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Introduction

As Chair of ABIM Council, the ABIM governance body that oversees the various discipline-specific Specialty Boards, I am very pleased to share with you a summary of the discussions that took place in spring 2019 at the ABIM Specialty Board meetings. The Council and Specialty Boards are comprised primarily of physician leaders from around the country and all forms of practice in internal medicine and its subspecialties, working on your behalf to make ABIM programs more relevant and valuable to ABIM diplomates and patients. 

It has been a very busy year at ABIM. With the continued rollout of the Knowledge Check-In assessment option in 2019, and other new assessment options in Cardiology and Medical Oncology being developed with our society partners, we remain committed to assessment innovations as a means to improve the Maintenance of Certification (MOC) program. We have also been digesting external developments in the ABMS Member Board community such as the Vision for the Future Commission’s report on continuing certification. This report from the Commission, an entity sponsored by the American Board of Medical Specialties (ABMS), has caused us to reflect on how its recommendations have validated many of our recent changes while also highlighting the need to further evolve our MOC program. As you will notice when reading the subsequent report, some overarching topics were discussed at all Specialty Board meetings, while others were specific to individual disciplines.

Engaging with our community of diplomates is a top priority at ABIM, and that includes both sharing updates and receiving feedback. We hope you will find this report to be valuable as our goal is increasing transparency and communications between the Specialty Boards and the diplomates we serve.

ABIM’s governance structure consists of more than 350 volunteer members on more than 50 boards and committees and includes physicians, allied professionals and public members. These governance groups include the Board of Directors, ABIM Council, Specialty Boards and Exam Committees.

The twelve Specialty Boards are where the frontline, discipline-specific work occurs. Specialty Boards are responsible for the broad definition of the discipline across Certification and MOC. ABIM currently has a Specialty Board for most disciplines in which it certifies physicians. Some, like the Cardiovascular Board, include physician members certified in different specialized areas within the field. Specialty Boards have oversight of the Exam Committees and are responsible for making sure Certification and MOC are relevant to their discipline.

The role of the Specialty Boards is to:

  • Define, refine and set standards in Certification and MOC in the discipline.
  • Perform oversight/review of performance assessments in the discipline.
  • Build partnerships with societies and other organizational stakeholders in support of ABIM’s mission.

Each of the twelve Specialty Boards meets once in the fall and once in the spring with conference calls as needed throughout the year. This report summarizes the general discussions that cut across all spring Specialty Board meetings and also provides insight into discipline-specific topics that were discussed at individual meetings.

GENERAL SPECIALTY BOARD UPDATES

One of the major topics of discussion at the Specialty Board meetings was the release of the Continuing Board Certification: Vision for the Future Commission’s final report, which outlined a set of recommendations to ABMS on the future of certification and MOC. Report highlights included:

  • ABMS Member Boards have the obligation to make summative decisions about who is and is not certified over the course of career.
  • Any Maintenance of Certification (MOC) program needs to have substantial educational value as well as assessment integrity.
  • MOC models that include “longitudinal assessment” should be encouraged. Traits of these models include self-pacing of material with some number of questions to be completed within a quarter and immediate sharing of the correct answer, rationale, references and, often, percentage of colleagues who chose each answer.
  • Broader collaboration with society partners should be encouraged.
  • The ABMS Member Boards are setting up a variety of work groups to study the report, and are encouraging all diplomates to stay engaged and sign up to receive updates from ABMS on the progress underway.

As ABIM continues to evolve assessment options, it looks forward to collaborative discussions with professional societies.

The Specialty Boards also discussed the ABMS requirement that Member Boards set a policy limiting a candidate’s time to become certified after completing the initial certification eligibility requirements.

In 2012, ABIM established its policy that defined Board Eligibility as a period of seven years that would begin after completion of initial certification eligibility requirements, the primary component of which is graduation from an ACGME-accredited residency and/or fellowship. The final year of Board Eligibility for all physicians meeting initial certification eligibility requirements on or before 2012 is 2019. Physicians who have not become initially certified within their Board Eligibility period will need to complete a year of accredited training in the relevant discipline in order to register for a future ABIM initial certification examination.     

