Maintenance of Certification (MOC) programs are a source of irritation and controversy in medical communities today. The American Board of Medical Specialties (ABMS), representing 24 specialty member boards, notes that prior to the 1970s, board certification of a physician provided them with lifetime credentials. These written and sometimes oral exams were designed to test for basic competence in that particular specialty. (This was analogous to medical licensure based on an individual passing the three parts of the examinations given by the National Board of Medical Examiners [NBME]. In 1992, this exam was superseded by the U.S. Medical Licensing Examination [USMLE], sponsored by the Federation of State Medical Boards [FSMB] and the [NBME]).