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Pulmonary Disease Board Meeting Summary | Fall 2024

November 19, 2024  |  Posted by admin  |  Specialty Board Meeting Summaries

Lynn T. Tanoue, MD, MBA, Chair, ABIM Pulmonary Disease Board

The Pulmonary Disease Board—which meets twice a year and is responsible for oversight of policy and assessment in the specialty—held its fall meeting on October 1, 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 Critical Care Nurses (AACN)
  • The American College of Chest Physicians (CHEST)
  • The American Thoracic Society (ATS)
  • The Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD)
  • The Society of Critical Care Medicine (SCCM)

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

Contents:

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 Maintenance of Certification (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 pulmonary disease. Completion rates are higher among subspecialists and physicians enrolled in the LKA.

Diplomates are encouraged to log in to their Physician Portal to review the DPP if they haven’t already done so.

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

Natalie S. Plummer, Esq., Manager, DEI Programs at ABIM, and Pamela White, Senior Vice President, Communications, and Chief DEI Officer, 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.

In conversation, some Specialty Board members made suggestions such as including Middle Eastern and North African descent as an option for race and ethnicity in the Physician Portal and described successful DEI efforts at their own institutions while acknowledging further work that still needs to be done.

Interventional Pulmonology as a Subspecialty*

At its spring meeting, representatives of the American Association for Bronchology and Interventional Pulmonology (AABIP) addressed the Pulmonary Disease Board with a proposal to begin the process of considering interventional pulmonology a subspecialty of pulmonary disease with its own distinct certificate, noting how interventional pulmonology meets the criteria for New and Emerging Disciplines in Internal Medicine-2 (NEDIM-2) for recognition as a new subspecialty area. As a result of the discussion, ABIM has created a plan for gathering community input on a new proposed subspecialty certificate in interventional pulmonology. This comprehensive process would involve stakeholder feedback from multiple groups including diplomates and pulmonary fellows. Both ABIM and the American Board of Medical Specialties (ABMS) would have to approve a new certificate. If approved, the rigorous process to engage stakeholder input and follow ABIM and ABMS policies may take several years before a new certificate would officially become an available opportunity.

Revisions to Procedural Requirements for Initial Certification in Pulmonary Disease*

Since 2022, the Pulmonary Disease Board has been working on identifying and evaluating potential changes to the initial certification requirements for the specialty, which have not been revised since 1991. ABIM has a standardized, structured approach to the consideration of changes to procedural requirements for certification which it has followed in other subspecialties of internal medicine, and which is guiding this review. To inform these discussions, ABIM has gathered data on clinical practice and the relevance of the current requirements through surveys of the diplomate population and other stakeholder groups. The Critical Care Medicine Board is likewise examining the initial requirements for certification in Critical Care Medicine. Given the overlapping nature of diplomates and procedural requirements in the two disciplines, the Specialty Boards hold periodic joint discussions on a regular basis.

In addition to current ABIM procedural requirements, the Specialty Boards requested data collection on the following suggested procedural competencies: intubation, diagnostic and procedural guidance on point-of-care ultrasound (POCUS), percutaneous tracheostomy and non-tunneled vascular access for temporary dialysis. Next, ABIM will share the suggestions with the program director community before synthesizing all findings for the Specialty Boards’ final consideration and decision-making. There will be the ability to differentiate on the extent of competency, for example, identifying required procedures that all fellows must be trained to “perform competently” for board eligibility, and “opportunity to train” procedures, which training programs must offer for fellows who identify a need for proficiency (not for board eligibility).

Hans Lee, MD, Chief of Learning for CHEST, encouraged the Specialty Board to consider how new requirements are made at a time of rapidly emerging technological innovations.

ABIM News and Conversation with the President*

Prior to the meeting, members and guests of the Pulmonary Disease 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 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 and 20% of eligible diplomates continue to prefer the traditional, 10-year MOC exam.
  • 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 by making the program simpler. The requirement to earn at least 100 MOC points every five years remains in effect.

On the topic of the LKA, several members of the group raised questions reflecting on its success rate among diplomates and its potential impact on assessment in the future, as well as concerns about time limits on questions. ABIM has been exploring how to address feedback about time limits among other enhancements based on physician input. On average across all specialties, physicians participating in the LKA answer questions in less than two minutes, and 66.1% of survey respondents indicated that they are satisfied with the time allotted per question while 22% indicated they were not satisfied. ABIM remains committed to offering the traditional, 10-year MOC exam as an option for those who prefer it over the LKA.

The group also briefly reflected on how advancements in artificial intelligence may affect certification and assessment in the future, and the importance of evolving with emerging technologies and using AI as a tool to make the organization’s work better and more efficient.

Setting a Quality Agenda in the Discipline*

In 2021, the 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 2024 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, noted that the quality agenda will not be static, but is expected to continue evolving as the field addresses quality gaps and identifies others. ABMS has not imposed an immediate deadline but rather focused on progress as a goal. This initiative is not a return to the former requirement for diplomates to report individual practice quality projects.

Society guests 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 openings on the Pulmonary Disease Board for a pulmonologist practicing in a non-academic, community setting, and an early career pulmonologist for terms beginning July 1, 2025. The announcement received a robust response from numerous outstanding candidates. At the fall meeting, the Pulmonary Disease Board discussed the candidates they had interviewed and voted on two for each position to recommend to the Council. ABIM will announce the final appointees in spring 2025 prior to the start of their terms.

Learn More

The Pulmonary Disease 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 society representatives were present for this agenda topic.

ABIM governance, LKA, Lynn Tanoue, Pulmonary Disease, Pulmonary Disease Board, Summary Report

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