The American Board of Internal Medicine (ABIM) works closely with societies representing physicians across all of internal medicine and its subspecialties, including the American Society of Hematology (ASH), to ensure our programs meet the needs of physicians while assuring patients that a physician has demonstrated they are keeping their medical knowledge current by passing regular assessments. This collaboration has led to meaningful enhancements to the Maintenance of Certification (MOC) program, and we will continue to listen to and learn from the physician community moving forward.
For example, specific to hematology, ABIM and ASH jointly conducted a study to gather practice data that can help guide the development of future assessment options; this led to the exploration of creating two “practice profile” assessments—differentiated by malignant or nonmalignant types of blood diseases—tailored so that the assessment better aligns with the patients these physicians see in their practice.
Leadership at ASH has been integral to this work. They are also regular guests at ABIM’s Hematology Board meetings, where they provide important feedback on behalf of members to guide the future of our programs.
Fundamental to a nationally recognized continuous certification program is that all those participating in it meet the same high standards. We look forward to continuing our work with ASH to achieve this standard, and appreciate the opportunity to respond to the specific points raised in their statement:
- With regard to establishing an MOC program that does not involve a high-stakes assessment: ABIM has already introduced a lower-stakes MOC assessment option. The Longitudinal Knowledge Assessment (LKA®), launched in 2022, consists of physicians taking questions on an ongoing basis and receiving regular feedback on their performance, including the correct answer, rationales and references. To date, 1,353 (77%) hematologists who have signed up for an MOC assessment have chosen the LKA. No physician can lose certification solely due to their performance on the LKA.
- While it is a lower-stakes assessment, the LKA is still an assessment of an individual physician’s clinical knowledge, meant to be the kind of “walking around” knowledge physicians rely on daily in patient care. Data show that physicians take less than two minutes to answer each question on average, equating to about an hour a quarter. Physicians taking the LKA can access any resource other than another person because we are gauging the knowledge of the physician taking the assessment, not of the care team.
- We will continue analyzing performance data to determine if the number of questions should be revised in the future. One important feature of the LKA is the level of detail physicians receive to support their learning and improvement opportunities. This requires a certain number of questions to be delivered in a variety of medical content areas in order to be able to evaluate their performance and provide accurate feedback. The LKA design facilitates improved performance over the course of the five-year cycle, so that if a physician is performing poorly early on, they have an opportunity to improve their performance during that cycle using the provided feedback.
- Being reported as board certified by any ABMS member board requires that a physician hold an active, unrestricted license in at least one state, but states vary dramatically in the CME they require; New York state, for example, has no CME requirement for licensure. Several states (e.g. Minnesota) accept participation in ABIM’s MOC program in lieu of CME, and many CME activities physicians are already participating in to meet licensure requirements also count for MOC points. ABIM has taken great strides to reduce the reporting burden and streamline this process by establishing a collaboration with ACCME to provide a seamless transfer of points for thousands of activities, including many offered by ASH. Physicians can visit CMEPassport.org and filter by ABIM and ASH to see these activities.