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Pulmonary Disease Board Meeting Summary | Spring 2025

August 25, 2025  |  Posted by ABIM  |  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 ABIM policy and assessment in the specialty, held its spring meeting on May 6, 2025. This meeting included a joint session with the Critical Care Medicine Board to discuss pertinent issues for both disciplines. Representatives from the American Association for Bronchology and Interventional Pulmonology (AABIP), 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) and the Society of Critical Care Medicine (SCCM) joined for a portion of the joint session*.

ABIM and the Pulmonary Disease Board gratefully acknowledge the service of Susan Murin, MD, and Kevin M. O’Neil, MD, whose terms ended June 30, 2025. They both joined the Specialty Board in 2019.

The following is a summary of the spring meeting. Visit the ABIM Blog for reports of prior meetings. To share your feedback with the Pulmonary Disease Board on this report or other issues that are important to you, please complete this brief survey.

Contents:

Interventional Pulmonology as a New Subspecialty of Internal Medicine*

The Pulmonary Disease Board is formally considering a proposal from AABIP to recognize interventional pulmonology as a subspecialty of pulmonary disease with its own distinct certificate. ABIM issued a public call for comment on the proposal in March 2025. Results of the survey were mixed but indicated general support from the pulmonary medicine community. Concerns raised by survey participants included potential impact on practicing pulmonologists, limitations of access to training opportunities, whether enough specialists practice in the area to support assessment and scoring and how certification might impact patient access to procedures. Ultimately, any decision will be informed by data, with careful  attention to inclusive engagement of stakeholders, particularly those currently practicing who have not had formal interventional pulmonology training. Should a new certification be approved in the future, the Pulmonary Disease Board would be responsible for defining the relevant knowledge and procedural standards that ultimately inform assessment.

Following a discussion with the Critical Care Medicine Board and society guests, and considering the themes identified in public comment, the Pulmonary Disease Board gathered separately to discuss next steps. The Specialty Board was persuaded by the strong alignment between interventional pulmonology and the criteria recognized for New and Emerging Disciplines in Medicine (NEDIM-2) to move forward to gain more insights from diplomates who raised concerns about the initial proposal, gather information relating to possible non-training eligibility pathways, and presenting the proposal for further consideration by the ABIM Council.  Additionally, the Pulmonary Diseases Board and the Critical Care Medicine Board are in the process of evaluating the training requirements for initial certification in the two disciplines (see below), which includes discussion of the standard for performance of EBUS in pulmonary medicine training being relevant to the proposal relating to interventional pulmonology. 

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

  • Nitin Bhatt, MD, of the Ohio State University, as Chair of the Pulmonary Disease Longitudinal Knowledge Assessment (LKA®) Approval Committee. Dr. Bhatt has served as a member of the committee since its inception in 2022 and served on the previous Pulmonary Disease Board Exam Committee and Item-Writing Task Force for two years.
  • Gopal Allada, MD, of Oregon Health & Science University, as a new member of the Pulmonary Disease LKA 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 Pulmonary Disease Approval Committees

Anne Dixon, MD, MA, BM BCh, Chair of the Pulmonary Disease Traditional, 10-Year Maintenance of Certification (MOC) Exam Approval Committee, and Neil S. Freedman, MD, Chair of the Pulmonary Disease LKA Approval Committee, reviewed recent meetings and the member composition of the Approval Committees, rates at which items are approved for use on assessments, and goals for item development with the Item-Writing Task Force. The Approval Committee reviewed more than 300 new questions and 650 existing questions to ensure content on the Pulmonary Disease assessments remains current, part of a process that ABIM and the Approval Committees conduct regularly. The chairs also noted that their committees aim to enhance question quality by continuing to fine-tune the feedback they deliver to Item-Writers.

ABIM and the Approval Committees plan to conduct a public blueprint review process in the fall. Board certified pulmonologists will receive email notifications from ABIM alerting them to the opportunity to participate and provide feedback on the topic areas and the criticality and frequency of specific procedures in their experience.

Climate Change and Health Inequities

The Pulmonary Disease Board discussed whether and how to integrate climate change in assessment questions. Several members raised concerns about relevance to the discipline, while others noted the correlation of climate-related events (like wildfires) with pulmonary conditions and how climate effects can affect disease management, for example inhaler composition. They debated whether raising awareness of how climate change can affect existing conditions would be preferable to creating new topic areas for assessment, and determined that the blueprint review in the fall would provide the opportunity for the community to weigh in on this question effectively.

