Summary Report: Fall 2020 Endocrinology, Diabetes and Metabolism Board Meeting

Summary Report: Fall 2020 Endocrinology, Diabetes and Metabolism Board Meeting

Fall 2020 Meeting

The fall meeting of the Endocrinology, Diabetes and Metabolism Board comes at an extremely important time for ABIM and its diplomates. The ongoing fight against the COVID-19 pandemic has brought many challenges upon the physician community, and it is against this backdrop that ABIM virtually convened the eight members of the Specialty Board to discuss moving the discipline forward.

Below is a recap of the key topics discussed during the fall meeting:

Ashok Balasubramanyam, MD | Chair, Endocrinology, Diabetes and Metabolism Board

Leadership Update

Richard J. Baron, MD, ABIM President and CEO, addressed the Endocrinology, Diabetes and Metabolism Board and commented on recent issues that have arisen in health care due to the pandemic, including the disparities in COVID-19 infection and mortality rates in Black and Brown communities. He reiterated the important role ABIM and the ABIM Foundation play in addressing these issues, calling forth the organization’s joint Statement on Racial Justice issued over the summer and new initiatives to make this vision a reality, including a grant program to build trust and equity in internal medicine training. He also noted the increasing mistrust in medicine and institutions occurring broadly across swaths of society, and that ABIM Board Certification may be more meaningful now than ever as it serves as a demonstration of knowledge and professionalism upon which patients rely.

He then highlighted key ABIM policy decisions that were made this spring to offer physicians more flexibility in maintaining their certification in response to the pandemic:

  • No one will lose certification if they aren’t able to complete a Maintenance of Certification (MOC) requirement this year.
  • Physicians that have an assessment, attestation or points due in 2020 will have until 12/31/21 to complete them.
  • Physicians currently in their grace year will be afforded an additional grace year in 2021.
  • Those physicians whose Board Eligibility expires in 2020 may take the exam in their discipline in either 2020 or 2021, whichever works best for their individual situation.

Dr. Baron also provided an update on progress in developing a longitudinal assessment pathway, scheduled to launch in Endocrinology, Diabetes and Metabolism in 2022. While this new pathway will better integrate education with assessment, Dr. Baron noted that it is still an assessment, and that a summative pass/fail judgement will be made at the end of a five-year cycle. More information about the longitudinal assessment pathway can be found later in the Specialty Board meeting summary.

New proposed ABMS Standards

The American Board of Medical Specialties (ABMS) Standards Task Force was created in July 2019 as a byproduct of the ABMS-sponsored Continuing Board Certification: Vision for the Future Commission (Vision Commission). The group is drafting new standards, incorporating many recommendations of the Vision Commission. It is anticipated that a draft of the new standards will be available for public comment in late 2020/early 2021 – with potential adoption of final standards by ABMS in mid-2021. The Specialty Board anticipates discussing this topic again at its spring meeting once the new ABMS draft standards have been made public.

Reimagining the MOC Point System

ABIM has taken a proactive approach to evaluating its MOC points system, which is aligned with the ABMS requirements for lifelong learning and self-assessment. Currently, ABIM diplomates are required to earn 100 MOC points every five years to maintain their certification, and to earn any amount of points every two years to be listed as “participating in MOC.”

Specialty Board members provided observations about the current MOC points system and whether they thought it helped endocrinologists stay current in knowledge and practice. They also discussed knowledge areas and skills that could be better recognized in the current MOC system, or by new activities created by external partners (e.g. professional societies, healthcare systems, medical schools). 

This topic will be explored again at future ABIM Governance meetings, and ABIM is planning outreach to diplomates and stakeholder organizations this fall in order to gather feedback.

Longitudinal Assessment Pathway Update

The Specialty Board dedicated a session to discussing progress on the longitudinal assessment pathway, scheduled to become available in Endocrinology, Diabetes and Metabolism in 2022.  Since the initial announcement in August 2019, ABIM has released many details:  

  • The longitudinal assessment pathway will have a five-year cycle and include both a participation requirement and performance standard:
    • Participation: Physicians will be offered 120 questions each year, for a total of 600 over five years; physicians will only have to complete 500 questions over the 5 years though. 

Because ABIM understands that physicians have times when professional or personal responsibilities are especially demanding, they can take a break from the longitudinal assessment—skipping up to 100 questions over the course of each five-year cycle—without penalty.

