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Morie Gertz, MD, MACP, Chair, ABIM Hematology Board

The Hematology Board—which meets twice a year and is responsible for oversight of policy and assessment in the specialty—held its fall meeting on November 15, 2024. The Specialty Board reviewed updates on ABIM’s work in a number of key areas and discussed other pressing issues in the field. In addition, representatives from the American Society of Hematology (ASH) joined for a portion of the meeting*.

The following is a summary of the fall meeting. For reports of prior meetings, visit the ABIM Blog.

Contents:

ABIM News and Conversation with the President*

Prior to the meeting, members and guests of the Hematology Board had the opportunity to view a recorded video update from Furman S. McDonald, MD, MPH, who assumed the role of President and Chief Executive Officer (CEO) of ABIM and ABIM Foundation on September 1, 2024. Dr. McDonald reflected on current transitions for ABIM as well as key topics for the Specialty Board’s consideration and awareness:

  • A proposed pilot model pathway for “exceptionally qualified” international medical graduates (IMGs) pursuing accredited subspecialty fellowship in the U.S. or Canada to become eligible for ABIM Board Certification: ABIM invited commentary from the diplomate community throughout September for the ABIM Council to consider before making a final decision early in 2025, and Dr. McDonald noted that this timing coincides fortuitously with—but is distinct from—similar initiatives for state medical board licensure. Learn more through a video and FAQs on the ABIM website.
  • ABIM’s progress in engaging more closely with early career physicians (diplomates who earned initial certification less than 10 years ago): a task force of Governance members is making plans for the coming year to convene early career physicians, create a platform for their perspectives and provide opportunities for them to be more directly involved in ABIM.
  • The continued popularity of the Longitudinal Knowledge Assessment (LKA®), high rates of reported satisfaction and ongoing enhancements: on average, 80% of eligible diplomates continue to choose the LKA over the traditional, 10-year Maintenance of Certification (MOC) exam, and 70.7% of survey respondents agreed with the statement, “I am satisfied with my LKA experience so far.” Still, Dr. McDonald noted, ABIM continues to evolve and improve the assessment based on diplomate feedback.
  • The recently announced removal of the requirement to earn some MOC points every two years to be considered “Participating in MOC.” With the availability of more activities that earn physicians MOC points (e.g., continuing medical education for MOC, UpToDate®, the LKA), the ABIM Council determined that the two-year point requirement was no longer needed and that its removal would benefit physicians and help promote engagement by making the program simpler.

Dr. McDonald’s discussion with the Hematology Board addressed several concerns around aspects of the MOC program and the LKA, underscoring work ABIM has done to evolve its processes, create enhancements based on physician feedback and support physicians more effectively.

Several members asked whether the fee structure might be simplified, or whether fees might be reduced in the future. Dr. McDonald noted that fees have not increased in more than five years since the current fee structure was implemented ($220 a year for the first certificate; $120 for each subsequent certificate) and that physicians who choose the LKA, which is included at no extra cost, realize a savings over ten years compared to the traditional, 10-year MOC (long-form) exam. He added that ABIM has begun introducing changes to simplify the program as well, such as the elimination of the two-year point requirement.

Regarding the LKA, the group discussed the time limit and possible alternatives. Dr. McDonald described different approaches that ABIM considered before settling on the extension of the four-minute time limit to five minutes, announced and effective on January 1, 2025.

He also addressed concerns about the ability of the new focused versions of the LKA (launching in 2026) to keep pace with developments in malignant hematology. He described ABIM’s rigorous process for reviewing the currency of assessment items. Among other things, ABIM recruits physician experts in specific subspecialty areas to serve on the Item-Writing Task Forces and Approval Committees, helping to ensure the assessments reflect the latest developments in medicine.

One Specialty Board member suggested that advocating for physicians to have dedicated study time might help alleviate burnout; Dr. McDonald described steps ABIM has taken to reduce burnout, noted that the larger issue required collaboration across the medical community and agreed that advocacy for study time would align with ABIM’s broader goals.

Diplomate Professional Profile*

In summer 2023, ABIM invited a pilot group of diplomates to complete the newly developed Diplomate Professional Profile (DPP), a questionnaire required of all diplomates that is built into the Physician Portal. The questionnaire relates to clinical work and practice patterns and serves to inform ABIM’s ongoing efforts to update assessment options and exam blueprints and develop policies for initial certification and MOC. Since last year, ABIM has continued to invite all remaining eligible diplomates on a rolling basis to complete the DPP. Diplomates receive a prompt to complete their professional profile when they sign in to their Portal.

Siddharta G. Reddy, MPH, Senior Research Associate at ABIM, reported to the Specialty Board that 31% of diplomates overall had completed their DPP to date. He also reviewed profile questions specific to hematology and explained in greater detail the process ABIM uses to notify diplomates and remind them to complete the DPP using pop-ups in the Physician Portal itself and allowing only one pop-up dismissal.

The Specialty Board members made several suggestions for staff to consider in order to better capture nuances of hematology practice and treatments, such as distinctions between inpatient and outpatient scenarios, procedures versus prescriptions and adding treatments for greater inclusivity. The group also discussed addressing the needs of advanced practitioners through society collaboration and aligning the blueprint with emerging priorities. The blueprint review is a standardized process that occurs regularly in each discipline, and which is designed to incorporate input from multiple groups at the diplomate and society levels.

Log in to your Physician Portal to complete the DPP survey.

