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Endocrinology, Diabetes and Metabolism Board Meeting Summary | Spring 2025

June 4, 2025  |  Posted by ABIM  |  Specialty Board Meeting Summaries

Christine Twining, MD, Chair, ABIM Endocrinology, Diabetes and Metabolism Board

The Endocrinology, Diabetes and Metabolism Board, which meets twice a year and is responsible for oversight of policy and assessment in the specialty, held its spring meeting on April 1, 2025. Representatives from the American Association of Clinical Endocrinology (AACE), the Association of Program Directors in Endocrinology, Diabetes and Metabolism (APDEM) and the Endocrine Society joined for a portion of the meeting*.

The following is a summary of the spring meeting. Visit the ABIM Blog for reports of prior meetings. To share your feedback with the Endocrinology, Diabetes and Metabolism 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 discuss 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.

In discussion, Dr. McDonald confirmed that while the LKA has maintained a steady enrollment rate for four years, the traditional, 10-year MOC or “longform” exam will remain available with about 20% of physicians who choose an assessment selecting it. He also shared more about ABIM’s work in health equity, focused on alternative licensure models and physicians who have trained but do not have a pathway to Board Eligibility or ABIM Board Certification. (See the discussion on the Special Consideration IMG (International Medical Graduates) Pilot Pathway below.)

Odelia Cooper, MD, Past-President of APDEM, asked how endocrinology fellowship programs can better prepare their graduates for board certification. Dr. McDonald spoke about ABIM’s work engaging early career physicians (those who earned initial certification within the last 10 years), including presentations and listening sessions at recent national meetings. He suggested a similar approach for APDEM’s annual meeting.

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 Endocrinology, Diabetes and Metabolism Board received statistics on the current state of active certification in endocrinology, diabetes and metabolism, assessment enrollment, demographics and pass rates, and data from post-assessment surveys. (Some data, such as exam pass rates and resident and fellow workforce trends, are publicly available on ABIM’s website.) Of note, 11,224 physicians have been board certified in endocrinology, diabetes and metabolism since the certification was first offered in 1972. In 2024, 77% of eligible ABIM Board Certified endocrinologists who chose an assessment opted for the LKA over the traditional, 10-year MOC exam.

Members of the Specialty Board discussed some data points in greater detail, such as the relatively higher number of IMGs who choose the traditional MOC exam over the LKA (55% compared to 43%), and the low number of physicians (3%) who have not met the LKA Participation Requirement since 2022 (and must therefore take the traditional exam instead). The Participation Requirement allows physicians to leave up to 100 questions unopened in their five-year LKA cycle.

The group also discussed pass rates in the Endocrinology, Diabetes and Metabolism Certification Examination, including possible reasons behind lower pass rates in 2021 and 2022, such as pandemic effects (74%) and correlations with physicians’ self-identified satisfaction with the exam in the post-assessment survey. ABIM staff confirmed that no significant correlation was found between pass rates and satisfaction in survey results.

Initial Certification and Training Data in Endocrinology, Diabetes and Metabolism*

The Endocrinology, Diabetes and Metabolism 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 endocrinology, diabetes and metabolism.

Several members of the group agreed on the need for an increased number of endocrinology fellowship positions to address a shortage of specialists in the field and the relatively higher number of physicians who do not match into a program (see NRMP data). Dr. Twining inquired whether APDEM could give further insight into ultimate outcomes for physicians who are not initially successful in matching into an endocrinology fellowship, but APDEM does not track data on residents who do not match. However, APDEM representatives shared that many residents complete fellowship through the subsequent Supplemental Offer and Acceptance Program and noted that the rates in the last match cycle were reassuring that the number of initially unsuccessful applicants was relatively low.

Diplomate Professional Profile*

The Diplomate Professional Profile is a questionnaire built into the ABIM Physician Portal and eventually is required to be completed by all ABIM Board Certified physicians. 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 with a higher completion rate of 46% among endocrinologists. Siddharta G. Reddy, MPH, Senior Research Associate in Assessment and Research at ABIM reviewed aggregate data gathered so far related to endocrinologists, including practice setting, practice size and physician ownership of practices. Highlights from the data so far show that 91% of respondents are clinically active, with a large majority practicing in hospital- or system-owned offices, private practice or academic faculty practice, and more than half in multi-specialty group practice.

Community Practice in ABIM Governance*

Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs at ABIM, led a discussion with the Endocrinology, Diabetes and Metabolism Board on 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 group discussed evolving trends in telehealth and how to capture that as a category of community practice. Several members of the Specialty Board shared concerns about legislation in different states threatening the availability of telehealth, with others underlining the large role it plays in their practice. They also noted a distinction in telehealth practices between remote consultations in different states and using telehealth to treat patients who live nearby. Mr. Reddy pointed out that through the Diplomate Professional Profile, ABIM is gathering information about the percentage of time physicians spend in telehealth as well as how many hours and weeks per year physicians work, which could contribute to the understanding of community practice, but the data have not been analyzed yet.

Special Consideration IMG Pilot Pathway*

In August 2024, the ABIM Council proposed a pilot model for exceptionally qualified IMGs pursuing accredited subspecialty fellowship in the U.S. or Canada to become eligible for ABIM Board Certification. These physicians currently do not have a pathway to Board Eligibility. Dr. Johnson updated the Specialty Board on the pilot proposal, which is currently under review by the American Board of Medical Specialties. In addition to a status update, she clarified that the evaluation for physicians who would qualify for the program would be retroactive as well as being instituted for new candidates.

