Gastroenterology Board Meeting Summary | Fall 2025
The Gastroenterology Board held its fall meeting on November 20, 2025. Representatives from the American Association for the Study of Liver Diseases (AASLD), the American College of Gastroenterology (ACG), the American Gastroenterological Association (AGA) and the American Society for Gastrointestinal Endoscopy (ASGE) joined for a portion of the meeting*.
The following is a summary of the fall 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:
- Enhancements to the Longitudinal Knowledge Assessment (LKA®), such as the possibility of expanded eligibility, developing focused versions in some specialties that will launch in 2026 and exploring additional focused versions in other specialties for the future
- Advancing and expanding ABIM’s research strategy with the appointment of Eric J. Warm, MD, MACP, as the inaugural Vice President of Research Strategy
- Supporting early career physicians and international medical graduates (IMGs) with the needs-based certification exam fee assistance program and the competency-based medical education (CBME) special consideration pathway pilot for IMGs
- Recognizing board-certified physicians at key career milestones, such as attaining more than 30 years of certification, and an end-of-year wrap-up for LKA participants
- Advancing innovation in assessment through new technology and society collaboration
Specialty Board members raised questions about physicians maintaining multiple certifications and the associated cost. Dr. McDonald explained that fewer than 30% of physicians hold multiple certificates, and that ABIM has implemented a 45% fee discount for each additional certificate to mitigate the financial burden. He emphasized that ABIM has not increased certification fees since 2019 and reduced Maintenance of Certification (MOC) fees in 2022 for those choosing the LKA. In addition, ABIM does not charge fellows during training and introduced the fee assistance pilot program in 2025 for initial certification examinees.
Several members discussed the importance of easing burdens for later-career physicians to support retention within the workforce. Dr. McDonald noted that available data does not demonstrate that certification or MOC requirements are primary drivers of physician attrition and that LKA’s at-home format has reduced the burden of in-person testing for many.
Gastroenterology Board members also inquired about how ABIM recognizes excellence in the MOC program and staff discussed the LKA participant recognition initiative: an email “wrap-up” with information about the most difficult questions or topic areas answered correctly, statistics of physicians with the same combination of certifications and other personalized stats. The email was piloted in 2024 with approximately 2,000 physicians and expanded in 2025 to recognize excellence above baseline certification for more than 70,000 LKA participants.
Workforce Development in Gastroenterology*
Laura L. Sessums, JD, MD, Chief Medical Officer, facilitated an open discussion with society guests on workforce challenges affecting gastroenterology and hepatology.
Matthew D’Uva, CEO of AASLD, reported that AASLD is conducting a national survey evaluating hepatology workforce distribution, utilization of advanced practice providers and training considerations, with preliminary findings anticipated in spring 2026.
Brad Stillman, Executive Director at ACG, described ACG’s three-arm workforce task force focusing on physician supply, advanced practice professionals utilization and education, and sedation training, noting concerns that declining exposure to conscious sedation during training could limit procedural capacity.
Donald Palmisano, CEO of ASGE, highlighted severe access issues in rural and underserved areas where patients often travel long distances or wait for prolonged periods for endoscopic care. He detailed ASGE’s state-based pilot projects aimed at identifying alternative state budget funding mechanisms beyond cancer-specific programs to sustain screening initiatives.
Vonda Reeves, MD, MBA, FACP, FACG, AGAF, shared emerging federal policy advocacy efforts, including the Resident Physician Shortage Reduction Act, which proposes adding approximately 14,000 training slots with rural allocation, and the Specialty Physicians Advancing Rural Care Act, which would establish loan-forgiveness incentives for specialty physicians serving in rural communities.
Health Equity Update*
ABIM remains firmly committed to advancing health equity, as reflected in a joint statement by the ABIM Board of Directors and the ABIM Foundation Board of Trustees dated June 2025. ABIM continues to work in the areas outlined in the Equity Statement: developing health equity content for assessments, ensuring that assessments are fair and researching to advance assessment strategies. ABIM also maintains collaborations with medical specialty societies working to advance health equity. During this session, staff highlighted both the progress achieved and the challenges that remain in ABIM’s ongoing health equity efforts.