Participating in ABIM governance provides a meaningful and rewarding opportunity to join outstanding colleagues in service of the profession. Governance members help define breadth of knowledge of  board certified internists and subspecialists, provide perspective on trends and scope of their discipline and collaborate with peers to develop the fairest and most up-to-date assessments possible.

Diplomates are encouraged to review the ABIM governance openings and apply themselves, or nominate a colleague for service. New governance members are announced in July when their terms begin.

During the Specialty Board meetings, members discussed the competencies to be sought for the next membership cycle.  

Oversight of assessments in the discipline is a core function of Specialty Boards. Throughout the spring, Specialty Boards reviewed data related to the population of new graduates entering the discipline and diplomates maintaining their certification. Periodic review of these data help to inform the Specialty Boards’ assessment decisions.  

  • The ABIM MOC program consists of two core requirements: passing a periodic assessment and earning 100 MOC points every five years. The 100-point requirement within a five-year period started in 2014, and 2018 was the first time many diplomates had to fulfill the requirement.
  • Because the policy was going into effect for the first time, ABIM launched a large communications campaign around the ‘Five Year Lookback’ to increase awareness of the need to complete 100 MOC points to avoid loss of certification. The Specialty Boards discussed the communication efforts by ABIM, as well as their colleagues’ experiences with the five-year lookback, and offered suggestions to help physicians better understand what the requirements are and how to meet them.
  • The ABIM Council has oversight of the twelve discipline-specific Specialty Boards. The Councilors selected final candidates based on recommendations from the Specialty Boards for positions open as of July 1, 2019. The Specialty Board members chosen represent desired competencies in their discipline(s) and will have oversight over the relevant Exam Committee.
  • The Council also encouraged the Specialty Boards to work with training and medical society partners to gather feedback on how internal medicine residents can be better prepared to enter fellowship training with regard to procedural experience.
  • The BOD approved a new, diplomate-focused certificate redesign. The new design was created after gathering feedback from governance members and the diplomate community.
  • The BOD formed a subcommittee of Directors and Councilors to develop a high-level research strategy to further ABIM’s mission and improve its programs. ABIM is committed to research regarding Certification, Maintenance of Certification (MOC) and our assessment tools. Research areas include Foundational Science, Effectiveness Research, and Public Awareness Research.  
  • The BOD asked a Governance Task Force of Directors and Councilors to review the initial five years of the current governance model and to recommend whether changes were needed for the Board to remain responsive and effective.
  • In response to the recommendations, the Board of Directors approved three minor amendments to the bylaws intended to: retain the institutional knowledge of the immediate-past Board Chair; increase the percentage of physician Directors (75%) who must have current clinical practice experience; and emphasize the importance of performance and competency evaluations in re-appointing governance members. The ABIM Bylaws are publicly available.
  • At their February meeting, the ABIM Board of Directors asked staff to look for ways to evolve the Knowledge Check-In (KCI) to provide more educational value, flexibility, feedback, and expanded resources for diplomates.

Both the ABIM Council and BOD covered the following topics at their recent meetings:

  • The ongoing evolution of board certification. This includes evaluating assessment innovations from other ABMS Member Boards to determine what is working in those models.
  • Considering whether to open new pathways to training and certification, e.g. Neurocritical Care.
  • ABIM assessments – the Council learned how pass rates for the KCI and 10-year assessments will be reported.
    • KCI exams are given every other year and the consequence of losing certification doesn’t occur until after the second failed attempt of the KCI. Starting from the year when the KCI is launched for a discipline, ABIM’s public pass rates for the discipline are reported on a rolling two-year average that includes first-time takers for the t 10-year exam and all takers for the KCI exam. For example, the 2018 pass rates for Internal Medicine and Nephrology are based on 2017 and 2018 takers. This explanation is noted on the website. Also, note the KCI and 10-year exams have the same blueprint and passing standard. 
    • All exam pass rates are publicly reported each year, along with other statistics.
  • The Council also heard the results of the first phase of implementing UpToDate® as an open resource for all MOC assessments – both the KCI and the 10-year assessment. Beginning in 2018, physicians have been able to access UpToDate®—an online, evidence-based clinical decision support resource—during all MOC assessments. UpToDate® was a very favorable enhancement on the exam; nearly 80% of diplomates who completed a KCI or 10-year exam in spring 2019 thought that UpToDate® was a valuable resource on the exam.

