The Nephrology Board held its spring meeting on March 17, 2026. Representatives from the American Society of Nephrology (ASN), the American Society of Transplantation (AST), the Renal Physicians Association (RPA) and the National Kidney Foundation (NKF) joined for part of the meeting.
ABIM and the Nephrology Board gratefully acknowledge the service of John C. Lieske, MD, Matthew A. Sparks, MD, and chair Rudolph A. Rodriguez, MD, whose final terms end June 30, 2026. Dr. Rodriguez first joined the Nephrology Board as a member in 2014 and has served as chair since 2020. Dr. Lieske served on the prior Nephrology Board Exam Committee 2015 – 2020 and subsequently the Nephrology Board. Dr. Sparks has served as a member of the Nephrology Board since 2020.
The following is a report of the spring meeting. Visit the ABIM Blog for reports of prior meetings.
ABIM Leadership Update*
Furman S. McDonald, MD, MPH, President and CEO of ABIM and the ABIM Foundation, discussed progress on ABIM’s strategic initiatives, including:
- Customized learning plans via partnership with the American College of Physicians (ACP) that launched in February. A new feature in ACP’s Medical Knowledge Self-Assessment Program (MKSAP) allows subscribers to import their most recent ABIM internal medicine assessment results directly into their account, which will suggest learning tools to build a tailored plan.
- Enhancing early career physician engagement through an interactive online community platform, tailored resources for residency programs and the creation of an Early Career Committee which will begin meeting in July.
- Progress of the Competency-Based Medical Education (CBME) pilot for International Medical Graduates (IMGs) which has received more than 160 applicants to date, including 65 in nephrology. ABIM is using the pilot to test a model for board eligibility using a CBME framework, while removing barriers for physicians who meet the same standards as peers who completed accredited internal medicine training.
- The recently expanded blueprint review process, which involves a schedule of plans for updating blueprints in every specialty over the next several years. Practicing physicians in each specialty will continue to be invited to participate in updating each blueprint to reflect current practice.
- Recent communications about the importance of exam integrity and, in particular, the appropriate use of artificial intelligence (AI) tools on the Longitudinal Knowledge Assessment (LKA®).
In response to questions about customized learning plans, Dr. McDonald explained that the ACP collaboration builds on prior approaches by using assessment data to identify individual knowledge gaps and guide learning. ABIM is not directly involved in society-led exam preparation tools, but multiple societies have expressed interest in exploring how to equip their members with similarly customized learning plans using ABIM assessment data.
In a discussion about physician burnout, Dr. McDonald spoke about the lack of agency as a primary driver and described ABIM’s exploration of ways to provide physicians with greater flexibility. The Nephrology Board discussed workforce concerns, including interest in expanding combined Internal Medicine-Nephrology training pathways. Dr. McDonald noted that certification and training changes alone will not fully address workforce issues. Finally, Specialty Board members expressed strong interest in the new IMG pathway. Nephrologists represent a majority of pilot applicants, suggesting previously unmet demand.
Developing a Quality Agenda in Nephrology*
As a next step in the development of a discipline-specific Quality Agenda, Nephrology Board members engaged in breakout discussions to further refine the aims, drivers and relevant society strategies agreed upon by the Nephrology Board and specialty society partners. The Quality Agenda is one of the standards for continuing certification issued by the American Board of Medical Specialties (ABMS) for all Member Boards in 2021. This standard requires that Member Boards “facilitate the process for developing an agenda for improving the quality of care in their specialties.” (ABMS Standards for Continuing Certification, p. 15: Requirements for Member Boards, 18. Quality Agenda.)
The Nephrology Board identified several key themes for the Quality Agenda, including expanding the focus on health equity beyond race to encompass broader social determinants of health, addressing workforce shortages in nephrology and their impact on access to care and emphasizing the importance of early detection of chronic kidney disease alongside gaps in current screening guidelines. The discussion also highlighted persistent barriers to care, including medication access, cost and challenges in care coordination. ABIM staff will compile the refinements and share the changes for review before submission to ABMS in June 2026.