Gastroenterology LKA Blueprint Review*
The chairs of the Gastroenterology Approval Committees reviewed the second-level blueprint percentages and relevance ratings derived from physician surveys and committee analyses for the Gastroenterology General LKA Blueprint and the Gastroenterology LKA with a Focus in Hepatology Blueprint. Specialty Board members discussed alignment between blueprint content distributions and Accreditation Council for Graduate Medical Education (ACGME) fellowship training priorities, acknowledging that although percentages may appear high in aggregate, many topics yield only a few exam questions. The chairs described the blueprints as forward-looking yet stable, with the intent that they remain applicable over approximately seven years with periodic updates as emerging clinical topics arise. Board certified gastroenterologists will continue to be included in opportunities to update the blueprints and may submit feedback to ABIM directly at any time, including through their LKA.
Gastroenterology Board members asked whether health equity warrants designation as a distinct blueprint domain. The chairs clarified that equity principles can be embedded within disease-specific questions rather than segregated into a separate category, enabling more integrated, clinically authentic assessment content. The Specialty Board unanimously voted to approve the blueprint percentages as recommended by the Approval Committees.
Society representatives departed at this point in the meeting.
Standard-Setting for the Gastroenterology LKA
Jerome Clauser, Ed.D., Vice President, Assessment Research & Innovations, lead a presentation and facilitated the Specialty Board’s selection of the Gastroenterology LKA passing score. The process incorporated content and policy evidence, including Angoff method-based judgments focused on the performance expectations of borderline examinees. In response to questions from the Specialty Board, Dr. Clauser explained that although examinees receive five minutes per question, the average response time remains approximately two minutes, and future presentations could incorporate more information regarding the testing environment and demographic impact.
Dr. DeVault emphasized the importance of adopting the standard at this time so that physicians nearing the end of the five-year LKA cycle would have clear guidance and adequate opportunity to adjust their learning strategies. The Specialty Board voted unanimously to set the passing score.
Transplant Hepatology Blueprint Review
Marwan S. Ghabril, MD, Chair of Transplant Hepatology Approval Committee, presented the proposed Transplant Hepatology Blueprint percentages developed from physician surveys and Approval Committee review. Society representatives discussed the importance of collaboration across organizations to ensure the blueprints reflect current practice. The Specialty Board voted unanimously to approve the blueprint percentages as recommended by the Approval Committee. New blueprints will be published in January 2026.
Candidates for the 2026 Gastroenterology Board
ABIM issued a notice in June about openings for two physician members on the Gastroenterology Board for terms beginning July 1, 2026. Specialty Board members reviewed applications and interviewed candidates, and at the fall meeting, voted on two to recommend to the ABIM Council, which makes the final appointments. ABIM expects to announce the appointees in July 2026.
Nutrition in Assessment
The Gastroenterology Board discussed the role of nutrition in patient care and assessment, emphasizing the importance of basing decisions to expand nutrition content in ABIM exams on sound scientific principles. Currently, the nutrition content in assessments varies across specialties.
Specialty Board members discussed the potential of AI-assisted tools to supplement patient education and clinical counseling in settings where access to registered dietitians is limited. Divyanshoo R. Kohli, MD, outlined evidence-based nutrition guidance relevant to conditions including management of feeding tubes, alcohol-associated liver disease, cirrhosis, ascites, inflammatory bowel disease, diarrhea, constipation and metabolic dysfunction-associated steatotic liver disease (MASLD), and referenced limited but growing data related to short-gut syndrome and total parenteral nutrition. Joy M. McGough, RN, MD, highlighted emerging evidence linking sarcopenia to transplant outcomes and its close relationship to nutritional management. Participants also noted increasing attention to GLP-1 therapies, SNAP nutritional policy changes in multiple states and expanding interest in the microbiome and its possible connections to early-onset colorectal cancer.
Specialty Board members acknowledged that nutrition currently accounts for only a small portion of the blueprint weighting and can be incorporated into disease-specific items without requiring a dedicated content category.
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*Indicates that society representatives were present for discussion of this agenda item.