HIGHLIGHTS FROM THE SPECIALTY BOARDS BY DISCIPLINE

All of the topics cited above were reviewed by each Specialty Board. The following are summaries of discipline-specific discussions.

ACC Collaborative Maintenance Pathway

For the Cardiovascular Board, the official announcement of the ABIM-ACC Collaborative Maintenance Pathway (CMP) for 2019 was a highlight of the American College of Cardiology’s 68th Annual Scientific Session (ACC.19).

ABIM staff reviewed the final outline of the ABIM-ACC CMP model, and gained insights from Cardiovascular Board members for implementation. Participating in the ACC CMP starts with engaging with the ACCSAP educational product, which is already underway, followed by an assessment component later in the year.

The Cardiovascular Disease Board also acknowledged the following members whose term of service ended as of July 1, 2019: Matthew Bosner, MD, John Brush Jr., MD, Vincent Bufalino, MD, Frederick Masoudi, MD and Kristen Patton, MD.

Co-Sponsorship Proposals – joint session of Critical Care Medicine and Pulmonary Disease Boards

The CCM Board recommended to the ABIM Council and BOD that ABIM pursue co-sponsorship of the Neurocritical Care certificate approved by ABMS last year. Co-sponsorship would allow physicians who are ABIM Board Certified in Critical Care Medicine to pursue training and certification in the newly-recognized discipline. The CCM Board took up the proposal after hearing from diplomates that they would be interested in this pathway. ABIM will gather information about the number of CCM diplomates who would be eligible for and would pursue this certification if ABIM were to co-sponsor. The ABIM Council considered the CCM Board’s resolution at their June meeting, and the BOD will consider the resolution and other strategic issues before making a decision about co-sponsorship later in the year.

The Pulmonary Disease Board and CCM Board discussed the idea of a pilot program to test the feasibility of incorporating family medicine-trained physicians into internal medicine critical care medicine fellowships, with successful completion resulting in eligibility for certification in IM-CCM. This would allow gathering data to inform the possible co-sponsorship of IM-CCM by the American Board of Family Medicine (ABFM). The Pulmonary Disease Board gave guidance to the CCM Board before the CCM Board continued their deliberations separately. 

The CCM Board voted to explore a potential pilot program proposal (as described above) from the ABFM, under the framework of the ACGME Advancing Innovation in Residency Education (AIRE) program. 

Exam Sequencing for Dual Certification in Pulmonary Disease and Critical Care Medicine – joint session of Critical Care Medicine and Pulmonary Disease Boards

Currently, pulmonary disease certification is required before critical care medicine certification only for those trainees who attain initial certification eligibility through combined pulmonary and critical care medicine fellowships. Some fellows have asked that this requirement be reconsidered to remove the restriction on certification sequence for those who successfully complete all three years of combined training.

The Pulmonary Disease Board and Critical Care Medicine Board discussed stakeholder feedback together, and then the CCM Board made the decision to approve the change to the exam sequencing rules, allowing the candidates to choose the order of certification that best fits their situation.

The proposed change went to the ABIM Council for a discussion of cross-disciplinary impact and final approval, and ABIM will follow up with stakeholders.

Critical Care Medicine Update

Antoinette Spevetz, MD, consultant advisor for the Society of Critical Care Medicine (SCCM), gave an update on the SCCM along with a presentation on her recently published paper, A Case for Change in Adult Critical Care Training for Physicians in the United States: A White Paper Developed by the Critical Care as a Specialty Task Force of the Society of Critical Care Medicine.

