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Cardiovascular Board Meeting Summary | Spring 2025

August 15, 2025  |  Posted by ABIM  |  Specialty Board Meeting Summaries

Andrea M. Russo, MD, Chair, ABIM Cardiovascular Board

The Cardiovascular Board, which meets twice a year and is responsible for oversight of ABIM policy and assessment in the specialty, held its spring meeting on May 15, 2025. Representatives from the American College of Cardiology (ACC), the American Heart Association (AHA), the Heart Failure Society of America (HFSA) and the Heart Rhythm Society (HRS) joined for a portion of the meeting*.

ABIM and the Cardiovascular Board gratefully acknowledge the service of Yuli Kim, MD, and Rowlens M. Melduni, MD, whose terms on the Specialty Board ended June 30, 2025.

The following is a summary of the spring meeting. Visit the ABIM Blog for reports of prior meetings. To share your feedback with the Cardiovascular Board on this report or other issues that are important to you, please complete this brief survey.

Contents:

ABIM Leadership Update*

Furman S. McDonald, MD, MPH, President and Chief Executive Officer of ABIM and the ABIM Foundation, joined the Specialty Board to share progress on key initiatives and ongoing areas of focus for ABIM, including:

  • Exploring the alignment of Maintenance of Certification (MOC) requirement due dates with the Longitudinal Knowledge Assessment (LKA®) cycle to help make the MOC program more reliably predictable.
  • Enhancements made to the LKA in response to feedback from physicians who identified areas for improvement, which are intended to keep the program relevant and effective.
  • Expanding ABIM’s engagement with stakeholder communities such as early career physicians, specialty societies and patient-focused organizations.
  • Upgrades to the ABIM website and Physician Portal for 2025, designed to make it easier for both physicians and the public to find information.

The Specialty Board discussed ABIM’s proposed pilot for “exceptionally qualified” international medical graduates (IMGs), designed to give IMGs a pathway to Board Eligibility in Internal Medicine for physicians trained outside of the U.S. who have satisfactorily completed fellowship training in a program accredited by the Accreditation Council for Graduate Medical Education (ACGME). They also discussed recent legislation in some states that allows licensure of IMGs without U.S.-based training, which ABIM and other certifying boards are monitoring due to concerns about quality.

There was also interest in further enhancements to the LKA, such as allowing participants a year break from questions after completing a five-year cycle. ABIM is exploring this development for the future as part of overall efforts to align MOC requirements while also keeping in mind psychometric rigor and fairness.

Specialty Board Oversight of Assessment*

Each spring, the ABIM Specialty Boards review data related to certification and assessment trends in their disciplines to help guide their decisions on assessments. At this meeting, the Cardiovascular Board received statistics on the current state of active certification in cardiovascular disease, assessment enrollment, demographics and pass rates, and data from post-assessment surveys. Reports showed that 40,737 physicians have been ABIM Board Certified in Cardiovascular Disease since it was first offered in 1941, with 30,263 maintaining valid certification and 18,552 (61%) concurrently maintaining certification in internal medicine. In the tertiary subspecialties: 10,815 have been certified in interventional cardiology in 1999, 4,034 in clinical cardiac electrophysiology since 1992, 1,778 in advanced heart failure and transplant cardiology since 2010 and 509 in adult congenital heart disease since 2015. The majority of those maintaining multiple certifications are in interventional cardiology (6,305) and clinical cardiac electrophysiology (2,629) with smaller numbers across the other subspecialties.

The LKA is currently offered only in cardiology and interventional cardiology. Of physicians due for an assessment in 2024 and who opted to take one, 46% chose the Cardiovascular LKA and 26% chose the ACC/ABIM Collaborative Maintenance Pathway (CMP). Meanwhile, 46% chose the Interventional Cardiology LKA and 20% the CMP to maintain certification in interventional cardiology.

The group discussed data related to demographics in the discipline, noting the rise of women and underrepresented groups entering the specialty and subspecialties, particularly clinical cardiac electrophysiology, perhaps due to programs like Women as One, Women in Innovations and Growth and Leadership Opportunity for Women in Electrophysiology. They encouraged ABIM and partner societies to share data more broadly to foster further change.

They also asked for investigation into data trends showing the number of physicians failing to maintain certification and the potential impact of fewer board certified cardiologists on clinical practice, particularly in smaller subspecialties. The conversation highlighted the need for more nuanced, data-informed policy adjustments to support fairness, workforce retention and collaboration.

