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Medical Oncology Board Meeting Summary | Spring 2024

June 28, 2024  |  Posted by ABIM  |  Specialty Board Meeting Summaries

A word from the Specialty Board chair: click to hear an introduction by Dr. Suresh Nair
Suresh G. Nair, MD, Chair of the Medical Oncology Board

The Medical Oncology Board held its spring meeting on Thursday, April 25, 2024. The agenda provided an opportunity to update the Specialty Board on activity at ABIM and allowed for discussion of pressing issues in the field. The Specialty Board was joined for a portion of the meeting* by guests from the American Society of Clinical Oncology (ASCO).

The following is a summary of the spring meeting.

ABIM and Physician Feedback*

Though ABIM has long prioritized physician feedback in shaping its programs, the organization has placed renewed emphasis on addressing elements of the certification program that can and should be improved, as well as fostering the community’s perception of the value of certification and physician pride in maintaining certification. Richard G. Battaglia, MD, FACP, Chief Medical Officer for ABIM, gave the Medical Oncology Board an overview of recent physician feedback and actions that ABIM is considering, and invited the group to share their ideas and suggestions for ABIM to consider as it continues working with societies, diplomates and the broader internal medicine community.

Members of the group offered a number of ideas for consideration around Maintenance of Certification (MOC) points and ways to make the MOC program more efficient and manageable. These included the possibility of waiving the requirement to earn 100 MOC points every five years for physicians participating in the Longitudinal Knowledge Assessment (LKA®). Others suggested reconsidering the four-minute time limit on LKA questions to allow more time for participants to focus on content and retain information.

Specialty Board Oversight of Assessments*

ABIM’s Specialty Boards are responsible for reviewing and approving the assessment blueprints and standards for certification, MOC and the LKA in their respective disciplines. Each spring, the Specialty Boards review data related to the population of new graduates entering the discipline, diplomates maintaining their certification, workforce information, and assessment performance trends and feedback. Periodic review of these data helps to inform the Specialty Boards’ assessment decisions. The Medical Oncology Board discussed assessment data in the discipline and provided feedback to ABIM staff about which data were most helpful for ongoing oversight of assessment. Some of the data the Specialty Board reviewed are publicly available on ABIM’s website, including:

Jamie H. Von Roenn, MD, FASCO, Vice President of Education, Science and Professional Development for ASCO, commented on the increase in the number of pilot sites and competition for applicants to the Advancing Innovation in Residency Education (AIRE) pilot for an oncology/hospice and palliative medicine pathway. She noted the differences between programs at different institutions, such as availability for an additional year for research and the ability to qualify for triple Board certification.

Discussion among Specialty Board members continued on the topic of the LKA, how diplomates learn and retain knowledge through participating, and reported enrollee retention rates in the LKA. Several members noted the importance of fostering a broad base of medical knowledge (which the LKA is designed to do) even among physicians in a highly specialized practice, particularly for the benefit of patients seeking specialist care who are unlikely to see more than one physician.

Update from ASCO*

Dr. Von Roenn reported on the results of a recent questionnaire distributed to ASCO members along with recommendations from a task force that ASCO convened to look into ways to make the LKA more accessible and beneficial for participants and ABIM. The task force recommended consideration of revisions to the medical oncology blueprint to reflect changes in practice (for example, the broad usage of immunotherapy and the increased focus on toxicity management), focused assessments in the discipline, extending the time limit on questions and eliminating the need for MOC points for diplomates participating in the LKA.

The group then discussed other possible areas of improvement, such as clearer and more frequent notifications about requirements coming due, updates to the ABIM website and clarifying the MOC program structure. Suresh G. Nair, MD, Chair of the Medical Oncology Board, asked whether ASCO members feel ABIM is being responsive to feedback and Dr. Von Roenn indicated plans to hold future listening sessions to better gauge their sentiments.

Exploring Focused Assessment(s) in the Discipline*

ABIM currently offers focused versions of its assessments in internal medicine (the Internal Medicine: Inpatient LKA and traditional, 10-year MOC exam) and sleep medicine (the Sleep Medicine LKA: Obstructive Sleep Apnea Emphasis). Additional explorations have begun in gastroenterology and hematology with plans announced recently to develop malignant- and classical-focused versions of the Hematology LKA (in addition to the general Hematology LKA) to launch in 2026. ABIM plans to continue exploring the idea of focused assessments in other specialties with stakeholder input at multiple levels, including that of the Specialty Boards, to determine whether focused assessments are appropriate in those disciplines. Therefore, the Medical Oncology Board was invited to discuss whether exploring focused assessments in medical oncology is warranted.

Members of the Specialty Board identified challenges to consider if a focused assessment were to be developed, such as how to ensure that questions continue to represent the current standard of practice, and are written and reviewed both by experts in the subspecialty and more general practitioners. Dr. Nair also pointed out that developing a focused assessment could attract more item-writers specializing in the focused area.

New Proposal for ABIM’s Approved Quality Improvement (AQI) 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 diplomates to earn MOC points for activities that support their local improvement priorities. Approved activities grant 20 MOC points to physicians who meaningfully participate in the activity. Elizabeth S. Ellent, MD,reviewed the following proposal for the program and provided her recommendation for approval:

  • “Cancer Care Navigation Program” sponsored by Kaiser Permanente South Bay Medical Center. The activity is intended to create a centralized, closed-loop care coordination program of expedited care for patients suspected to have cancer and create a personalized journey for them through diagnosis, treatment and survivorship.

After a brief discussion, the Medical Oncology Board voted to approve the AQI proposal for MOC credit.

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.

Society guests departed at this point in the meeting.

