ABIM LKA vs the 10-year MOC exam
To keep ABIM certification, you pass either the Longitudinal Knowledge Assessment (LKA) or the traditional 10-year MOC exam. The LKA spreads 600 open-book questions over five years, 30 a quarter, answered wherever you are; the 10-year exam is a single day at a test center. ABIM says 85% of physicians due for assessment in 2026 chose the LKA.
From ABIM’s LKA tour page, its MOC options chart and its fee pages. Checked October 12, 2026.
| LKA | 10-year MOC exam | |
|---|---|---|
| Format | 30 questions each quarter for 5 years (600 total) | One day at a test center, up to 60 questions per session |
| Where | Anywhere you have a device | Pearson VUE test center |
| Time per question | 4 minutes, plus a 30-minute annual time bank | Session time limits |
| Open book | Yes, UpToDate | Yes, UpToDate |
| Skipping | Up to 100 questions over 5 years | No |
| Extra cost | Included in the annual MOC fee | $700 test center fee plus the annual MOC fee |
| Result | Pass/fail at the end of the cycle | Pass/fail after the exam |
LKA rules to know
- Questions expire at the end of each quarter, and expired questions count against your 100 skips, so enroll early.
- You must open at least 500 of 600 questions to meet the participation requirement.
- Each correct answer earns 0.2 MOC points, so the LKA can meet your MOC point requirement on its own over time.
- If you don’t pass, you take the 10-year exam the following year to stay certified.
Common questions
Does the LKA cost extra?
ABIM’s annual MOC fee is $220 for the first certificate and $120 for each additional one, and includes the LKA. The traditional 10-year exam adds a $700 test center fee.
Official source & community discussion
ABIM: the LKA (official) →
See related questions on Quora →