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Pulmonary Disease Board Meeting Summary | Spring 2024

July 1, 2024  |  Posted by ABIM  |  Specialty Board Meeting Summaries

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

The Pulmonary Disease Board held its spring meeting on Friday, May 10, 2024. The agenda provided an opportunity to update the Pulmonary Disease 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 representatives of the American College of Chest Physicians (CHEST), the American Association for Bronchology and Interventional Pulmonology (AABIP), the American Thoracic Society (ATS),the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD) and the Society of Critical Care Medicine (SCCM).

The Pulmonary Disease Board gratefully acknowledges the service of Corinne R. Young, MSN, FNP-C, FCCP, whose term on the Specialty Board ends June 30, 2024. Ms. Young has served as a member since 2018. Learn more about her on the ABIM Blog.

The following is a summary of the spring meeting.

Conversation with the President*

Prior to the meeting, members and guests of the Pulmonary Disease 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 Maintenance of Certification (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updated the way it reports certification status for physicians to be more transparent about why some certificates are no longer active, such as being “Revoked,” “Suspended” or “Lapsed.”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 this report, Furman S. McDonald, MD, MPH, who currently serves as ABIM’s Senior Vice President, Academic and Medical Affairs, has been announced as ABIM’s new CEO, effective September 1, 2024.

Some members of the Specialty Board raised questions or offered suggestions about the MOC program, such as identifying a way for newly certified diplomates to participate in the Longitudinal Knowledge Assessment (LKA®) before their assessment due year. Additionally, ABIM is holding listening sessions with early career physicians (those within the first 10 years of initial certification) to better understand their needs, how they want to engage with ABIM, and how to better communicate with them about ABIM. The group also discussed the value of MOC points and how the MOC points requirement affects the way physicians engage with educational materials.

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 Pulmonary Disease 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.

Suggestions from the group included providing more detailed data about the LKA to societies. Dr. Battaglia noted that as it launched in 2022, the first cohort of physicians who enrolled in the LKA have not yet completed their first five-year cycle, and that as time goes on and more data accumulate, ABIM will be able to share more. He also noted the specialty knowledge gaps reports currently available on the website.

The group also discussed proposed changes to the MOC points requirement, which were vetted with societies with mixed reactions. The ABIM Council, in a meeting following this one in June, chose to defer any changes for the time being, agreeing that ABIM should work with key stakeholders to identify ways to mitigate the concerns raised, then revisit the issue after some of those conversations have been held.

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 Pulmonary Disease 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:

The group discussed what motivates diplomates to choose the LKA, with one of the reasons being its flexibility. One member of the group observed that there may be more diplomates switching from the LKA back to the traditional, 10-year MOC exam in the future. ABIM will continue to offer the longform exam so that diplomates can choose the assessment option that works best for them.

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, with  launch targeted 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.

During conversation, staff clarified that focused versions are not a way for diplomates to create their own assessments, but rather a tailored option of the general assessment with more questions in one area of the discipline. Data will determine where there is a need and a sufficient number of physicians who focus their practice in a particular area of the specialty to support the development of a focused assessment. ABIM uses a variety of sources to obtain data, including surveys of the physician community, cluster analyses and Medicare data used for comparison and validation. The group agreed that a survey of the pulmonary disease diplomate community would be useful and will be meeting later this summer to discuss details of the survey questions.

Proposal from AABIP: Interventional Pulmonology as a Subspecialty*

Representatives of AABIP addressed the Specialty Board with a proposal to begin the process of considering interventional pulmonology a subspecialty of pulmonary disease with its own distinct certificate. Septimiu Murgu, MD, President of AABIP; Carla Lamb, MD, Vice President of AABIP; Hans Lee, MD, FCCP, AABIP member and Vice Chair of the Education Committee for CHEST; John Mullon, MD, FCCP, FACP, AABIP Member and Co-Chair of the Joint Interventional Pulmonology Fellowship Accreditation Committee for AABIP; Nicholas Pastis, MD, AABIP member and Chair of the Certification Committee, and Sonali Sethi, MD, Secretary-Treasurer of AABIP, shared how interventional pulmonology meets the criteria for New and Emerging Disciplines in Internal Medicine-2 (NEDIM-2) for recognition as a new subspecialty area and invited questions from the group.

