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Suresh G. Nair, MD, Chair, ABIM Medical Oncology Board

The Medical Oncology Board—which meets twice a year and is responsible for oversight of policy and assessment in the specialty—held its fall meeting on October 24, 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 American Society of Clinical Oncology (ASCO) joined for a portion of the meeting*.

ABIM and the Medical Oncology Board are pleased to note that in October, Suresh G. Nair, MD, Chair of the Medical Oncology Board, joined the ABIM Board of Directors as Council Director.

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

Contents:

ABIM News and Conversation with the President*

Prior to the meeting, members and guests of the Medical Oncology 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 Maintenance of Certification (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.
  • 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 and help promote engagement by making the program simpler.

The discussion continued around changes ABIM has implemented over the last decade. Dr. Nair noted how physicians want simplicity and stability in the program; Dr. McDonald agreed, adding that stability does not imply being static, and discussed how changes ABIM made in the past were necessary in order to achieve its goals of ensuring the certification program’s relevance and value.

The group also discussed concerns about mental health and burnout among health care providers, particularly in oncology. Dr. McDonald discussed ABIM’s role in conversations about burnout, noting that MOC is not a leading cause, but that there is a need for innovative solutions to multiple systemic challenges that contribute to burnout. He also spoke more about the Council’s initiatives to engage early career physicians across all specialties and funding dedicated to this purpose. Finally, he shared more about enhancements to the LKA, such as modifying the way ABIM requests feedback on LKA questions and the extension of the four-minute (now five-minute) time limit on questions that went into effect on January 1.

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 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 had completed their DPP to date, with a similar proportion of diplomates who held a Medical Oncology certificate having completed it. He also reviewed profile questions specific to medical oncology. The group discussed ways to increase participation in the survey and how the data could provide valuable insight into how specialists are practicing. Representatives of ASCO mentioned plans to coordinate with ABIM on communications strategies and sharing insights from ASCO’s own work on refining membership profiles. They also discussed the importance of accuracy in self-reporting on surveys and how this affects clarity in the public’s understanding of health care providers’ expertise, and what kind of medical expertise is available to patients seeking care.

Log in to your Physician Portal to complete the DPP survey.

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

Natalie S. Plummer, Esq., Manager, DEI Programs at ABIM, Lorna Lynn, MD, Vice President of Medical Education Research and Administrator of the Equity Committee, 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

The group discussed additional strategies and challenges in advancing DEI initiatives, emphasizing the importance of partnerships, persistence and leveraging tools like graduate medical education standards and data to promote DEI efforts. Some noted the lack of demographic categorization in research proposals, with hesitancy among certain groups to provide such information due to historical mistrust, and the need for clear communication about the intent of data collection. They also discussed collaboration with societies to improve diplomate participation in the Physician Portal self-identification survey.

The conversation also addressed socioeconomic barriers, with examples of clinics implementing initiatives to support patient access to care regardless of their medical conditions.

Ms. Plummer welcomed feedback on the project, and noted how the current study is focused on translating findings into actionable insights. The group discussed the idea of publishing a letter in a medical journal to reach broader audiences and agreed on the need for continuing dialogue to advance DEI initiatives in a meaningful way.

Update on Developing Focused Assessments in Medical Oncology*

At its spring 2024 meeting, the Medical Oncology Board discussed plans for exploring focused versions of the Medical Oncology LKA, similar to what ABIM did with the Hematology LKA. Rebecca S. Lipner, Ph.D., Senior Vice President, Assessment and Research, and Suzanne De la Cruz, Director of Test Development Operations, updated the Specialty Board on work that ABIM is doing to identify common practice profiles in the discipline in order to provide enhanced clinical content on the assessment pertaining to a subspecialty area of practice, while still testing across the general Medical Oncology Blueprint. At the time, the Specialty Board discussed plans to decide in December whether to develop profiles in medical oncology, which would require an increase in the number of item-writers and Approval Committee members to meet the need for writing more questions.

ABIM employs a data-driven approach to potentially identify common practice profiles that can form the basis of focused blueprints for the LKA. Following a survey of diplomates, ABIM researchers perform cluster analyses of the data and an analysis of Medicare data to see whether feasible practice profiles are present. ABIM also reviews the data and analysis with society partners, Approval Committee chairs and the Specialty Board prior to the latter’s decision.

In discussing the possible development of focused LKAs, the group touched on concerns about the time limit on questions, data supporting the time limit and possible solutions for these concerns. On January 1, 2025, ABIM announced that the four-minute time limit on LKA questions would now be extended to five minutes.