Diversity, Equity and Inclusion (DEI) Initiatives at ABIM*

Natalie S. Plummer, Esq., Manager, DEI Programs at ABIM, and Lorna Lynn, MD, Vice President of Medical Education Research and Administrator for the Equity Committee, reported on the work of the DEI team at ABIM and recent advances in ABIM’s DEI initiatives. These include:

  • ABIM’s work with participating medical society partners, which led to the formation of the Diversity, Equity and Inclusion Collaborative Network. The goal of the network is to share best practices, coordinate resources and create strategies to support and move diversity work forward as a community dedicated to this work.
  • Improvements to the ABIM Physician Portal that now allow diplomates to more accurately self-identify their race/ethnicity and gender with an expanded list of options. This also aligns with ABIM’s efforts to increase diversity in governance and eliminate bias in assessment questions. Since this effort began, ABIM has seen consistent growth in the number of physicians supplying information, with more than 77,000 diplomates updating their information.
  • A report led by Dr. Sara Ray, a medical historian from the University of Pennsylvania, to study the governance records of ABIM. The goal of this project was to determine whether ABIM’s practices within the context of the past caused harm to historically disadvantaged groups and whether that might require restorative action and transparency. The team noted that they planned to share findings from this project in 2025.

Nathalie van Havre, MD, MSc, FRACP, Chief Learning Officer for ASH, discussed the importance of maintaining DEI programs despite external challenges. Dr. van Havre noted how the program nomenclature changed over time, but the core work remains the same and that ASH continues its commitment to the work.

The group also discussed how to safeguard DEI initiatives while making progress in the face of current challenges. Iberia Romina Sosa, MD, Ph.D., Specialty Board member, expressed her concern about keeping pace with changes in society and advocated for greater community representation, protection of women’s rights and adapting to present challenges over celebrating past milestones.

Update from ASH

Robby Reynolds, MPA, Director of Hematology Workforce and Career Development for ASH, shared information about ASH’s new Classical Hematology Advancement Membership Program (CHAMP) which connects first or second-year pediatric and adult hematology/oncology fellows with an external mentor specializing in classical hematology. He noted the program’s inaugural year showed a diverse applicant pool and discussed possibilities for partnerships with other organizations after addressing some initial challenges with the program. The application deadline for fellows to join CHAMP was January 9, 2025.

Dr. van Havre provided updates about ASH’s DEI and workforce initiatives, which focus on gender pay disparity and barriers to advancement. Morie Gertz, MD, MACP, Chair of the Hematology Board, expressed concerns about gender pay disparity in academic institutions; Dr. van Havre acknowledged structural inequalities that Dr. Gertz highlighted and emphasized that ASH needs more data to address them. She also shared information about “Horizon in Hematology,” an online program designed for residents who have not yet chosen a subspecialty focus.

Hematology: Discussion on Issues in the Discipline*

Dr. Gertz suggested hosting a session or sessions in the future at the ASH Annual Meeting & Exposition. He proposed focusing on information about ABIM that would be useful to diplomates and residents preparing for initial certification, as well as broader information about how ABIM creates assessments, the role of psychometricians and statisticians, and addressing misconceptions or misinformation about certification. Others weighed in with suggestions about possible formats and the importance of transparency and clarity around how ABIM uses MOC fees and how to prepare for board certification exams. In addition, Dr. Gertz proposed presenting certification data in light of the prevalence of dual training programs, highlighting potential barriers to becoming certified only in hematology.

The group also discussed raising greater awareness in the patient population about the importance of board certification, particularly what distinguishes board certified physicians from those who are not. Members of the Specialty Board expressed agreement about the need for improved public and professional outreach about the significance and value of board certification.

Setting a Quality Agenda in the Discipline*

In 2021, the American Board of Medical Specialties (ABMS)—which comprises 24 medical certifying boards in the U.S., including ABIM—adopted new standards for continuing certification that include a requirement for member boards to work with stakeholders to support the development of discipline-specific quality agendas. The Specialty Boards discussed this in their spring 2023 meetings and agreed on three key themes: addressing inherent bias and health disparities, enhancing physician well-being and improving access to quality care.

As part of this process, ASH presented ABIM with a series of potential topics to consider for the quality agenda based on its own initiatives

  • Access to comprehensive and coordinated care for sickle cell disease
  • Race-based clinical decisions
  • Diagnosis and management of iron deficiency
  • Diversity in clinical trials
  • Workforce development for classical hematologists

Richard G. Battaglia, MD, FACP, Chief Medical Officer for ABIM, reviewed these as well as additional potential topics to consider while developing the agenda, such as using artificial intelligence to improve hematologic care and ASH’s Quality Improvement Training Institute. He noted that the next step would be for volunteers from the Hematology Board to work with ASH on developing the quality agenda, and then for ABIM to look at ways to support that—for example, by providing MOC points for physicians who participate in certain initiatives that meet quality agenda objectives.

Society representatives departed at this point in the meeting.

Selecting a New Co-Chair and Members of the Hematology LKA Approval Committee

ABIM Specialty Boards are responsible for selecting members and chairs of the Approval Committees annually and as needed. At the fall meeting, the Hematology Board reviewed candidate materials for a co-chair and open positions on the Hematology LKA Approval Committee. The group unanimously voted to approve Margaret Kasner, MD, MSCE, as co-chair, effective immediately. They also approved the following new members of the Approval Committee for terms beginning January 1, 2025:

  • Ashok Pai, MD, Kaiser Permanente Northern California
  • Jenny H. Petkova, MD, Houston Methodist Hospital
  • Jesus Hermosillo Rodriguez, MD, University of Colorado School of Medicine, Colorado Permanente Medical Group and Saint Joseph Hospital
  • Joshua Kra, MD, Rutgers New Jersey Medical School and the Rutgers Cancer Institute of New Jersey

Learn More

The Hematology Board values the feedback and commentary of the entire medical community, including diplomates and society partners.

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*Indicates that society representatives were present for this agenda topic.