The group discussed the history of specialization within critical care medicine, as well as the opportunities and barriers in creating a path to unify the discipline. The discussion ended with a consideration of possible next steps that need to be further explored.

Pulmonary Disease Update

The Pulmonary Disease Board heard from Peter Sporn, MD, Chair of the Pulmonary Disease Exam Committee, about the current Exam Committee membership and their efforts to create rigorous questions for ABIM assessments, and how that effort has evolved with recent changes. 

Jeremy Dugosh, PhD, ABIM’s Vice President of Test Development, described the new techniques being utilized to increase the number of questions that can be created, given the new assessment options for diplomates.

The Pulmonary Disease Board also acknowledged Stanton Siu, MD and Michael Nelson, MD whose terms of service ended as of July 1, 2019.

ABIM received several requests from the community to provide “aggregate feedback” on initial certification exam performance. Responding to those requests, ABIM identified content areas with the largest knowledge gaps in a given discipline. ABIM already provides information about performance on the certification examination to examinees and to their training programs. The EDM Board discussed how aggregating information about difficult subjects could help EDM training programs better focus their educational efforts.

It was also noted that this could be an opportunity to share similar aggregated and de-identified knowledge gap information with societies, which could consider creating or emphasizing educational resources designed to close those gaps. The EDM Board will continue to explore this topic.

Endocrinology Practice Profiles

The EDM Board received an update on customizing MOC assessments to better reflect the specialization of their practice. It was noted that with the KCI launching this spring in the discipline, ABIM would look toward future administrations to move forward with specialization. ABIM will work closely with our society partners to review and analyze information on the potential development of practice profiles within the KCI.

EDM Board members confirmed that this could be seen as a very positive change in the field. They asked for the opportunity to talk with the community about the specialization effort as the blueprints are constructed and approved, recognizing that diplomates would be interested in discussing the content of specialized assessments.

Exam Chair Report and Blueprint Update

The EDM Board heard from the Exam Committee Chair and approved content additions to the Endocrinology, Diabetes, and Metabolism blueprint. Approved additions to the Certification and MOC blueprints included subtopic questions on lipids, obesity, nutrition, diabetes mellitus and hypoglycemia.

Collaboration with GI Societies

Prior to the GI Board’s spring meeting, ABIM staff met with representatives from the four GI societies to discuss the societies’ Gastroenterology Ongoing Assessment and Learning (GOAL) Program proposal.

During the GI Board meeting, members reviewed the proposal, then shared feedback on the aspects of the program that align well with ABIM’s plans for evolving the MOC program, and on areas that will require more conversation. The response from the societies was generally positive, with the predominant theme being collaboration and finding common ground. The meeting provided encouraging momentum for continued discussions.

GI – Transplant Hepatology CBME Pilot

At the fall 2018 GI Board meeting, members heard about the outcomes and learnings from the long-standing Competency-Based Medical Education (CBME) pilot program in Gastroenterology (GI) and Transplant Hepatology (TH). Graduates of the pilot program are eligible to seek ABIM certification in both areas with one less year of total training than the standard four-year pathway if training in both disciplines were pursued separately.

At the end of the fall meeting, the GI Board asked staff to seek feedback from the GI and transplant hepatology communities to inform a decision about whether the pilot should transition to a formal training pathway.

At the spring meeting, the GI Board reviewed the data gathered since the fall meeting, which nearly universally supported the new pathway. The GI Board voted to approve the combined GI/TH training pathway. The Council approved the proposal at their June meeting and the next step is consideration by the ABMS Committee on Certification in September. If approved, the training community will be informed of the new pathway and when it will be available to trainees.

