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Endocrinology, Diabetes & Metabolism Board Meeting Summary | Fall 2024

December 5, 2024  |  Posted by ABIM  |  Specialty Board Meeting Summaries

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

The Endocrinology, Diabetes & Metabolism Board—which meets twice a year and is responsible for oversight of policy and assessment in the specialty—held its fall meeting on October 9, 2024. The Specialty Board reviewed updates on ABIM’s work in a number of key areas and discussed other pressing issues in the field. In addition, representatives from the following organizations joined for a portion of the meeting*:

  • The American Association of Clinical Endocrinology (AACE)
  • The Association of Program Directors in Endocrinology, Diabetes and Metabolism (APDEM)
  • The Endocrine Society

The following is a summary of the fall meeting. For reports of prior meetings, visit the ABIM Blog.

Contents:

ABIM News and Conversation with the President*

Prior to the meeting, members and guests of the Endocrinology, Diabetes & Metabolism Board had the opportunity to view a recorded video update from Furman S. McDonald, MD, MPH, who assumed the role of President and Chief Executive Officer (CEO) of ABIM and ABIM Foundation on September 1, 2024. Dr. McDonald reflected on current transitions for ABIM as well as key topics for the Specialty Board’s consideration and awareness:

  • A proposed pilot model for “exceptionally qualified” international medical graduates (IMGs) pursuing accredited subspecialty fellowship in the U.S. or Canada to become eligible for ABIM Board Certification: ABIM invited commentary from the diplomate community throughout September for the ABIM Council to consider before making a final decision early in 2025, and Dr. McDonald noted that this timing coincides fortuitously with—but is distinct from—similar initiatives for state medical board licensure. Learn more through a video and FAQs on the ABIM website.
  • ABIM’s progress in engaging more closely with early career physicians (diplomates who earned initial certification less than 10 years ago): a task force of Governance members is making plans for the coming year to convene early career physicians, create a platform for their perspectives and provide opportunities for them to be more directly involved in ABIM.
  • The continued popularity of the Longitudinal Knowledge Assessment (LKA®), high rates of reported satisfaction and ongoing enhancements: on average, 80% of eligible diplomates continue to choose the LKA over the traditional, 10-year Maintenance of Certification (MOC) exam, and 70.7% of survey respondents agreed with the statement, “I am satisfied with my LKA experience so far.” Still, Dr. McDonald noted, ABIM continues to evolve and improve the assessment based on diplomate feedback.
  • The recently announced removal of the requirement to earn some MOC points every two years to be considered “Participating in MOC.” With the availability of more activities that earn physicians MOC points (e.g., continuing medical education for MOC, UpToDate®, the LKA), the ABIM Council determined that the two-year point requirement was no longer needed and that its removal would benefit physicians and help promote engagement by making the program simpler.

The group discussed some questions about the proposed pilot model for IMGs, its potential implications as well as challenges. Dr. McDonald acknowledged the complexities surrounding the issue and pointed out that the pilot aims to address critical questions. If implemented, it would make at least 4,000 physicians eligible with an additional 500 becoming eligible each year after that but ABIM will rely on the pilot to evaluate its overall impact. The Council is also committed to addressing concerns that respondents shared in the public survey in October.

Dr. McDonald also went into further detail about additional topics in answer to questions from Specialty Board members. He discussed ABIM’s focus on enhancing the certification program and expanding stakeholder engagement, and briefly reviewed ABIM’s efforts to address medical misinformation. He spoke more about how ABIM has engaged with early career physicians by maintaining contact after initial certification and soliciting feedback about their needs.

Setting a Quality Agenda in the Discipline*

In 2021, the American Board of Medical Specialties (ABMS)—which comprises 24 medical certifying boards in the U.S., including ABIM—adopted new standards for continuing certification that include a requirement for member boards to work with stakeholders to facilitate the development of discipline-specific quality agendas. The Specialty Boards discussed this in their spring 2023 meetings and agreed on three key themes: addressing inherent bias and health disparities, enhancing physician well-being and improving access to quality care.

Richard G. Battaglia, MD, FACP, Chief Medical Officer for ABIM, added that ABIM’s role is to bring key groups together so that no organization is working on quality advancement alone, and to educate these groups about issues central to other organizations’ advocacy.

Diversity, Equity and Inclusion (DEI) Initiatives at ABIM*

Natalie S. Plummer, Esq., Manager, DEI Programs at ABIM, reported on the work of the DEI team at ABIM and recent advances in ABIM’s DEI initiatives. These include:

  • ABIM’s work with participating medical society partners, which led to the formation of the Diversity, Equity and Inclusion Collaborative Network. The goal of the network is to share best practices, coordinate resources and create strategies to support and move diversity work forward as a community dedicated to this work.
  • Improvements to the ABIM Physician Portal that now allow diplomates to more accurately self-identify their race/ethnicity and gender with an expanded list of options. This also aligns with ABIM’s efforts to increase diversity in governance and eliminate bias in assessment questions. Since this effort began, ABIM has seen consistent growth in the number of physicians supplying information, with more than 77,000 diplomates updating their information.
  • A report led by Dr. Sara Ray, a medical historian from the University of Pennsylvania, to study the governance records of ABIM. The goal of this project was to determine whether ABIM’s practices within the context of the past caused harm to historically disadvantaged groups and whether that might require restorative action and transparency.

Members of the group asked for additional information about the data collected in the Portal, such as whether it includes or could include educational background, age, primary language, etc. Ms. Plummer clarified that some of those data are collected in a different part of the Portal, while others offer potential for future exploration. She noted that future plans for the project include publication of findings from aggregate data for diplomates and others to better understand the diversity of the workforce.