In December, the Medical Oncology Board voted to approve plans to develop two new versions of the Medical Oncology LKA—one with a focus on breast cancer, and one with a focus on hematologic neoplasms. ABIM announced a target launch of July 2026. Diplomates who are due for an assessment in 2025 or 2026 will receive reminders about the new options with details about how and when to enroll and switch to the one of the new versions.

Learn more about the new focused assessments in medical oncology on the ABIM Blog.

Engaging Early Career Physicians*

As mentioned during the Specialty Board’s earlier discussion with Dr. McDonald, the ABIM Council has instituted a task force to work on engaging early career physicians and residents, which has so far included listening sessions and group discussions about the early career physician experience. The task force’s goals are to build long-term relationships, identify needs and potential impacts at ABIM and involve a diverse range of early career physicians—including first-generation physicians—in ABIM’s policy and decision-making work.

The group discussed the importance of this work as early career physicians are navigating a changing environment, and the need to effectively engage them through channels they use (namely, social media). Several members of the group supported the idea of allowing diplomates to engage with the LKA earlier than 10 years after initial certification, which, they posited, could help foster a culture of lifelong learning that aligned with the intended goals of certification early in physicians’ careers before other priorities take precedence.

Setting a Quality Agenda in the Discipline*

In 2021, the American Board of Medical Specialties (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 2023 meetings and agreed on three key themes: addressing inherent bias and health disparities, enhancing physician well-being and improving access to quality care.

The work of setting a quality agenda has varied with each discipline of internal medicine. In the case of medical oncology, Elizabeth S. Ellent, MD, as a representative of the Specialty Board, worked with volunteers from ASCO to review work ASCO is already doing to improve the quality of care for patients. They identified gaps based on ASCO Certified Standards to share with the Specialty Board:

  • Addressing health disparities/access to care, such as diversity in clinical trial enrollment, food insecurities assessments, and screening and transportation challenges in underserved communities.
  • Improving patient communications, including discussions about goals of care and palliative or end of life care, survivorship care programs and ensuring patient education materials are appropriate based on the patient audience.
  • Understanding medication and treatment options: oral oncolytic therapy medication management, oncology treatment pathways, chemotherapy safety, avoiding emergency room and hospitalization, and developing triage pathway processes.

Dr. Stephen S. Grubbs, MD, FASCO, Vice President of Clinical Affairs for ASCO, noted how this represented the evolution of ASCO’s quality improvement. He shared more about ASCO Certified: Patient-Centered Cancer Care Standards for practices and how the process helps identify gaps in quality. One of the new tools ASCO developed is the Equity Quality Improvement Practice (EQuIP) site assessment, which identifies health disparity issues as well as a blueprint for performing quality improvement in those areas. ASCO is also developing a pilot for a program that will address barriers in clinical trial recruitment in underserved populations.

The group also touched on the need to rebuild trust with the patient community, for instance, in the area of clinical trials. They noted the challenges of finding patients to participate in clinical trials because of mistrust, as well as the need to address historical mistrust by acknowledging past atrocities of medical experimentation without consent. Many patients need further education about historical cases, and greater transparency about the purpose and benefits of current trials.

Update from ASCO*

Julia Close, MD, MBA, FASCO, Chief Education Officer and Executive Vice President for ASCO, provided news and information about ASCO, including an update on a Board of Directors task force dedicated to exploring members’ experience of and feedback about the MOC program. The task force has had meetings with ABIM to share member feedback and conducted a listening session with ASCO members in 2024. ABIM released enhancements to the LKA in 2024 and early 2025 based on feedback from diplomates and specialty societies, including ASCO. Dr. Close noted how the task force is focused on continuing to identify opportunities to improve the LKA and MOC experience for physicians and to partner with ABIM on further enhancements. The ASCO Board of Directors Task Force will continue meetings with ABIM in 2025, along with listening sessions for ASCO members.

Society representatives departed at this point in the meeting.

Recommending Candidates for the Specialty Board to ABIM Council

Each year, ABIM initiates the process to recruit 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 two openings on the Medical Oncology Board for terms beginning July 1, 2025: one for medical oncologist and one for an interprofessional health care team member with experience in medical oncology. At the fall meeting, the Medical Oncology Board discussed the candidates they had interviewed and voted on two for the care team member opening to recommend to the Council. The Specialty Board will review and vote on additional candidates for the physician opening early in 2025. ABIM will announce the final appointees in spring 2025 prior to the start of their terms.

Learn More

The Medical Oncology Board values the feedback and commentary of the entire medical community, including diplomates and society partners.

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*Indicates society representatives were present for this agenda topic.