As of 2007 self-assessment is required of active Diplomates, regardless of age, who hold lifetime certificates (certificates issued prior to 1994) and who are in the10th year of their re-credentialing cycle.

As of 2011 Lifetime certificate holders may continue to re-credential through the self-assessment examination specified in the Re-credentialing Information Document, or may elect to enter the Maintenance of Certification (MOC) process as described in the Re-credentialing Information Document.