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Internal Medicine Board Meeting Summary | Spring 2025

August 18, 2025  |  Posted by ABIM  |  Specialty Board Meeting Summaries

Richard M. Wardrop III, MD, MACP, Chair, ABIM Internal Medicine Board

The Internal Medicine 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 22, 2025. Representatives from the Alliance for Academic Internal Medicine (AAIM), the American College of Osteopathic Internists (ACOI), the American College of Physicians (ACP) and the Society of Hospital Medicine (SHM) joined for a portion of the meeting*.

ABIM and the Internal Medicine Board gratefully acknowledge the service of Nagendra Gupta, MD, and Jonathan J. Roberts, 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 Internal Medicine 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.

Dr. Wardrop mentioned the successes of ABIM’s ongoing collaboration with societies and asked about potential further enhancements to the LKA based on individual physicians’ performance. Dr. McDonald explained how ABIM publishes the annual Specialty Knowledge Gaps Reports to highlight in aggregate how physicians are performing in topic areas, and to provide information to societies as they assess whether there is need to develop educational programs or resources to address aggregate learning needs in the discipline. He noted that ACP is among the first to begin exploring this work.

The group also discussed the importance of organizations collaborating across internal medicine to strategize on common goals while upholding their individual missions. Dr. McDonald responded that among evolving changes in the healthcare landscape, ABIM remains focused on promoting evidence-based science.

Finally, the group discussed ABIM’s ongoing sessions with early career physicians, defined as those within the first ten years of initial certification. These sessions are designed to increase transparency around assessment development, introduce new technologies and programs, and gather meaningful feedback on how this cohort prefers to engage with ABIM. Insights from these sessions will inform future improvements and foster effective engagement with ABIM.

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 Internal Medicine Board received statistics on the current state of active certification in internal medicine, 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.) There are 170,649 physicians who certified in internal medicine and did not go on to subspecialize and 115,748 who are currently maintaining their internal medicine certificate. In 2024, of those choosing the General Internal Medicine assessment, 77% opted to take the LKA versus the longform, and of those who opted for the Internal Medicine: Inpatient assessment, 89% chose the LKA versus the longform.

One Specialty Board member inquired about end-of-year survey results from the LKA and how participating physicians rank the assessment’s fairness. Staff teams are exploring how people interpret fairness in their survey responses and what aspects of the testing experience influence those perceptions. Further research is being conducted to understand how diplomates consider fairness and guide efforts to improve assessment experience.

Initial Certification and Training Data in Internal Medicine*

The Internal Medicine 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 internal medicine. There are currently two approved AIRE programs: 1) Mount Sinai Health System (for internal medicine and geriatric medicine) allowing participants to become Board Eligible after 30 months of internal medicine training, double counting six months of geriatric rotations; 2) American Society of Nephrology allowing residents to count their third year of training towards nephrology fellowship eligibility, totaling four years of training for internal medicine and nephrology certification.

The Specialty Board also discussed pass rates for the initial certification exam and the numbers of physicians who retrain after experiencing a lapse in their 7-year period of board eligibility. ABIM is still gathering information on these populations, but the numbers are very small: Board Eligibility lapsed in 2024 for only 141 candidates who became eligible in 2017. Generally, fewer than 150 physicians each year experience a lapse in Board Eligibility for the Internal Medicine Certification Exam. The first attempt initial certification exam pass rate in internal medicine was 87% in 2024.

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. Of those who responded, 84% were clinically active, with the majority in hospital inpatient practice (35%), private practice (21.5%), hospital- or system-owned practice (20%) and academic faculty practice (16%). The dominant practice structures were multi-specialty group practice (40%) and single-specialty group practice (35%) (as opposed to solo or variable) and 44.6% of practices were owned by a hospital or health system.

Community Practice in ABIM Governance*

Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs, led a discussion with the Internal Medicine 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.

Several considerations came up in discussion, such as the intersection of rural medicine and inpatient/outpatient settings, overlapping roles for hospitalists who also work in a group practice and the influence of private equity on these settings. One member also noted that community inpatient hospitalists working with residents are not captured in the existing category choices for residency-teaching clinics. Another noted that correctional facilities were missing as an option, with staff noting that the open text field could capture this feedback.

The conversation illustrated the challenges of defining community practice for hospitals that may be a community clinic with an academic focus (offering training programs). They discussed how the distinction should come from resources available to practice, like consultants, diagnostic and therapeutic services, and residents rather than a binary choice between academic and community.

Society guests departed at this point in the meeting.