Initial Certification and Training Data in Cardiovascular Disease*

The Cardiovascular Board also reviewed new data from the National Resident Matching Program (NRMP), Board Eligibility data, outcomes for candidates requiring retraining, faculty pathway pass rates and approved Advancing Innovation in Residency Education (AIRE) programs in cardiovascular disease.

Some discussion centered on trends identified in advanced heart failure and transplant cardiology (AHFTC), and how market forces such as funding may be driving trainees interested in subspecialized training toward general cardiology instead. The group also discussed trainees approaching certification through special consideration pathways; Dr. Johnson added it could be useful to compare the outcomes of the future pilot Board Eligibility pathway for exceptionally-qualified IMGs to the existing Special Consideration Pathway for IMGs who are full-time US or Canadian faculty as it may better suit clinically focused physicians outside academic programs. She also said that while there is no current proposal for AHFTC under this model, such efforts often start with sponsoring groups and could still happen.

Diplomate Professional Profile*

The Diplomate Professional Profile is a questionnaire built into the ABIM Physician Portal and required of all ABIM Board Certified physicians every five years. The questionnaire gathers information about clinical work and practice patterns, and ABIM uses the information to help update exam blueprints, develop policies for initial certification and MOC, and ensure adequately diverse representation of the profession in research. To date, 44% of physicians have completed the Diplomate Professional Profile. Siddharta G. Reddy, MPH, Senior Research Associate for ABIM, reviewed some of the aggregate data gathered so far related to cardiologists, including practice setting, practice size and physician ownership of practices.

The report showed that 89% of respondents were clinically active, with the majority in hospital- or system-owned practice (43%), private practice (31%), academic faculty practice (24%) or hospital inpatient practice (18%) settings. Additionally, the majority are in a single-specialty group practice (45%) or multi-specialty group (39%) practice structure and half of practices operate in hospital- or health system-owned models. Mr. Reddy also described how the data are useful in identifying gaps in governance representation, informing blueprint updates and supporting the design and interpretation of research surveys.

The Specialty Board expressed particular interest in engaging more physicians in completing the profile to support more complete data collection, stressing the need for clear communication about its purpose and intent and collaborating with societies to spread the message. Mr. Reddy noted too that the response rate is much higher among physicians participating in the LKA because the LKA necessitates physicians make frequent visits to their physician portal, thus increasing the likelihood of completing the DPP.

Focused Assessments in Cardiovascular Disease*

ABIM is currently developing focused assessments in gastroenterology, hematology and medical oncology based on focus  areas identified by board certified physicians, societies and analyses using Medicare data. ABIM uses a process to identify potential areas for focus, which includes broad surveys of the community . In some disciplines, this process has shown that a focused assessment would not be valuable or sustainable, meaning there are not enough physicians practicing exclusively in a given clinical area to make it possible to create and reliably score an assessment. In previous meetings, the Cardiovascular Board voted to defer exploring a focused assessment in the discipline but with evolving practice patterns, the Specialty Board revisited the topic. Some members noted that focused options could better align with how cardiologists practice, especially those working in areas without a designated certification under one of the ABMS Member Boards. Others cautioned about the need for careful planning, but overall, the Specialty Board expressed support for conducting a survey to gauge prevalence in practice and identify potential areas of clinical focus, including areas of practice focus that evolve over specialists’ careers.

Innovations in Assessment*

ABIM’s Research and Innovations Department has been leading a program of research on improving assessments through three main areas: supporting the efficiency of assessment staff, facilitating the item development process and enhancing the assessment experience for physicians. The Cardiovascular Board received an overview of the team’s current projects.

The Specialty Board expressed interest in using new technologies to evaluate skills like emotional intelligence and cultural sensitivity, provide feedback to Item-Writers and enhance assessment content. There were some concerns about ensuring a balance of patient characteristics in questions and data security because of use of AI, but staff assured the Specialty Board that no ABIM data are being used to train AI models. The discussion highlighted how new AI tools are helping staff and Item-Writers create better content and optimize job efficiency.

Annual Diplomate Report*

ABIM is looking into the potential for publishing annual reports of data that will highlight broad statistics across each discipline of internal medicine, both for a given year and historic trends over time. This would include the current number of physicians certified in each discipline and its geographic distribution, participation rates in MOC, demographic characteristics and assessment performance. While some of these data have been made available on request for research purposes, ABIM has never published a consolidated annual report.