Society guests departed at this point in the meeting.

Following discussion, the Pulmonary Disease Board voted in favor of vetting the physician community on the idea of creating a new subspecialty certificate in interventional pulmonology. The last time a similar process was followed was in 2018–2019 when ABIM vetted the diplomate community on whether to become a cosponsor of the neurocritical care medicine exam, which resulted in the current Neurocritical Care Certification Program.

Update on the Pulmonary Disease Approval Committees

Neil S. Freedman, MD, Northshore University Health System, Chair of the Pulmonary Disease LKA Approval Committee

ABIM Approval Committees are responsible for approving and editing all assessment content, and maintaining the blueprints for the Initial Certification Exam, the MOC Exam and the LKA. There are two ABIM Approval Committees related to pulmonary disease: the Traditional, 10-Year MOC Exam Approval Committee (which is also responsible for the initial certification exam), and the LKA Approval Committee. Dr. Freedman provided a brief update for the Specialty Board on the composition of the Approval Committees, progress on item development in meetings this year and news about the Item-Writing Task Force. He also noted the upcoming end dates of some item-writer terms and the need for more item-writers in the discipline, encouraging members of the group to refer colleagues to apply.

For more information about openings in ABIM Governance and the volunteer Item-Writing Task Forces, visit the website.

New Ways to Recognize Diplomates for Their Commitment to Staying Current

ABIM is exploring new ways to recognize physicians who participate in the MOC program. This includes finding opportunities 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 Pulmonary Disease Board, including a number of proposed ideas 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.

Suggestions from the Specialty Board included suggestions such as recognizing performance on the LKA with a reduced number of questions per year or per quarter or giving time off from requirements as recognition for completing set milestones in certification. Others noted that patients do not recognize or understand what is meant by or involved in Board certification and pointed out areas of improvement for the ABIM website to improve meaningful recognition for diplomates and communicate better about requirements. They stressed the importance of providing clear communication and guidance, especially for newly certified physicians unfamiliar with the process.

Procedural Requirements for Initial Certification in Pulmonary Disease

In October 2023, during a joint session with the Critical Care Medicine Board, the Pulmonary Disease Board discussed whether changes should be made to the procedural skills required for initial certification in their disciplines, part of a series of conversations on this topic that have been occurring since 2022. At that meeting, the two Specialty Boards reviewed survey data about how often certain procedures are performed in clinical practice and whether the procedural requirements for ABIM certification remain relevant to current practice. Since then, ABIM has been engaging with stakeholders in the discipline on policy questions, with plans to share findings with program directors later this year. Next, ABIM will begin the process of analyzing and publishing the survey results through a writing group comprising members of the two Specialty Boards. More information will be available in the fall.

Announcing the Appointment of a New Specialty Board Member

Each year, ABIM initiates the process to recruit for openings on the Specialty Boards; each member serves a three-year term with the option for one renewal, and positions open on a rolling basis each year. Openings are posted publicly on the website and shared with stakeholder groups. Upon completion of the application process, the Specialty Board chair reviews all applications and asks members of the Specialty Board to conduct candidate interviews and make recommendations. Special attention is paid to the composition of each Specialty Board, such as practice setting and region, career stage, educational background (U.S., international) and race and ethnicity. Final selections are made by the ABIM Council based on the Specialty Board’s top two recommendations.

At the spring meeting, the Pulmonary Disease Board discussed the most recent opening for a term beginning July 1, 2024. The opening was posted on ABIM’s website in July 2023 and applications were accepted through mid-September. Specialty Board members conducted interviews with candidates and at the fall meeting recommended two for the Council’s consideration.

In December, the Council appointed Abdullah Alismail, Ph.D., RRT, FCCP, FAARC, ATSF, of Loma Linda University, to serve as the new interprofessional health care team member of the Pulmonary Disease Board starting in July.

Look for emails this summer announcing openings on the Pulmonary Disease Board. Visit ABIM’s website for a full list of current openings.

In Closing

The Pulmonary Disease 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 ABIM Council has three openings for terms beginning July 1, 2025:

Applications are due August 12, 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, interventional pulmonology, Lynn Tanoue, Pulmonary Disease, Pulmonary Disease Board, Summary Report

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