Focused Assessments in Pulmonary Disease

In spring 2024, the Pulmonary Disease Board agreed that ABIM should proceed with surveying the physician community about practice patterns that could inform the development of a version of the LKA focused in a subspecialty area of pulmonary disease. ABIM is currently developing focused assessments in gastroenterology, hematology and medical oncology based on focused areas  identified by board certified physicians and societies, and through analysis of Medicare data. Rebecca S. Lipner, Ph.D., Senior Vice President, Assessment and Research for ABIM, reviewed the process that ABIM uses to identify potential areas for focus, which includes broad surveys of the community. The group agreed that pursuing the discovery work would be valuable and would also coincide with the explorations around interventional pulmonology.

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 Pulmonary Disease Board received an overview of the team’s current projects and in particular discussed the benefits and challenges of using AI tools in assessment development, such as the potential for greater productivity and exploring different formats for questions. Staff noted that use of AI tools remains exploratory and augments the work of human physicians and testing experts. They also discussed possibilities like using AI to support the creation of simulation patients and the development of constructed responses (rather than multiple-choice questions) that could be matched to preset responses. Specialty Board members felt these were important and innovative steps forward, but emphasized the need for a cautious approach when incorporating new item types into assessments.

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. One member suggested incorporating trend data for sleep apnea and staff shared that the report would also include a map of per capita figures by state population. One of the hoped-for outcomes of the report would be to stimulate further research and conversation in the physician community about workforce trends and other areas.

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 with a proportionate number in pulmonary disease. Siddharta G. Reddy, MPH, Senior Research Associate for ABIM, reviewed some of the aggregate data gathered so far related to pulmonologists, including practice setting, practice size and physician ownership of practices. Of note, 87% of respondents reported being clinically active, largely split between hospital inpatient practice (32%), academic faculty practice (31%), hospital- or system-owned practice (29%) and private practice (26%). Practice structure was mostly multi-specialty group practice and hospital- or health system-owned.

Dr. Tanoue asked how long it would take to attain 100% completion rate of the Diplomate Professional Profile. Mr. Reddy explained that ABIM expects the process to take two or three years, but physicians who have no need to visit the Portal (for example after retirement) and other factors may mean that 100% completion is never attained. ABIM expects total participation to reach the upper 80% range in time.

Community Practice in ABIM Governance

Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs, led a discussion with the Pulmonary Disease Board on 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.

The group discussed the complexities of defining and categorizing physician practice settings, especially private practice where the lines are more blurred. Suggestions included adding safety net hospitals and “community-based academic practice” as a hybrid choice. Ultimately, the group agreed that a broader, more inclusive definition is needed, which ABIM will continue to refine based on all of the Specialty Boards’ input this spring.

Nomenclature for the Specialty

The Specialty Board considered a proposal from the chair to change the official name of the specialty from “Pulmonary Disease” to “Pulmonary Medicine” to more accurately reflect the scope and nature of the field. This change would apply to official nomenclature like the name of the Specialty Board and associated Approval Committees that it oversees, the names of the assessments (the Pulmonary Disease Certification Exam, the Pulmonary Disease Traditional, 10-Year MOC Exam, the Pulmonary Disease LKA) and broad references to the discipline in other communications. ABIM has a process for pursuing this kind of change which includes seeking input from the physician community, medical societies and partner organizations to identify support for and understand the implications of a name change, securing approval from the ABIM Council and the Board of Directors, and submitting the request to the American Board of Medical Specialties (ABMS) for additional stakeholder vetting and final approval.

After discussion, the Pulmonary Disease Board expressed interest in continuing the discussion of changing the name of the specialty.

Joint Session with the Critical Care Medicine Board

ABIM Leadership Update*

Furman S. McDonald, MD, MPH, President and Chief Executive Officer of ABIM and the ABIM Foundation, joined the Specialty Boards 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 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.

The group discussed how to better engage early career physicians through stronger partnerships with medical societies, noting the societies’ role in education and staying current. The relationship between ABIM and societies was seen as an area of continued importance. Dr. McDonald also mentioned ongoing collaboration with other ABMS Member Boards to slow the spread of medical misinformation and address other challenges to the medical community. He affirmed ABIM’s commitment to evidence-based medicine and working with societies to defend scientific standards.

Some members of the group also inquired about AI’s role in training and assessment. Dr. McDonald explained how ABIM monitors the impact of AI on assessment and how new technologies can be used to enhance staff processes.

Specialty Boards 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 Critical Care Medicine and Pulmonary Disease Boards received statistics on the current state of active certification in their disciplines, 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.)