Some remarked on trends in the data, like more osteopathic-trained physicians in the discipline aligning with a broader transition to a unified accreditation system of allopathic and osteopathic training programs. Others spoke about the possibilities of extending the data to cardiology subspecialties (though it would be limited for the newer ones) and gathering more detailed geographic data (though this also has challenges due to the difference between practice location and reported residences). There was also interest in more analysis of states with lower numbers of cardiologists, but overall, the group expressed approval for the clarity and inclusiveness of the report.

Community Practice in ABIM Governance*

Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs, led a discussion with the Cardiovascular Board on defining community practice in the specialty to create a more inclusive understanding of its role and scope. She also sought input on overlapping aspects of community practice across the disciplines of internal medicine to inform ABIM’s recruitment efforts for broad physician representation in governance roles.

Since 2013, ABIM Specialty Boards have been required to include at least one physician member primarily engaged in community practice, defined broadly in applications as “clinical practice in a non-university, community setting.” A workgroup convened in 2020 found that the existing practice categories candidates could choose were inadequate to the real scope of community practice and proposed updates drawn from the American Medical Association and the Diplomate Professional Profile.

The discussion highlighted how cardiologists often practice across academic, private, rural and government settings, blurring boundaries. Some suggested that they might consider defining community practice in daily clinical work and the availability of resources like cardiac catheterization laboratories and diagnostic tools. Other considerations adding to the complexity of the question included geography and infrastructure, namely the proximity of rural hospitals and the tiered relationship between academic medical centers, community hospitals and remote outpatient offices. Overall, the group agreed that defining community practice depends on context and cannot easily be conceived under one definition.

Society guests departed at this point in the meeting.

Standard-Setting for the Cardiovascular LKA

ABIM uses a process called standard-setting to determine the score a physician must achieve in order to pass an assessment. While ABIM publishes pass rates for a cohort of exam takers, it does not pre-determine the pass rate nor consider it when scoring exams. The standard is reset for each specialty at different times, based on how the discipline has evolved. ABIM’s physician-led governance is a key part of determining the passing score for assessments when this happens. The Specialty Boards are responsible for considering both the content-based passing score recommendation as well as policy considerations and approving the final passing score.

The Cardiovascular Board was tasked with determining the passing standard for the Cardiovascular Disease LKA. Since there are already physicians participating in the LKA, the new passing standard will affect them at different points in their individual five-year cycles. No physician will lose certification for not meeting the passing standard at the end of the five-year cycle; if they are unsuccessful, they have one year (the grace period) to meet the standard by taking the traditional, 10-year MOC exam.

The Cardiovascular Board voted to set the passing standard at this meeting based on recommendations from the standard-setting panels. . For more information on how ABIM develops and scores exams, visit the ABIM Blog and website.

Candidates for the Cardiovascular Approval Committees

ABIM Specialty Boards are responsible for selecting members and chairs of the Approval Committees annually and as needed. At the spring meeting, the Cardiovascular Board reviewed candidate materials and voted to approve the following appointments, effective July 1, 2025:

  • Aurangzeb Baber, MD, of Baylor Scott & White Health, to the Cardiovascular Disease LKA Approval Committee
  • Thomas J. McGarry, MD, Ph.D., FHRS, of the Spencer Fox Eccles School of Medicine at the University of Utah to the Cardiovascular Disease Traditional, 10-Year MOC Exam Approval Committee
  • Andrew H. Voigt, MD, of the University of Pittsburgh School of Medicine (UPMC) and UPMC Shadyside to the Clinical Cardiac Electrophysiology Traditional, 10-Year MOC Exam Approval Committee

Visit ABIM’s website for a full list of current openings.
Approval Committee openings are usually posted in the fall.

Updates from the Cardiovascular Approval Committees

Prior to the meeting, Cardiovascular Board members reviewed reports from the chairs of the Approval Committees (Adult Congenital Heart Disease, Advanced Heart Failure and Transplant Cardiology, Cardiovascular Disease, Clinical Cardiac Electrophysiology and Interventional Cardiology) regarding recent meetings, committee demographics and composition, rates at which items are approved for use on assessments and goals for item development with the Item-Writing Task Force. In particular, the Cardiovascular Disease Approval Committee chairs noted that the mentorship program developed within the last few years has helped orient new Item-Writers and supported experienced Item-Writers, with noted improvements to approval rates and item drafts. They also noted that the Cardiovascular Blueprints will be up for blueprint review in 2027. The Clinical Cardiac Electrophysiology Blueprint and Interventional Cardiology Blueprints are also in the midst of being updated, with proposed changes close to being finalized in June 2025.

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

ABIM governance, Andrea M. Russo, Cardiology, Cardiovascular, Cardiovascular Board, Cardiovascular Disease, Summary Report

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