Reviewing the Medical Oncology Blueprint

The ABIM blueprints for initial certification, MOC and the LKA are maintained by the Approval Committees in each discipline and periodically subjected to review to keep up with the latest changes in medicine and physician practice. In 2022, the Medical Oncology Approval Committees started the process of identifying areas of the blueprint that would benefit from revision and drafted proposed changes the following year.

The Medical Oncology Board reviewed the proposed blueprint at its spring meeting. The members discussed some further revisions with respect to including genomics and specific complications currently not included in the blueprint, and then approved the proposed blueprint changes with those revisions. Next, ABIM will communicate the proposed changes to ASCO and they will be shared in a survey of diplomates in 2025 allowing for commentary before the changes are accepted into the final blueprint. This is part of the standard blueprint review process in all disciplines, in which ABIM seeks input from diplomates on the importance and frequency of topics and tasks from the blueprint in actual practice.

Update on the Medical Oncology Approval Committees

Nina Karlin, MD, Mayo Clinic Arizona; Chair of the Medical Oncology LKA Approval Committee

Pamela N. Munster, MD, University of California San Francisco; Chair of the Medical Oncology Traditional, 10-Year MOC Exam Approval Committee

ABIM Approval Committees are responsible for approving and editing all assessment content, and maintaining the blueprints for the initial certification examination, the MOC exam and the LKA. There are two ABIM approval committees related to medical oncology: the Traditional, 10-Year MOC Exam Approval Committee (which also deals with the initial certification exam) and the LKA Approval Committee. Dr. Karlin provided a brief update for the Medical Oncology Board on the composition of the Approval Committees, progress on item development in meetings this year and news about the Item-Writing Task Force.

Member Selection for the Medical Oncology Approval Committees

ABIM’s Specialty Boards are responsible for selecting members and chairs of the Approval Committees annually and as needed. At the spring meeting, the Medical Oncology Board reviewed candidate materials for a new member on the Medical Oncology Traditional, 10-Year MOC Exam Approval Committee. The Specialty Board voted to approve John Jakob, MD, Ph.D., Summa Health System, Northeast Ohio Medical University and Akron City Hospital, to join the Approval Committee starting July 1.

Openings for Specialty Board positions starting July 2025 will be posted online in the summer of 2024; openings for Approval Committee positions starting July 2025 will be posted online in October. Visit ABIM.org for more information and a list of current openings.

New Ways to Recognize Diplomates for Their Commitment to MOC

ABIM is exploring new ways to recognize physicians who participate in the MOC program. This includes finding new ways to celebrate assessment milestones and ongoing efforts to stay current. Nicole Welk-Joerger, Ph.D., Program Manager of Stakeholder Engagement for ABIM, shared information about the project with the Specialty Board including a number of proposed tactics for early consideration. Dr. Welk-Joerger invited members to share their feedback and reactions on how diplomates want to be recognized and what forms of recognition are most impactful for physicians.

Members voiced how initial certification can be difficult to recognize when it is a requirement for employment. Suggestions from the group for better MOC recognition focused on intrinsic tactics—reinforcing positive, congratulatory messaging, making MOC requirements clearer in communications, and building breaks into the process. The micro-recognition idea posed to the group (sharing back MOC data, interests and standing in a congratulatory email) became a focal point of the conversation as it seemed to reflect some of these desired recognition markers. At the end of the session, Dr. Nair suggested engaging directly with physicians who express criticisms of and concerns about ABIM and its program to better understand their viewpoint and identify opportunities to improve the program.

Conversation with the President

Prior to the meeting, members and guests of the Medical Oncology Board had the opportunity to view a video update from Richard J. Baron, MD, MACP, President and Chief Executive Officer of ABIM and ABIM Foundation, reflecting on current issues for ABIM and the internal medicine community, including:

  • The ongoing collaboration between ABIM and internal medicine societies to address their members’ concerns and feedback about the MOC program. More than 30 societies met with ABIM in fall 2023, in addition to ongoing discussions throughout the year. In part, the collaboration also explores the need for focused assessments in select subdomains of specific specialties where enough physicians are focusing their practice. Focused assessments have already launched in sleep medicine and internal medicine, with more to come in the future, including hematology in 2026.
  • ABIM’s work to mitigate the spread and negative impact of misinformation for physicians and patients. Most recently, ABIM updated the way it reports certification status for physicians to be more transparent about why some certificates are no longer active, such as being “Revoked,” “Suspended” or “Lapsed.”
  • The establishment of a dedicated innovation team at ABIM to explore how emerging technology and artificial intelligence (AI) can be used to assess physicians in the rapidly evolving context of their requisite skills and practice environments.
  • Dr. Baron’s approaching retirement later this year, the Board of Directors’ search for a new CEO and ABIM’s transition to new leadership. (As of the time of this report, the new CEO has been announced.)

In discussion with the Specialty Board, Dr. Baron shared further thoughts on ABIM’s response to criticism and efforts to make improvements. He emphasized that collaborative work takes time and the development of focused assessments has many challenges. He also spoke about the importance of ABIM’s mission and the need for a unified profession, as well as the need to innovate and explore the use of AI in medicine, both in the realms of assessment and practice.

In Closing

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

Do you have any questions? Are you interested in getting involved?

If you have questions after reading this report, please connect with us through the following channels:

Join ABIM Governance

The Medical Oncology Board has three openings for terms beginning July 1, 2025:

In addition, the ABIM Council has three openings for terms beginning July 1, 2025:

Applications are due July 22, 2024, and appointments are expected to be announced in spring 2025.

Openings on ABIM’s Approval Committees will be announced fall 2024. Visit the website for a complete list of current openings.

*Indicates society guests were present for this session.

ABIM governance, ASCO, Medical oncology, Medical Oncology Board, Summary Report, Suresh Nair

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