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 development staff, facilitating the item development process and enhancing the assessment experience for physicians. The Endocrinology, Diabetes and Metabolism Board received an overview of the team’s current projects.

Several members of the Specialty Board were interested in the use of artificial intelligence (AI) to improve the quality of assessment questions (items). Pamela Kaliski, Manager, Exam Innovations for ABIM, shared more about ABIM’s goal of prioritizing security pertaining to AI use, avoiding redundancies and helping physician Item-Writers create insightful questions that test clinical knowledge and judgment. She emphasized that all assessment content is created by physicians, and AI would only serve as a support and refinement tool. Susan L. Samson, MD, PhD, FRCPC, FACE, Chair of the Endocrinology, Diabetes and Metabolism LKA Approval Committee, which oversees the process of content creation for the LKA, added that the goal is ensuring the questions test critical thinking rather than a physician’s ability to look up information and the Approval Committee has adjusted its process for reviewing items based on this goal.

Annual Diplomate Report*

ABIM’s Research and Innovations Department is looking into the potential for ABIM to publish annual reports with specific data highlighting broad statistics for 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, MOC participation rates, demographic characteristics and assessment pass rates. While some of these data have been made available upon request for research purposes, ABIM has never published a consolidated report.

Mara Schwartz, RN, CDCES, BSN, suggested including the location of board certified endocrinologists’ practice location within each state, something that might be achievable once more physicians complete the Diplomate Professional Profile.

Updates from Specialty Societies*

AACE

Elizabeth Lepkowski, Chief Learning Officer for AACE, shared that AACE 2025 in Orlando (May 15 – 17) would focus on breakthroughs in obesity and metabolic management, new clinical guidelines, AI and emerging technologies, and environmental endocrinology. She also noted that AACE helped achieve a record number of student registrations thanks to a new initiative to address workforce shortages in endocrinology. AACE is also updating its strategic plan based on research into endocrinologists’ educational needs and launching a new open-access journal this spring, AACE Endocrinology and Diabetes, and is now accepting manuscripts.

APDEM

Matthew J. Levine, MD, President of APDEM, reported that more than 40% of APDEM members are volunteering on committees, including diversity, equity and inclusion and health equity subcommittees, and a new committee forming to strengthen relationships with partner societies. Efforts to recruit physicians and students to train in endocrinology have included working with the Latino Medical Student Association. Dr. Levine noted that APDEM is also assessing how new executive orders may affect endocrinology training programs and IMGs.

Endocrine Society

Robert W. Lash, MD, Chief Medical Officer for the Endocrine Society, highlighted the society’s advocacy work, including the “Take Action” page on its website, which provides physicians with the information and tools they need to contact their legislators on specific issues affecting the discipline. The Endocrine Society has also been addressing workforce issues through the Medical School Engagement Program providing grants to medical schools to create interest groups and awareness of the specialty and fund the attendance of top students at ENDO, the Society’s annual meeting. The program has doubled to 20 schools and will be awarding 40 Excellence in Endocrinology awards to medical students.

Supporting Research and Important Issues in Endocrinology, Diabetes and Metabolism*

Dr. Johnson led the Endocrinology, Diabetes and Metabolism Board in a discussion about opportunities for ABIM Governance members to support important issues and research that demonstrates the value of board certification. As a 501(c)3 organization, ABIM is under strict limits with regards to political and lobbying activities but may address issues within those limits and consider policy issues in an educational manner. Dr. Johnson asked the Specialty Board to identify current or emerging issues that affect health care in endocrinology, diabetes and metabolism, and to consider opportunities for the Specialty Board to address these issues within the appropriate framework of its oversight of the discipline.

Members of the Specialty Board identified three major areas of concern: continuing efforts to address medical misinformation; emerging barriers to gender-affirming care; and administrative barriers to evidence-based treatments and medications from insurance companies.

Society representatives departed at this point in the meeting.

Updates from the Endocrinology, Diabetes and Metabolism Approval Committees

Shehzad S. Basaria, MD, Chair of the Endocrinology, Diabetes and Metabolism Traditional, 10-Year MOC Exam Approval Committee, and Dr. Samson updated the Specialty Board on the composition of the two Approval Committees with the backgrounds, demographic data and areas of clinical expertise for each member (visit the website for more details). They also reviewed Approval Committee meetings with information about the rate of items approved and goals for the coming year, including preparation for the Blueprint Review that will occur in 2026.

Approval Committees continue to work with staff to refine the feedback process for the Endocrinology, Diabetes and Metabolism Item-Writing Task Force, providing more detailed information about performance rates for the items each physician writes. Some Approval Committee members serve as mentors for new Item-Writers to provide live feedback and guidance as they learn the process. Drs. Basaria and Samson reflected on changes to the item development process that have resulted in improved quality in questions and noted how feedback that physicians submit through the LKA plays a key role in improving the assessment.

ABIM is seeking more endocrinologists—including specialists in lipids and thyroid, among other areas—to join the Item-Writing Task Force and accepting applications on the website.

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*Indicates that society representatives and guests were present for discussion of this agenda topic.

ABIM governance, Christine Twining, Endocrinology, Endocrinology Diabetes & Metabolism Board, Endocrinology Diabetes and Metabolism, IMG, LKA

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