    • Performance: Feedback relative to the standard will be provided over the course of the five-year cycle, and a final passing determination will be calculated at the end of year five.
  • It is a lower-stakes assessment option:
    • Physicians cannot lose certification if they do not successfully meet the participation requirement or performance standard for the longitudinal pathway.
    • In those instances, they can pass the traditional, 10-year MOC exam the following year to remain certified.
  • There are many key features of longitudinal assessment that differentiate it from ABIM’s current assessment options, some of which include:
    • The assessment promotes learning by providing immediate feedback, rationales and references for most questions.
    • Questions can be answered any place or time, and the platform will be available on mobile phones, tablets, laptops and desktop computers.*
    • Physicians will have four minutes to answer each question, along with a pool of extra time to access if necessary. 
    • There is no camera monitoring in use while answering questions; user identity and assessment security is achieved using alternative methods of validation.

*For questions that contain media files with audio, video or still images, the user experience is optimized on a laptop or desktop computer.

  • The longitudinal assessment rollout schedule (see below):

As part of the longitudinal update in the Fall 2020 News and Notes that was emailed to all ABIM diplomates, Dr. Baron shares a video overview of the new pathway and its features that physicians can look forward to.

Endocrinology, Diabetes and Metabolism Board members discussed the longitudinal assessment updates with senior ABIM staff, and shared their thoughts on what has been developed thus far as well as the elements of the pathway that still need to be formalized.

Board members asked if it would be possible to incorporate Practice Profiles, which the Specialty Board has discussed in the past. This was first explored in 2018 by an Endocrinology Specialization Task Force that included representation from ABIM, the Endocrine Society and the American Association of Clinical Endocrinologists (AACE). This approach would utilize practice data from physicians participating in MOC to determine what profiles of practice specialization exist in endocrinology and whether there are enough physicians in a particular specialization area. These Practice Profiles would then be used to create customized MOC assessments for different kinds of generalist endocrinologists, who see a range of patients but have a concentration in a particular area.

ABIM Senior Vice President of Assessment and Research, Rebecca Lipner, PhD, shared that ABIM is actively exploring Practice Profiles and will look into the possibility of utilizing them as part of the longitudinal pathway after all disciplines have launched in 2023. In addition to endocrinology, diabetes and metabolism, ABIM is exploring the possibility of Practice Profiles in other disciplines such as medical oncology, hematology and gastroenterology; Dr. Lipner pointed out that the approach is more feasible in some disciplines than others.

Diplomates are encouraged to provide feedback as additional features of longitudinal are still in development.

Enhancing the Connection between ABIM Governance and the Physician Community

ABIM Governance includes a diverse and talented group of over 350 members across more than 50 boards and committees. They are critical to helping ABIM achieve its mission to enhance the quality of health care by certifying internists and subspecialists who demonstrate the knowledge, skills and attitudes essential for excellent patient care. One of the ways they do this is by being connected to the community – sharing updates, having conversations with colleagues and collecting feedback.

During this session, members discussed ways to effectively communicate with the community and some shared their firsthand experiences. They spoke of simple engagement such as initiating a conversation with colleagues to garner feedback on longitudinal assessment, or more in-depth activities such as writing articles, making presentations or recording videos to better connect with fellow physicians on a personal level.

Exam Blueprint Update

The Endocrinology, Diabetes and Metabolism Board was joined by former Specialty Board member and current Exam Committee Chair, Paul W. Ladenson, MD, who informed the group about the Endocrinology, Diabetes and Metabolism MOC Exam Blueprint that was updated in January 2020. Exam blueprints show content specifications for each exam, including an outline of the content areas and approximate percentages for a typical exam. They are periodically reviewed by ABIM diplomates to inform and update all MOC assessments created by ABIM, with oversight by the Exam Committee.

Dr. Ladenson also provided an update on the Endocrinology, Diabetes and Metabolism Exam Committee, which has held two virtual meetings since the start of the pandemic with high levels of member participation. The Endocrinology, Diabetes and Metabolism Exam Committee and the Item-Writing Task Force have been tasked with developing the question content for all initial certification and MOC assessments, including the new longitudinal assessment that will launch in 2022. Dr. Ladenson reported that he is pleased with the Exam Committee’s success in working remotely to fulfill these responsibilities

Discussion of Future Specialty Board Membership

The Endocrinology, Diabetes and Metabolism Board received many outstanding candidates for Specialty Board membership and dedicated significant time to discussing their qualifications. Throughout this process, special care is given to ensuring that new members enhance the group’s diversity in terms of age, gender, race/ethnicity, geographic location and practice type. Specialty Board members are ultimately chosen by the ABIM Council, who have oversight of Specialty Board composition across ABIM disciplines.

In Closing

The Endocrinology, Diabetes and Metabolism Board welcomes feedback and commentary from diplomates, society partners and the greater medical community.

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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