The ABIM Longitudinal Knowledge Assessment (LKA) is an alternative MOC pathway delivered over a five-year cycle. You receive a small batch of questions each quarter, get immediate feedback, and a pass/fail decision is made at the end of the 5-year cycle.
How it differs from the traditional (10-year) MOC exam — short bullets:
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Cadence: LKA = quarterly questions across 5 years (30 new items each quarter); Traditional MOC = single, proctored exam every 10 years.
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Volume & participation: LKA offers 600 questions over 5 years; participants must open at least 500 of those to meet the participation requirement.
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Timing & format: LKA questions are short (recently updated to a 5-minute time limit per question) and completed remotely; the 10-year exam is a single long session at a testing center.
Practical note: Enrollment windows and quarter schedules are managed by ABIM (enrollment commonly opens Dec. 1 and closes June 30); unanswered questions after a quarter closes cannot be returned to, and you have a limited “skip” allowance across the cycle.