The American Board of Medical Specialties (ABMS) is working closely with its 24 member boards to implement the four components of a Maintenance of Certification (MOC) program. Those components include evidence of professional standing, lifelong learning and self-assessment, cognitive expertise, and evaluation of performance in practice. The new MOC program of the ABMS represents a dramatic shift from how graduate medical education, initial certification in the medical specialties, and recertification in the medical specialties are being conducted. This article updates how specialty boards are implementing the four components.