Summary Report: Fall 2019 Critical Care Medicine Board Meeting

Summary Report: Fall 2019 Critical Care Medicine Board Meeting

Meeting Highlights

J. Christopher Farmer, MD | Chair, Critical Care Medicine Board

At our fall meeting, ABIM’s announcement regarding the development of a longitudinal assessment option for Maintenance of Certification (MOC) was a central focus. We also touched on a number of other key issues for ABIM and the critical care medicine community, and received important updates from ABIM leadership. The following is a report covering the highlights of our meeting.

About the Longitudinal Assessment Option

Richard J. Baron, MD, ABIM President and CEO, addressed the Specialty Board and provided an update on the development of the longitudinal assessment option, and reactions of society partners and diplomates. He also described ongoing planning activities related to the new pathway and efforts to gain input from the many stakeholders in the physician community.

The longitudinal assessment option is anticipated to be available in 2022 and additional information on its features and transition plans will be provided at a later date. You are invited to share comments and suggestions here.

Following Dr. Baron’s update and presentations from other ABIM staff on the longitudinal assessment option, the Critical Care Medicine Board (CCM) shared their thoughts on the new pathway, and how it would work for intensivists.

  • The group illustrated how most physicians in their discipline have multiple certificates to maintain, and that having the option to take either a traditional 10-year MOC exam or the longitudinal assessment could help in maintaining their certifications in several areas.
  • Members agreed that the immediate feedback feature of a longitudinal assessment is an advantage. The group urged ABIM to communicate one’s assessment performance over time and the potential consequences of poor performance so that physicians can utilize the opportunity to improve.
  • When comparing the longitudinal assessment option to the 2-Year Knowledge Check-In (KCI), some members noted that they recently took the KCI and they had a good experience.

Society Engagement

The CCM Board was joined by guests from partner societies:

  • Peter Lenz, MD; President of the Association of Pulmonary and Critical Care Medicine Program Directors (APCCMPD)
  • Karen A. McQuillan, RN; Past-President of the American Association of Critical-Care Nurses (AACN)
  • Mangala Narasimhan, DO; Member of the American College of Chest Physicians (CHEST) Education Committee
  • Stephen M. Pastores, MD; Chancellor of the Society of Critical Care Medicine (SCCM) Board of Regents.

The Specialty Board had an open discussion with society guests about what their organizations needed from ABIM. The consensus was that continued dialogue with societies on a variety of topics would be welcome. ABIM was also encouraged to connect with other specialties that certify physicians in critical care medicine (e.g. Surgery, Anesthesiology).

One guest noted that having different groups at the table offers opportunities for all to learn from different perspectives and take potential changes back to their home organizations. Working together to discover more information about critical care practice patterns and having that influence the development of assessments would be perceived favorably. Another guest asserted that the younger generations in the discipline are focused on changing established practices, and there is a role for our organizations to help facilitate those changes.

Members and guests rounded out the conversation by discussing opportunities to share more information about the new longitudinal assessment option at upcoming society meetings as well as ways for ABIM and society partners to exchange ideas. 

ABIM Proposal to Co-sponsor Neurocritical Care Certificate

The group heard an update on the proposal for ABIM to co-sponsor the Neurocritical Care certification administered by the American Board of Psychiatry and Neurology. Both the Critical Care Medicine Board and the ABIM Pulmonary Board discussed this proposal at length over the course of the fall 2018 and spring 2019 meetings. The Pulmonary Board provided guidance to the CCM Board, which undertook an extensive vetting of the critical care community before the CCM Board, recommended to the ABIM Council and Board of Directors that ABIM pursue co-sponsorship of the Neurocritical Care Examination. 

During its October meeting, the ABIM Board of Directors voted in favor of ABIM applying to the American Board of Medical Specialties’ Committee on Certification (COCERT) to become a co-sponsor. ABIM would be co-sponsoring it as a tertiary certification, with Internal Medicine and Critical Care Medicine certifications as prerequisites after the practice pathway period closes. COCERT will review the proposal and we anticipate having an update on its decision by fall 2020 with the first exam scheduled to be administered in fall 2021.

Pre-Fellowship Procedures

The Critical Care Medicine Board discussed procedural competencies internal medicine residents should have an opportunity to perform before they transition successfully to a pulmonary/critical care medicine fellowship, i.e. pre-fellowship procedures. The concept of “pre-fellowship procedures” came out of the Internal Medicine Board’s decision that all residents must do some procedures, but not all residents must learn the same procedures and Program Directors must make opportunities available to become competent in practice-specific procedures needed for their next level of training. Before its spring meeting, the CCM Board will work with APCCMPD and CHEST to gain more input from pulmonary/critical care medicine program directors and trainees about pre-fellowship procedures.

Diplomate Professional Profiles

The Diplomate Professional Profile is currently being updated to include specialty-specific questions.  Once it is finalized, diplomates will be asked to complete a periodic survey about the characteristics of their professional activity so that ABIM can assure relevancy of our programs and assessments based on what physicians see in practice. Members reviewed the questions that all diplomates answer on the survey, regardless of specialty. In addition, they reviewed and offered refinements to the critical care medicine-specific questions that all diplomates maintaining certification in critical care medicine will be asked.

Exam Committee Update

As part of ABIM’s organization-wide effort to enhance the connection between Exam Committees and their corresponding Specialty Boards, the Critical Care Medicine Board Exam Committee Chair, Victor Kim, MD briefed the group on how the Exam Committee work is evolving to meet the demand for more questions for ABIM assessments while maintaining the same quality and rigor. This entails collaborating with ABIM Item-Writing Task Forces whose work contributes to developing content by utilizing an innovative, model-based approach. The Task Forces’ question development techniques involve establishing a set of specifications for creating exam questions for a given content area. These specifications are then used to produce many high-quality questions in a given subject area.

In Closing

The Critical Care Medicine Board welcomes feedback and commentary from diplomates, society partners and the greater medical community. We believe you find this report to be valuable and informative.

Do you have any questions? Are you interested in how to get involved?

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

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