Review the complete Nephrology Quality Agenda.
Physicians Engaging in Improving Health and Health Care*
ABMS Standard 19 (ABMS Standards for Continuing Certification, p. 16) focuses on increasing the proportion of physicians engaged in improving health and health care, including quality improvement and patient safety. It requires ongoing reporting, increased participation and collaboration to ease engagement and reporting burdens. ABIM is not reintroducing a requirement for individual diplomates to participate in quality improvement activities. Instead, ABIM will look to increase engagement in and recognition of quality improvement activities through existing pathways. In addition, ABIM will develop and implement new opportunities to recognize and reward diplomate engagement in quality improvement under the expanded definition.
Laura L. Sessums, JD, MD, ABIM’s Chief Medical Officer, outlined plans to expand ABIM’s definition of quality improvement activities to better align with real-world physician practice, refine baseline reporting and develop new approaches in the coming years. Discussion of prior programs underscored challenges with sustained participation and the importance of designing more practical and valuable pathways for physicians.
CBME Special Consideration Pathway for IMGs*
The pilot pathway launched last year has experienced strong early uptake, particularly among physicians in nephrology and related specialties, with more than 160 individuals approved and achieving Internal Medicine Board Eligibility at the time of the meeting.
Nephrology Board members discussed how to assess training in countries where internal medicine is not clearly delineated or program lengths and internships differ from U.S. standards. Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs, noted that credentialing processes include detailed transcript review, verification of at least 36 months of internal medicine training, and program director attestations to achievement of competence upon subspecialty training completion. However, Specialty Board members noted a need for clearer guidance to program directors, more consistent evaluation criteria for eligibility to train in an accredited fellowship program and potentially stronger quality-control mechanisms, including better ways to assess or compare Graduate Medical Education training programs internationally.
Nephrology Board members emphasized tracking long-term outcomes, such as certification rates, exam performance and participant experience, to refine the pathway. The ABIM Council will evaluate the pilot for at least five years to assess whether it is meeting its goals across specialties and inform future decisions.
Initial Certification Exam Pass Rates for Nephrology Fellowship Programs*
The Nephrology Board noted that while first-time exam pass rates on the Nephrology Certification Examination are lower than many other subspecialities (80 – 83% in recent years), eventual pass rates remain strong at 97 – 98%, with most who do not pass on the first attempt passing on the second attempt. This eventual pass rate is similar to other subspecialties. Specialty Board members expressed interest in better longitudinal tracking of fellowship program-specific performance of their graduates, including revisiting older studies related to exam performance, identifying predictors of exam success, and exploring how to better identify fellowship programs with poor Nephrology initial certification exam pass rates.
Jeffrey S. Berns, MD, FASN, Councilor for ASN and past chair of both the ABIM Council and the Nephrology Board, advocated for greater transparency in pass rate reporting and the development of dashboards to monitor program performance trends. The group also discussed opportunities for ASN and other societies to support targeted educational interventions to address knowledge gaps and improve first-time pass rates.
Oversight of Nephrology Assessments*
A large part of the purview of the Nephrology Board is its oversight of assessment. Each year, the Specialty Board examines data from recent LKA, initial certification and Maintenance of Certification (MOC) activities within the discipline. Members received population-level information, assessment updates and performance data to support informed decision-making and future assessment strategies.
Pass rates on the Nephrology Certification Examination and MOC assessments remained stable across certification pathways, while LKA participation continued to grow alongside an increase in total number of test takers. Data also showed a substantial proportion of internationally trained candidates in the testing population.
Society representatives departed at this point in the meeting.
Candidates for the Nephrology Approval Committees
Specialty Boards are responsible for selecting incoming members and chairs of the Approval Committees in advance of new terms that begin in July of each year and as seats become vacant for other reasons. Following a review of the candidate materials and a candidate interview, the Specialty Board appointed a new chair of the Nephrology Traditional, 10-Year MOC Exam Approval Committee. ABIM will announce all final governance appointees in July 2026 when their terms begin.
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*Indicates that society representatives and other guests were present for discussion on this agenda topic.