Approval of Exam Committee Chair Selection

The GI Board reviewed candidates for the position of Gastroenterology Exam Committee Chair in preparation for selecting a new chair later this summer. The current chair is William Tremaine, MD. Dr. Tremaine is a Consultant in Gastroenterology and the Maxine and Jack Zarrow Professor, Division of Gastroenterology, at the Mayo Clinic in Rochester, Minnesota. He is also the Medical Director of the Human Research Protection Program at the Mayo Clinic. The newly-elected chair is Charlene Prather, MD, a gastroenterologist and Professor of Internal Medicine in the Division of Gastroenterology and Hepatology at Saint Louis University School of Medicine. She is also Director of the school’s GI Fellowship Training Program. 

The GI Board also acknowledged Lawrence Friedman, MD, an internist and gastroenterologist, who is the Anton R. Fried, MD, Chair, Department of Medicine, Newton-Wellesley Hospital; Assistant Chief of Medicine, Massachusetts General Hospital; Professor of Medicine, Harvard Medical School; and Professor of Medicine, Tufts University School of Medicine, whose term of service ended as of July 1, 2019 after years of distinguished service on the board.

Geriatric Medicine Training

Nancy Lundebjerg, CEO of the American Geriatrics Society (AGS), joined the spring meeting of the Geriatrics Board as it continued its discussion on training and related workplace issues, focusing on recent developments and future directions.

Geriatric Medicine Survey Results

More ABIM Board Certified geriatricians choose to maintain their internal medicine certification than their geriatric medicine certification, which is unique among subspecialists. The Geriatric Medicine Board has been working to gain a better understanding of this trend. Staff presented the final results of a survey of ABIM diplomates certified in geriatric medicine and another subspecialty (e.g. cardiology, nephrology, etc.). The study found that trainees chose to complete a geriatrics fellowship in addition to other subspecialty training because of their interest in the field of geriatrics. They also felt geriatric medicine training would enhance their ability to provide care in the other subspecialty.

A next step for this work is for ABIM staff to work with a research group initially brought together by the AGS to interview physicians who earned geriatric medicine certification but chose not to maintain it.

ACGME Advancing Innovation in Residency Education (AIRE) Program

Specialty Board members, ABIM staff and Nancy Lundebjerg discussed current plans for innovative, competency-based training programs designed to address workforce needs in geriatric medicine. AGS and the Association of Directors of Geriatric Academic Programs (ADGAP) have been developing a pilot for a “Geriatrics Residency Track” with the goal of presenting the pilot to ABIM and ACGME for approval under AIRE competency and outcomes-based criteria. Ms. Lundebjerg talked about the pilot and updated the group about the launch of two ADGAP initiatives.

Mid-Career Training in Geriatrics

At prior meetings, Geriatric Medicine Board members noted that some physicians develop an interest in geriatric medicine long after completing training. The Specialty Board expressed interest in exploring options to allow a mid-career physician to train in geriatrics.  Bruce Leff, MD, Chair of ABIM’s Geriatric Medicine Board, indicated that he will work with AGS and ADGAP to determine if there is an “appetite” to explore this in more detail.

Strategies to “Geriatricize” Other Medical Specialties

At the fall meeting of the ABIM Council, Dr. Leff presented the idea of providing assistance to Exam Committees in other fields with developing appropriate items to cover important geriatric content in their field. The initial response from the Council was positive.

The Geriatric Medicine Board explored the feasibility of exam content development in other medical specialties and staff provided an update on a new model-based approach to item development that might be well-suited to achieve this goal. Dr. Leff will propose the idea to the Exam Chairs Committee.

Collaboration with Medical Oncology Board on MOC Assessment

Interest has recently been expressed regarding ways in which burdens can be lessened for physicians maintaining certification in both medical oncology and hematology. Both the Hematology Board and the American Society of Hematology (ASH) have brought the issue forward. Additionally, the American Society of Clinical Oncology (ASCO) has expressed willingness to discuss this matter with ABIM governance bodies and ASH leadership.

It was acknowledged that this would not be a short-term effort, and will require conversations between various ABIM governance bodies as well as the potential development of new processes for aligned or joint work. The Hematology Board discussed the goals, benefits and possible unintended consequences of collaborating with the Medical Oncology Board and ASCO.

