Pulmonary Disease Board Meeting Summary | Fall 2026
The ABIM Pulmonary Disease Board met on Oct. 2, 2026, voting to approve the passing score for the Pulmonary Disease Longitudinal Knowledge Assessment (LKA®) and discussing important issues around health equity, patient engagement and defining quality improvement in the discipline. The Specialty Board also discussed a potential new ABIM Certification in Interventional Pulmonology.
The meeting included representatives from the following societies*:
- The American Association of Critical-Care Nurses (AACN)
- The American College of Chest Physicians (CHEST)
- The American Thoracic Society (ATS)
- The Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD)
- The Society of Critical Care Medicine (SCCM)
See below for details of each agenda item. ABIM publishes reports of all Specialty Board meetings on the ABIM Blog.
Learn more about ABIM Specialty Boards.
ABIM Leadership Update*
Furman S. McDonald, MD, MPH, MACP, President and CEO of ABIM and the ABIM Foundation, met with the Specialty Board to report updates across ABIM’s strategic initiatives, including program enhancements, expanding stakeholder engagement, new research—including a systematic review of 44 studies associating stronger performance on certification exams with better patient outcomes—and investments in technological innovation.
Dr. McDonald provided further information on the competency-based medical education Special Consideration Pathway introduced last year as a pilot, which allows graduates of accredited fellowship programs who completed training in internal medicine abroad to apply for eligibility to ABIM Board Certification. The pilot pathway has already received nearly 200 applicants, the majority of whom sat for the Internal Medicine Certification Examination this year. He also highlighted a recent research letter by ABIM researchers published in JAMA revealing insights on the contributions of foreign-born physicians to the care of underserved communities in the U.S.
A Specialty Board member also asked how ABIM considers emerging disciplines across its specialties in light of its consideration of interventional pulmonology (see topic for further details below). There are separate processes for accreditation and certification, and any new certification depends on a sufficient population of specialists taking the exam to support validity when scoring it.
Health Equity*
Lorna Lynn, MD, Senior Vice President for Health Equity and Medical Assessment Engagement, updated the Specialty Board on ABIM’s health equity work. ABIM remains firmly committed to advancing health equity and continues to work in the areas outlined in the Equity Statement: developing health equity content for assessments, working to ensure that assessments are fair and conducting research to advance equity in the profession. Dr. Lynn noted that this work involves staff throughout the organization, along with many physician volunteers, including Item-Writers and Approval Committee members. ABIM continues training staff and volunteers and building the systems needed to expand this work through all disciplines. Dr. Lynn noted recent research published in JAMA that highlights the contributions of physicians born outside the U.S. to the internal medicine workforce, authored by ABIM researchers and members of the ABIM Equity Committee.
ABIM’s equity work has also benefited candidates for initial certification through the Needs-Based Certification Exam Fee Assistance Program. Now in the second year of a planned five-year pilot, the Fee Assistance Program provides a 50% fee credit—$715—on the Internal Medicine Certification Exam for eligible first-time candidates who apply and attest to financial need, regardless of medical training background. Last year, more than 850 physicians applied for and received the credit on their 2026 exam fee.
ABMS Standard 19: Engagement in Improving Health and Health Care*
Continuing its discussion from the spring, the Specialty Board returned to the American Board of Medical Specialties (ABMS) Standards for Continuing Certification, No. 19, which requires ABMS Member Boards to better track physician engagement in quality improvement work using existing measurements and reporting (i.e., without creating a new requirement for physicians themselves). Each of the Specialty Boards and the cosponsored Advisory Committees is involved in developing the definition of quality improvement with respect to their disciplines.
Laura L. Sessums, JD, MD, Chief Medical Officer, proposed a working definition of quality improvement based on three ideas: that quality improvement is intentional and involves action, that it produces a measurable or observable result, and that it does not require a demonstration of improvement.
Dr. Sessums asked the Specialty Board to discuss how a broad definition could recognize meaningful physician activity without adding unnecessary burden. Members pointed out practical challenges in verifying an individual physician’s contribution to team-based or institution-wide improvement efforts, and considered how to recognize and document activities that are already part of clinical practice.
The Specialty Board’s feedback will inform the final definition of quality improvement that will be slated for review and approval by the ABIM Council in December. Determination of diplomate activities within the definition that qualify for recognition will follow in 2027.
Patient Engagement*
Yuvaram Reddy, MBBS, MPH, who joined ABIM in July as the inaugural Deputy Chief Medical Officer, is leading ABIM’s initiative to deepen engagement with patients and the broader public. In general, patients and the broader public have a limited understanding of the value of ABMS certification—particularly how board certified physicians take several steps to remain current in medical knowledge and how studies show the association between board certification and improved patient care. (See the independent review published in August 2026 in Academic Medicine.) Dr. Sessums presented the initial strategy for patient engagement on Dr. Reddy’s behalf to the Pulmonary Disease Board and sought their feedback, including their recommendations for patient-facing organizations with whom ABIM might engage.
