has shown that the act of quizzing and re-quizzing over time actually improves learning and memory retention better than other study methods, such as reading a text or studying flashcards.

  • How is longitudinal assessment different from an examination?

    It's different in some fundamental ways, representing a shift in how we're approaching post-certification assessment:

    • Longitudinal assessment transforms post-certification assessment from a periodic secure test of current knowledge to an assessment for learning over time. Now, the ABPMR not only sets the standard for knowledge in the specialty, but also provides the tools to facilitate learning and ongoing improvement.
    • Any questions in LA-PM&R that are answered incorrectly are repeated at specific intervals—a method that has been shown to enhance memory retention. The assessment doesn’t just test what you know; it helps you identify what you don’t know so you can make a plan to improve.
    • Tools within LA-PM&R provide valuable personalized insight for participants. As knowledge gaps become apparent in question history, eventually targeted resources (CME and other suggestions) will provide additional learning opportunities.
  • Why is there a three-minute time limit on each question?

    The purpose of limiting the time a user has to answer the question is that part of the ABPMR design for longitudinal assessment is to assess and improve ‘walking-around knowledge,’ i.e., those PM&R concepts that should be part of any board-certified physiatrist’s repertoire. Our board of directors felt it was important to test current knowledge, not what a physician could look up if given five minutes instead of three. Additionally, the point of longitudinal assessment is to show knowledge gaps and give tools for improvement; we anticipate most diplomates will see an improvement of their performance over time as the system helps them learn.

  • How will this affect me?

    LA-PM&R is open to all diplomates, and we encourage everyone to participate for learning and SA-CME benefits. As part of continuing certification requirements, LA-PM&R is rolling out to all diplomates over a few years; your requirements depend on your current certificate’s end date. Check out our “What About Me?” interactive tool for more details.

  • How does LA-PM&R fit into my certification requirements?

    LA-PM&R replaced the now-retired MOC Examination as the assessment requirement for continuing certification.

    In addition to the assessment requirement, LA-PM&R also counts toward the lifelong learning requirement—for every quarter of full participation (answering all questions), users are awarded three (3) self-assessment CME (SA-CME) credits, or up to 12 per year. This means that this one activity now counts for multiple continuing certification requirements, which is part of an ongoing effort to integrate and streamline the Continuing Certification Program.

  • Is the MOC Examination still available?

    No, the MOC Examination was retired in 2020. Starting in 2021, diplomates must use LA-PM&R for the assessment requirement of continuing certification.

    Those with expired certificates or those who do not participate in LA-PM&R may take the PM&R Re-Entry Examination to meet the assessment requirement, which is based on the blueprint and difficulty level of the Part I Examination for initial certification in PM&R. The Re-Entry Examination is available annually.

  • What if I’ve already passed the MOC Examination for my current certification requirements? Do I still have to participate in LA-PM&R?

    No. If you passed the MOC Examination for your current set of requirements, your required LA-PM&R participation is 0%. However, we still encourage all diplomates to participate for the learning and SA-CME benefits.

  • It’s less than five years before my certification expires. What if I don’t fulfill the participation requirement before the certificate expiration date?

    If you don’t fulfill your LA-PM&R participation requirement (see details here) or pass the MOC Examination before your current certificate expiration date, OR if you don’t complete all other continuing certification requirements, your certification will expire and you will no longer be board certified.

    If your certification expires, you can regain it via one of two re-entry pathways. Read more on re-entry.

  • It’s more than five years before my certification expires. What if I don’t participate in my LA-PM&R assessment cycle in the last five years of my certification?

    First, the ABPMR is honoring the terms of all current 10-year certificates, so even if you do nothing, you will retain your board-certified status until your certificate expiration date.

    If you don’t participate in LA-PM&R during your assessment phase, you will not meet the performance standard and will not fulfill the assessment portion of your CC requirements, resulting in a loss of certification after your current certificate expires. In addition, non-participation will result in an CC participation status change of Certified, Not Meeting Requirements.

  • What if I do not meet the LA-PM&R performance standard?

    As explained above under ‘Re-Entry Pathways,’ any diplomate not meeting the LA-PM&R performance standard (don’t worry, you’ll know far in advance if this is the case) will be able to regain certification by undergoing another five-year LA-PM&R assessment cycle (while expired) or by passing the Re-Entry Examination, which is based on the blueprint and difficulty level of the Part I Examination.

    Based on the experience of other boards, the ABPMR anticipates that most cases of not meeting the LA-PM&R assessment standard will be the result of non-compliance, not performance issues. However, be assured that we will give you performance feedback and suggestions for learning and remediation along the way.

  • Will longitudinal assessment be offered for subspecialties?

    Currently two subspecialties - Pain Medicine and Brain Injury Medicine - have transitioned to longitudinal assessment. Pediatric Rehabilitation Medicine and Spinal Cord Injury Medicine are planned to transition to LA in 2025. More details will be available to diplomates in the coming months.

  • Can diplomates with non-time-limited certificated participate in LA-PM&R?

    Yes! Evidence shows that longitudinal assessment has benefits for all physicians, and we strongly encourage all diplomates to participate regardless of continuing certification status. To participate, enroll via your abpmr.org account; you’ll just need to pay the $350 annual fee for every year of participation.