During this session, two facets of the issue were discussed:

  • What are the goals and benefits for collaboration between the two specialties?
  • What are the perceived drawbacks or unintended consequences of this collaborative effort?

Based on the feedback from this session and a similar session that occurred at the Medical Oncology Board meeting in May, ABIM staff and Specialty Board members considered how to move the conversations forward – and how to meaningfully engage external stakeholders.

Now that both boards have discussed the issue, staff will report back to Dr. Siegel and Dr. Udden, Chairs of the Medical Oncology and Hematology Boards, respectively, to determine next steps.

The Hematology Board also acknowledged the following members whose term of service ended as of July 1, 2019: Gerardo Colon-Otero, MD, Elda Ford (Public Member) and William Hammond, MD.

Coding of Exam Questions

The Specialty Board inquired about the Infectious Disease (ID) MOC exam blueprint and coding of test questions. Randall Edson, MD, Chair of the ID Exam Committee, and the ID Board reviewed the current exam blueprint to assess if some quoted percentages of questions gave the impression that relatively rare conditions have greater representation on the exam than they actually do.

The issue of blueprinting is a difficult concept and the ID blueprint includes organisms, treatments and disease categories which means topics do overlap. The Specialty Board encouraged the Exam Committee to look at the blueprint from the diplomate’s perspective and adapt the blueprint to better show the changes relevant to practice that resulted from the diplomate-driven blueprint review a few years ago.

The ID Board also acknowledged the following members whose term of service ended as of July 1, 2019: Antigone Dempsey (Public Member) and Jeffrey Rapp, MD. 

Procedural Competency in Internal Medicine

The IM Board approved the following changes to initial certification procedural requirements:

  • To be eligible for initial certification in internal medicine, all residents will still need to perform procedures before graduation, but there will no longer be a requirement for a common set of procedures to be performed by all residents for the purpose of initial certification eligibility.
  • Residents must demonstrate effective consent discussions, universal precautions and establishment of a sterile field that is applicable to all invasive procedures a resident may perform by the time they finish their training.
  • Training programs must continue to offer flexible opportunities to learners to develop competence in procedures in their intended fields.

The Council then approved these changes at their June meeting and will follow up with the stakeholders who provided input.

The Specialty Board approved Benjamin Hohmuth, MD to become the Chair of the Hospital Medicine Exam Committee.

The IM Board also acknowledged the following members whose term of service ended as of July 1, 2019: Heather Burton, MD and Robert Sidlow, MD. 

Approval of ABIM/ASCO Medical Oncology: Learning & Assessment Blueprints

The Medical Oncology Board reviewed and approved all of the blueprints for the upcoming fall 2019 Certification and MOC examinations as well as the ABIM/ASCO Medical Oncology: Learning & Assessment, which will be offered in spring 2020 in three focused clinical areas: General Oncology, Breast Cancer, and Hematologic Malignancies. Each area has a “Core” component or section that will be consistent across specialty areas and will cover topics such as anticancer therapeutics, ethics, palliative care and genetics/genomics. These Core categories represent content that all medical oncologists should know, regardless of how specialized their practice may be.

National Comprehensive Cancer Network (NCCN) Guidelines

The Medical Oncology Board voted to continue to explore the use of the National Comprehensive Cancer Network (NCCN) guidelines as a resource for the Medical Oncology Learning & Assessment and the 10-year MOC assessment, noting that staff will continue to work on implementation questions, such as operational feasibility and cost.

Collaboration with Hematology Board on MOC Assessment

Interest has recently been expressed in lessening burdens for physicians maintaining certification in both Medical Oncology and Hematology. Both the Hematology Board and the American Society of Hematology (ASH) have brought the issue forward. Additionally, the American Society of Clinical Oncology (ASCO) has expressed willingness to discuss this matter with ABIM governance bodies and ASH leadership. It was acknowledged that this would not be a short-term effort, and will require conversations between various ABIM governance bodies and the potential development of new processes for aligned or joint work.