Members recommended engaging established disease-specific nonprofit organizations rather than creating parallel outreach structures. They discussed opportunities to help patients understand board certification and to make it more visible in patient-facing materials and accreditation programs, using consumer-facing channels and partnerships to communicate the importance of physician certification.
Dr. Reddy’s team will use this input, alongside additional research, to develop an engagement plan over the coming months.
Updates from Specialty Societies*
Specialty Board meetings routinely include opportunities for specialty societies to share updates on educational and professional priorities in their disciplines for the mutual benefit of the groups, and to identify opportunities for collaboration. Updates at this meeting included SCCM’s annual conference in San Diego and its centers of excellence program, AACN’s work on healthy work environments, APCCMPD’s educational courses and ATS’s conference and digital learning initiatives.
Society guests departed at this point in the meeting.
Pulmonary Disease LKA Passing Score
All ABIM assessments have a unique passing score, or standard, established through the recommendation of a panel of physician experts and the final approval of the Specialty Board of each discipline. This is known as the standard-setting procedure. Following the Angoff method, the standard-setting procedure convened three panels comprising 26 physicians in total to provide the content evidence for the Pulmonary Disease LKA passing score. These experts review assessment content and recommend the minimum proportion of questions an examinee must answer correctly to pass the exam (the passing score). The Specialty Boards then review the recommendation, the process documentation and the relevant policy data before adopting the final passing score for the exam. The final adopted passing score is used for approximately seven years until the standard-setting process is repeated. For the initial certification and MOC exams, a standardized score metric based on the passing score recommendation is published on the Score Report that examinees receive after the exam. For the LKA, interim Progress Reports (issued quarterly after the fifth quarter of participating) show the current passing score and a participant’s performance relative to that standard.
The passing score is distinct from the pass rate, which is the proportion of examinees who pass an assessment in a given year and varies with each cohort of examinees. ABIM publishes cumulative pass rates for initial certification and a report of certificates meeting the MOC assessment requirement each spring.
The Pulmonary Disease Board held a formal vote to adopt the passing score informed by recommendations from the panels, which will go into effect on January 1, 2027. LKA participants will be able to see their performance relative to the new standard on the Progress Report they receive in early January.
Learn more about ABIM’s standard-setting procedure.
Interventional Pulmonology Practice Pathways
ABIM’s Board of Directors is considering a proposal to create a new subspecialty certificate in interventional pulmonology. The Pulmonary Disease Board has shown support for the proposal made by the American Association for Bronchoscopy and Interventional Pulmonology (AABIP) to establish it as a subspecialty, and considered it to have met the criteria of New and Emerging Disciplines in Internal Medicine (NEDIM) – 2. At this meeting, the Specialty Board focused on possible practice pathways, which would allow practicing physicians to become eligible for the certificate based on experience rather than completion of accredited fellowship training. Practice pathways are time-limited routes for existing specialists whose experience predates accredited training and certification. Once a pathway closes, new applicants complete the standard training requirement to become eligible for certification.
The pathways under consideration include 1) prior or current certification by AABIP; 2) completion of AABIP-accredited fellowship training with documented practice experience; and 3) documented practice experience alone. Members supported recognizing AABIP certification and fellowship completion as possible routes to ABIM Board Eligibility while keeping the exam as the final deciding threshold for certification, and emphasized the importance of inclusive pathway options.
ABIM has surveyed pulmonary disease diplomates about their practice experience in interventional pulmonology, and staff shared preliminary findings to help the Specialty Board consider how inclusive the pathways should be.
No eligibility decisions were made at this meeting. Staff will complete the survey, refine the analysis and combine it with other data sources to estimate the size of the potential candidate pool and whether a new certification in interventional pulmonology would be sustainable. The Specialty Board expects to make formal practice pathway decisions at a later date once final results are available and pending the ABIM Board of Directors’ decision about whether to support a certificate in interventional pulmonology. Diplomates can expect to hear more from ABIM when a decision is made.
Learn More
Subscribe to the ABIM Blog to stay on top of the latest news.
Get Involved
Apply to openings on ABIM Governance and the Item-Writing Task Forces and be part of shaping the future of ABIM’s assessments. Join the Community Insights Network to share feedback with ABIM through focus groups, surveys, user testing and more as we develop and refine our programs together.
*Society representatives and other guests are invited to join for a limited portion of the agenda, marked with an asterisk. Other items are discussed by the Specialty Board in private.
