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Geriatric Medicine Board Meeting Summary | Fall 2024

December 23, 2024  |  Posted by ABIM  |  Specialty Board Meeting Summaries

Jorge G. Ruiz, MD, Chair, Geriatric Medicine Board

The Geriatric Medicine Board— which meets twice a year and is responsible for oversight of policy and assessment in the specialty—held its fall meeting on October 7, 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 American Geriatrics Society (AGS) and the Post-Acute and Long-Term Care Medical Association (PALTmed) joined for a portion of the meeting.

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 Geriatric Medicine 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.

In response to inquiries from Specialty Board members, Dr. McDonald went into further detail on some of the items above. He explained that one of the features of the LKA is regular progress reports issued after the fifth quarter of participation, designed to help physicians focus on areas of lower performance. Regarding early career physician engagement, he added that ABIM Specialty Boards and Advisory Committees each hold one seat for an early career physician and that a planning group convened by the ABIM Council is at work on planning engagement opportunities for the next year.

The group also discussed international medical graduates, including efforts around state licensure and the implications of the pilot model on training and practice. Dr. McDonald remarked on recent public comment periods and conversations with state medical boards about improving access to care in rural areas. He also suggested ways to raise awareness in the community about the public comment period for a set of preliminary draft recommendations developed by the Advisory Commission on Additional Licensing Models, designed to assist state and territorial medical boards and legislators in developing or modifying additional licensing pathways for IMGs. (Please note that the public comment period for the Advisory Commission closed on December 6.)

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 had completed their DPP to date. He also reviewed profile questions specific to geriatric medicine. The group briefly discussed plans for the data and how it might be shared. Mr. Reddy explained that the data would not be publicly available but noted that, in the past, ABIM has collaborated with other institutions to share relevant insights from similar projects.

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.

The group discussed recent research about the prevalence of ageism, the importance of gathering age-related data and the importance for individuals disclosing that information to understand the rationale behind the request. One Specialty Board member also emphasized the need for data to inform and enhance board certification and assessment. Ms. Plummer spoke further about the need to create a safe space for people to disclose information about their identities and outlined next steps, which involve reviewing what has been accomplished to date and forming work groups and task forces to determine necessary actions based on those findings.

Geriatric Medicine: Discussions on the Discipline*

The Specialty Board held an open discussion on pressing topics in the discipline of geriatric medicine and exchanged ideas for future topics of conversation, including artificial intelligence in education, barriers to geriatric medicine and the value of geriatric medicine in health care. The group discussed challenges that training programs face, such as graduates leaving to enter palliative care, and the need to advocate for and redefine the specialty with a focus on geriatric syndromes.

Workforce

Kathryn Ross, Research Associate at ABIM, has been working with the Geriatric Medicine Board on research to understand why some diplomates do not maintain certification in geriatric medicine but still practice in the discipline. She shared that 44% of geriatric medicine diplomates practice both internal medicine and geriatric medicine, 41% practice only internal medicine, 4% practice only geriatric medicine and 11% are not actively practicing in either discipline.

CMS Quality Measure

Nancy Lundebjerg, MPA, Chief Executive Officer of AGS reported that the Centers for Medicare and Medicaid (CMS) had included a new age-friendly hospital measure in the 2025 Hospital Inpatient Quality Program that will evaluate hospitals’ progress toward improving care for patients aged 65 and above in the inpatient hospital setting.

Issues for LGBTQ+ Fellows in Geriatric Medicine

The group briefly discussed the effect of recent legislation on geriatric medicine fellows, the need for updated statements from healthcare organizations regarding LGBTQ+ care and the importance of integrating LGBTQ+ health-related content in medical education and training. They also discussed concerns around the potential impact of changing healthcare equity legislation in some states.

Palliative Care and Geriatric Medicine

The group discussed how palliative care has evolved as a field of medicine, successfully engaging healthcare providers in contrast to geriatric medicine’s more traditional outpatient focus. Some participants noted how the future strategies for advancing geriatric medicine could be based on lessons learned from earlier approaches.

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 support 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.

Promoting Geriatric Medicine Certification*

In July,  ABIM published a panel discussion led by Dr. Ruiz and featuring geriatric medicine providers working in a range of cross-disciplinary career paths: Diane L. Chau, MD, Medical Director, Molina Healthcare; Daniel E. Forman, MD, Professor of Medicine and Chair of Geriatric Cardiology, the University of Pittsburgh; and Suzanne P. Gillespie, MD, RD, CMD, Associate Professor of Medicine and Associate Professor of Emergency Medicine, the University of Rochester School of Medicine and Dentistry. The conversation centered on the importance and value of board certification in geriatric medicine, aiming to explore how board certification is beneficial and to foster interest in the field among students and trainees.

The Specialty Board discussed ways to continue promoting this concept, such as brief video or audio content for social media featuring fellows to enhance engagement and accessibility, similar to an initiative of the 2023 AGS Annual Meeting.

Society representatives departed at this point in the meeting.

Recommending Candidates for the Specialty Board to ABIM Council

Each year, ABIM initiates the process of recruiting candidates for open seats on the Specialty Boards; each member serves a three-year term with the option for one renewal, and positions open on a rolling basis. ABIM posts all openings on its website and shares them with diplomates and other stakeholder groups. The Specialty Board pays close attention to its own present and future composition, namely how practice setting and region, career stage, educational background (U.S., international) and race and ethnicity are represented among its members. The ABIM Council makes final selections based on the Specialty Board’s top two recommendations for each open seat.

In June, ABIM issued notice about three openings on the Geriatric Medicine Board for terms beginning July 1, 2025: one for an early career geriatrician, one for a geriatrician practicing in a community/non-university setting, and one for a patient or caregiver with experience in geriatric medicine. At the fall meeting, the Geriatric Medicine Board discussed the candidates they had interviewed and voted on two to recommend to the Council for each opening. ABIM will announce the final appointees in spring 2025 prior to the start of their terms.

Learn More

The Geriatric Medicine Board values the feedback and commentary of the entire medical community, including diplomates and society partners.

Are you interested in getting involved?

Keep on top of the latest news from ABIM.

Do you have questions? Contact ABIM directly:

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

ABIM governance, DEI, Geriatric medicine, Geriatric Medicine Board, Jorge G. Ruiz, Quality Agenda, Summary Report

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