The Medical Oncology Board also discussed the goals, benefits and possible unintended consequences of collaborating across the specialties, and a similar conversation was held at the Hematology Board meeting.

During this session, two facets of the issue were discussed:

  • What are the goals and perceived benefits for collaboration between the two specialties?
  • What are the perceived drawbacks or unintended consequences of this collaborative effort?

Based on feedback from this session and a similar one held by the Hematology Board, ABIM staff and Specialty Board members considered ways to move the conversations forward and meaningfully engage external stakeholders. 

Now that both boards have discussed the issue, staff will report back to Dr. Siegel and Dr. Udden, Chairs of the Medical Oncology and Hematology Boards, respectively, to determine next steps.

The Medical Oncology Board also acknowledged the following members whose term of service ended as of July 1, 2019: Ilene Galinsky (Public Member) and Robert Maki, MD.

The IM Board finalized revisions to the procedural requirements for initial certification in IM. This opened the question of how subspecialty disciplines might best advise IM programs about the kinds of procedures graduating residents should be able to perform in residency to be best prepared for fellowship in their chosen field. Members discussed the implications for nephrology fellowships.

Development of Nephrology Practice Profiles

During discussions with the American Society of Nephrology (ASN) this spring, staff from ABIM and ASN identified a physician workgroup to review current Medicare data as well as to develop a separate survey for nephrologists with the goal of identifying whether there were any set practice patterns that might inform assessments to better reflect specialization within nephrology. ABIM will work closely with our society partners and the physician workgroup to review and analyze survey results to inform the development of potential practice profiles within the Knowledge Check-In.

Nephrology Initial Certification Pass Rates

ABIM makes public the national residency program pass rates for the Internal Medicine Certification Examination, but does not do the same for fellowship pass rates since the program sizes are smaller. 

The group reviewed five-year rolling pass rates for first-takers on the Nephrology Certification Examination.

 Jeffrey Berns, MD, Chair of the ABIM Council and the Nephrology Board, discussed ways they might be able to better understand the factors associated with higher fellowship program pass rates.

Approved Quality Improvement (AQI) Activities

During this session, members were briefed on an application submitted for review by the Chinle Comprehensive Care Center for the Interventions to Address the Opioid Crisis: a Hospital Opioid Committee-based approach activity. Chinle is a service area within the Indian Health Service.

Nephrology Board Member Andrew Narva, MD, who spent a significant period of his career caring for patients with the Indian Health Service, provided a recommendation to the board for consideration. The Nephrology Board approved the activity for MOC recognition, which will grant 20 Practice Assessment MOC points to physicians who meaningfully participate.

Dr. Berns shared an update from the Renal Physicians Association (RPA) on a previously-approved AQI activity which allows medical directors to receive MOC credit for the quality improvement inherent in their roles running dialysis centers. To date, more than 1500 medical directors have received MOC credit, and up to 20 dialysis organizations have signed up to participate in the program.

The Nephrology Board also acknowledged the following members whose term of service ended as of July 1, 2019: Laura Greenberg (Public Member) and Dr. Narva.

American College of Rheumatology Relationship

Since the last meeting of the Rheumatology Board, the American College of Rheumatology (ACR) has released more specific data from their 2018 survey of rheumatologists regarding MOC preferences. The ABIM Assessment and Research (A&R) staff reviewed the survey’s methodology and results.

ABIM leadership continues to have regular communication with leaders at the American Board of Allergy and Immunology (ABAI). ABAI governance will review the survey soon and continue conversations about the issue.

The Rheumatology Board members shared what they are hearing from colleagues and ACR leaders, and stressed that they are still eager to collaborate with ACR. The goal is to arrive at a principled agreement on how to move forward together with the realization that now is the time to work on change.

The Rheumatology Board also acknowledged the following members whose term of service ended as of July 1, 2019: Elana Eisner, MD, Salahuddin Kazi, MD and Benjamin Smith (Public Member).

Do you have any questions? Are you interested in how to get involved?

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