Of note: 22,886 physicians have been ABIM Board Certified in Pulmonary Disease since it was first offered in 1941 with 17,776 currently holding a valid certificate. Since Critical Care Medicine became an independent certificate in 1987, 21,232 physicians have been ABIM Board Certified in Critical Care Medicine, with 14,869 currently holding a valid certificate. 12,236 physicians maintain certification in both Pulmonary Disease and Critical Care Medicine, while 2062 physicians maintain certification in Pulmonary Disease, Critical Care, and Sleep Medicine. There is also a small overlap (124) with Hospice and Palliative Medicine, Critical Care Medicine and Pulmonary Disease. Small numbers of physicians certified in critical care medicine also maintain certifications in cardiovascular disease, nephrology, or infectious disease.

The LKA continues to be a leading choice of physicians due for an assessment in 2024. Of ABIM board certified pulmonologists and critical care physicians who chose to take an ABIM assessment in 2024, 73% chose the Pulmonary Disease LKA and 69% chose the Critical Care Medicine LKA . In addition, 99% of cosponsored (i.e., physicians who qualified for certification in Critical Care Medicine through another ABMS Member Board such as the American Board of Emergency Medicine) critical care medicine physicians are recertifying through the LKA.

A chief topic of discussion was how physicians maintaining multiple certifications manage the LKA, which provides 30 questions each quarter in each discipline for a five-year cycle. Some Specialty Board members raised concerns over the ability of physicians to manage answering 60 or 90 questions each quarter if they maintain multiple certifications. The idea of reducing question loads for dual- or triple-boarded physicians has been raised before and ABIM is still exploring whether this is possible to do while upholding the security and fairness of the assessment. Some in the group suggested using AI tools or adaptive testing, but they agreed on the need for more data overall related to practice settings and trends in how physicians choose assessment options, including whether they drop out of the LKA and register for the traditional exam over time.

Initial Certification and Training Data in Critical Care Medicine and Pulmonary Disease*

The Specialty Boards 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 their specialties. Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs for ABIM, also explained more about the special consideration pathways available for physicians with different training backgrounds offering alternative routes to Board Eligibility. ABIM expects to announce a new pilot pathway later this summer 2025 for “exceptionally qualified” international medical graduates who received medical education or training outside of the United States but who complete an ACGME-accredited fellowship. ABMS reviewed and approved the pilot in June.

Initial Certification Procedures*

The Pulmonary Disease Board and Critical Care Medicine Board are in the process of determining which procedures should be required to qualify for initial certification in the two specialties following fellowship, and whether any changes are needed.  They discussed the need for each Specialty Board to be responsible for making recommendations separately and agreed to institute working groups comprising Specialty Board and Approval Committee members to help define standards before opening a public comment period. They also discussed how program directors can be invited to contribute feedback about overlapping areas of training; program directors are routinely included in procedural requirement review processes.

More information will be forthcoming. Once draft recommendations have been made, ABIM will invite the physician community to provide input for the Specialty Boards to consider before making final decisions about training requirements for fellows. There would be at least one year between the Specialty Boards’ decisions and the requirements becoming effective for fellows entering pulmonary and/or critical care medicine fellowship. 

Supporting Research and Important Issues in the Disciplines*

Dr. Johnson led the Specialty Boards in a discussion about opportunities for ABIM Governance members to support important issues and research that demonstrates the value of board certification. Dr. Johnson asked the Specialty Boards to identify current or emerging issues that affect health care in critical care medicine and pulmonary disease, and to consider opportunities for the Specialty Boards to address these issues within the appropriate framework of their oversight of the disciplines.

Colleen Connor, a patient member on the Pulmonary Disease Board living with pulmonary hypertension and a member of the Board of Trustees of the Pulmonary Hypertension Association (PHA), spoke about efforts to improve access for people who need oxygen. She explained how some patients face significant barriers accessing supplemental oxygen equipment, sometimes forcing them to remain hospitalized longer or remain homebound due to a lack of portable options. This particularly impacts patients with advanced lung disease who require higher oxygen flows but cannot access liquid oxygen—the lightest, most portable option—because insurance reimbursement rates limit its availability, thereby limiting their independence. She stressed the need to spread awareness to healthcare centers and physicians as more patients need this support. Ms. Connor also shared that Congress is considering the Supplemental Oxygen Access Reform Act (SOAR), a bipartisan bill that shifts focus from “home oxygen” to “supplemental oxygen” to ensure liquid oxygen availability and support full lives outside the home for people who need oxygen.

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

ABIM governance, Critical Care Medicine, Lynn Tanoue, Pulmonary Disease, Pulmonary Disease Board, Summary Report

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