ABIM Approved Quality Improvement Program

The AQI Program is the process through which ABIM recognizes externally developed quality improvement activities that physicians are doing in practice. It also allows physicians to earn up to 20 MOC points for meaningfully participating in activities that support their local improvement priorities. Dr. Gupta and Erin Ramelb, MD, reviewed the following proposals and recommended them for approval:

  • Aledade Annual Wellness Visit Improvement 2025 – 2026: This project aims to improve the percentage of patients current with their annual wellness visits and increase outreach to patients due for annual wellness visits. The opportunity is only available for physicians in Aledade accountable care organizations (ACOs).
  • Quality Improvement in Blood Pressure Control in Aledade ACOs: This project aims for physicians to examine and improve their hypertension control rates by focusing on accurate measurement, timely follow-ups, minimizing therapeutic inertia, and patient outreach.

After a brief discussion, the Internal Medicine Board voted to approve both AQI proposals for MOC credit. Any ABIM Board Certified physician who is a participant will be eligible to receive credit for these activities.

ABIM welcomes proposals from sponsors that may include medical specialty societies, hospitals or departments within hospitals, medical groups, clinics or other health-related organizations that wish to approve a single activity. Organizations with a quality improvement activity to submit to ABIM for MOC credit recognition are encouraged to take the following steps: 

  1. Download the ABIM AQI Program Guide (PDF). 
  2. Download and complete the AQI Application (PDF). 
  3. Email completed applications to mocprograms@abim.org.

Blueprint Review

The blueprint is a table of specifications that ABIM publishes for each assessment. Blueprints provide an outline of what content will appear on an assessment and the relative percentage of the assessment covered by each topic area. ABIM regularly conducts reviews of assessment blueprints to ensure they are reflective of what physicians see in practice. The blueprints for the Internal Medicine and Internal Medicine: Inpatient Assessments are due for review in 2025. To prepare for this process, the Internal Medicine Approval Committees and Internal Medicine: Inpatient Approval Committees developed draft content outlines with input from specialty societies and presented them to the Specialty Board to review.

The Internal Medicine Board discussed the proposed blueprints and voted to approve them with minor changes. The new blueprints will go into effect for the 2026 exam administration year.

Candidates for the Internal Medicine 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 Internal Medicine Board reviewed candidate materials and voted to approve the following appointments, effective July 1, 2025:

  • Teresa Cheng, MD, MSc, of the University of California, San Francisco, as Chair of the Internal Medicine LKA Approval Committee. Dr. Cheng has served as a member since 2020 and served on the former Internal Medicine Board Exam Committee.
  • Luke Barré, MD, MPH, RhMSUS, of Hawthorn Medical Associates, and Manajyoti Yadav, MD, FACP, FRCP, of the University of Illinois College of Medicine, to the Internal Medicine LKA Approval Committee
  • Terrence Shaneyfelt, MD, MPH, of the University of Alabama at Birmingham, and Alexander L. Rittenberg, MD, of Virginia Commonwealth University, to the Internal Medicine 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 Internal Medicine Approval Committees

Prior to the meeting, Internal Medicine Board members reviewed reports from the chairs of the Internal Medicine and Internal Medicine: Inpatient Approval Committees 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. Of note, the Internal Medicine Item-Writing Task Force has recently added new members.

If you are interested in joining the Item-Writing Task Forces
 and developing content for ABIM assessments, visit the website to apply.

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 Internal Medicine Board received an overview of the team’s current projects. There was discussion of how including patient demographics in assessment questions would be closer to real-life clinical practice, but the tools demonstrated under development would already be an improvement on current state. Staff explained that if ABIM proceeded with the inclusion of patient characteristics it would require clear communication with examinees and Item-Writers.

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 members of the Internal Medicine Board were interested in a map showing the concentration of internists per state, and how to show shifts in the number over time. Historical data do not permit this level of detail, but staff stated that it might be possible in future with new data collection occurring.

Primary Care

Since early 2024, the Internal Medicine Board has been engaged in discussions about the roles of internal medicine and its specialties in primary care. This was prompted by a charge from the ad hoc Primary Care Committee of the Board of Directors. At the spring meeting, the Internal Medicine Board briefly reviewed discussions to date and considered how to proceed in the coming year with new Specialty Board members with a primary care practice joining in July. Dr. Ramelb noted that the University of Nebraska has a hybrid position for physicians interested in both primary care and hospital medicine, a unique situation that has encouraged many internal medicine residents to enter primary care since they have the option to do both.

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Join the Community Insights Network to share feedback with ABIM through focus groups, surveys, user testing and more as we develop and refine our programs together.

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

ABIM governance, internal medicine, Internal Medicine Board, Richard M. Wardrop III, Summary Report

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