Diplomate Professional Profile*

In summer 2023, ABIM invited a pilot group of diplomates to complete the newly developed Diplomate Professional Profile (DPP), a questionnaire required of all diplomates that is built into the Physician Portal. The questionnaire relates to clinical work and practice patterns and serves to inform ABIM’s ongoing efforts to update assessment options and exam blueprints and develop policies for initial certification and MOC. Since last year, ABIM has continued to invite all remaining eligible diplomates on a rolling basis to complete the DPP. Diplomates receive a prompt to complete their professional profile when they sign in to their Portal.

Siddharta G. Reddy, MPH, Senior Research Associate at ABIM, reported to the Specialty Board that 31% of diplomates overall have completed their DPP; he also reviewed profile questions specific to endocrinology, diabetes and metabolism. In answer to questions, he also noted that the DPP collects ZIP codes and includes telehealth as a component of total clinical care time.

Updates from Societies*

AACE

Elizabeth Lepkowski, Chief Learning Officer for AACE, reported on the new AACE Advocacy Training Program, which took place following the meeting on October 18, and on plans for AACE Annual Meeting 2025, scheduled for May 15–17 in Orlando, Florida. The annual meeting will focus on endocrine innovation and breakthroughs in obesity treatment.

APDEM

Matthew J. Levine, MD, Council President of APDEM, provided some highlights about the organization and updates on recent initiatives. In June, APDEM announced its merger with the Endocrine Society. APDEM represents 85% of endocrine fellowship programs; its members are program directors, associate program directors and program coordinators, and 41% of its members sit on APDEM committees. APDEM recently merged its DEI and Health Equity committees and introduced specific curricula on transgender health and health equity. APDEM is also working to increase interest in endocrinology among students and residents and has formed a joint task force with ABIM and the Endocrine Society to address low scores on certification examinations.

Endocrine Society

Chris Urena, MBA, CAE, Chief Learning Officer for the Endocrine Society, shared news about the society’s inaugural Artificial Intelligence (AI) in Healthcare Virtual Summit, taking place November 8–9, and small “boutique” conferences that the society is beginning to host on specific topics, leading with the International Conference on Steroid Hormones and Receptors. The Endocrine Society is also partnering with the Keystone Symposia to offer annual conferences (2025 and beyond) focusing on translational research in cardiovascular disease, diabetes and oncology. The Endocrine Society annual meeting, ENDO 2025, will take place July 12–15 in San Francisco.

Society representatives departed at this point in the meeting.

Overview of the Standard-Setting Process for the LKA

Bradley Brossman, Ph.D., Vice President of Psychometrics for ABIM, reviewed the standard-setting process for the Endocrinology, Diabetes & Metabolism Board. He provided an overview of the standard setting process that the Specialty Board will undertake later this fall, with particular detail to differences between standard-setting for the traditional, 10-year MOC exam and the LKA. ABIM reviews the passing standard regularly for all assessments in a rigorous process that determines the score a physician must meet or exceed in order to pass. The Specialty Board is responsible for considering both the content-based passing score recommendation as well as policy considerations and approving the final passing score, a step slated for November.

Update from Approval Committees on Item-Writing

Shehzad S. Basaria, MD, Chair of the Endocrinology, Diabetes & Metabolism Traditional, 10-Year MOC Exam Approval Committee, and Susan L. Samson, MD, Ph.D., FRCPC, FACE, Chair of the Endocrinology, Diabetes & Metabolism LKA Approval Committee, provided an update on the Item-Writing Task Force, which is responsible for developing questions for assessments in the discipline. The Approval Committees are responsible for reviewing question drafts, providing feedback and approving final items, as well as generally ensuring the highest possible quality and relevance of assessment items. To this end, they noted the need for content expertise among the new item-writers and the group discussed working more with societies to recruit item-writers with content expertise. The chairs also acknowledged the challenges regarding retention of item-writers after their initial two-year term and suggested incentives to encourage retention.

ABIM is accepting applications for the Item-Writing Task Force. Learn more on the ABIM website.

Engaging Early Career Physicians

As mentioned during the Specialty Board’s earlier discussion with Dr. McDonald, the ABIM Council has instituted a task force to work on engaging early career physicians and residents, which has so far included listening sessions and group discussions about the early career physician experience. The task force’s goals are to build long-term relationships, identify needs and potential impacts at ABIM and involve a diverse range of early career physicians—including first-generation physicians—in ABIM’s policy and decision-making work.

The Specialty Board discussed what ABIM should try to learn from early career physicians and what the planning group might do specific to the discipline. Their suggestions included working with APDEM to develop programs for program directors to assist fellows beyond specialty certification, making enhancements to the website with clearer career guidance, and establishing an online forum to foster community engagement. Christine Twining, MD, Chair of the Endocrinology, Diabetes & Metabolism Board, remarked on the challenge that new attending physicians face in combating medical misinformation in patient care. She also noted how she found the ABIM Foundation’s Choosing Wisely® campaign useful for talking to patients about avoiding unnecessary care and the rationale behind it, and how something similar related to misinformation would be useful. The Foundation also has the Building Trust initiative, designed to address the primary causes of mistrust and misinformation, and improve clinicians’ ability to deliver high-quality care.

Learn More

The Endocrinology, Diabetes & Metabolism Board values the feedback and commentary of the entire medical community, including diplomates and society partners.

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Do you have questions? Contact ABIM directly:

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

ABIM governance, Christine Twining, Endocrinology, Endocrinology Diabetes & Metabolism Board, Endocrinology Diabetes and Metabolism, Summary Report

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