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Andrea M. Russo, MD, Chair, ABIM Cardiovascular Board

The Cardiovascular Board—which meets twice a year and is responsible for oversight of policy and assessment in the specialty—held its fall meeting on October 29, 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 following organizations joined for a portion of the meeting*:

  • The American College of Cardiology (ACC)
  • The American Heart Association (AHA)
  • The American Society of Nuclear Cardiology (ASNC)
  • The Heart Rhythm Society (HRS)
  • Society for Cardiovascular Angiography and Interventions (SCAI)

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 Cardiovascular 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.

Andrea M. Russo, MD, Chair of the Cardiovascular Board, inquired whether ABIM would explore practice profiles in cardiovascular disease to develop focused versions of the LKA for specialists who do not currently have that option. The group discussed challenges related to the reliability of assessments in subspecialties that have a small number of practicing physicians and the ability of subspecialists to meet the demands of multiple assessments. ABIM affirmed that it plans to continue offering the traditional, 10-year (longform) exam as well as the existing Collaborative Maintenance Pathway (CMP) developed in partnership with ACC.

The Specialty Board also discussed a pending application by five cardiovascular organizations to the American Board of Medical Specialties (ABMS) to form an independent certifying board in cardiovascular medicine. ABMS has not yet announced a decision on the application, but ABIM remains committed to offering certification and MOC in cardiovascular disease and its subspecialties, as well as engaging with the cardiovascular community to encourage dialogue and foster relationships with diplomates. The Specialty Board expressed optimistic views on the future of the discipline based on Dr. McDonald’s recent appointment as CEO and his vision for the organization. This led to a conversation about the role of ABIM and the ABIM Foundation in fostering and rebuilding public trust in medicine and health care. Building trust has been part of the Foundation’s work for several years as it seeks to better support physicians overall.

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. He also reviewed profile questions specific to cardiovascular disease. Data from the DPP are not yet publicly available but ABIM has plans to release aggregate information once there are sufficient data.

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

Natalie S. Plummer, Esq., Manager, DEI Programs at ABIM, 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.

Laura Porter, CMP, Assistant Director of Education at SCAI, shared her concerns about the impact of recent federal court decisions on DEI in medical training recruitment and noted that program directors often lack guidance on how to safely move forward with DEI initiatives. ABIM is working with societies to create best practices and crowdsource information to address this and other challenges through data collection. The goal is to enhance representation in medical programs and examine structural bias in assessments. The group discussed the importance of continuing to further diversify governance and encourage participation of minority groups.

Advanced Heart Failure and Transplant Cardiology External Blueprint Review

The blueprint is a document that defines the scope of content to be tested on ABIM assessments. It serves as a study guide for physicians preparing for an assessment and as a tool for item-writers and exam development staff creating the assessment. The Specialty Board and Approval Committees in each discipline work together to update the blueprint periodically and ensure that changes reflect diplomate and society input, and that assessment content remains relevant to current clinical practice.

The Specialty Board received a brief overview of the blueprint review process, which involves gathering feedback from various diplomate and stakeholder groups, proposing revisions based on the feedback and securing final approval from the Specialty Board. Savitri E. Fedson, MA, MD, Chair of the Advanced Heart Failure and Transplant Cardiology (AHFTC) Traditional, 10-Year MOC Exam Approval Committee, reviewed proposed changes to the AHFTC Blueprint and feedback gathered from ACC and HRS to focus on heart failure and palliative care. Additional considerations include team-based care, managing transitions of care and general heart failure therapies as potential topics on the exam.

Society representatives departed following discussion of this topic and prior to the Specialty Board’s vote.

Following the departure of society representatives, the Cardiovascular Board voted to approve the proposed revisions to the AHFTC Blueprint. Next, ABIM will begin the process of vetting the blueprint through the broader diplomate community in Spring 2025.

Selecting a New Member for the Adult Congenital Heart Disease Traditional, 10-Year MOC Exam Approval Committee

ABIM Specialty Boards are responsible for selecting members and chairs of the Approval Committees annually and as needed. At the fall meeting, the Cardiovascular Board reviewed candidate materials for an open position on the Adult Congenital Heart Disease Traditional, 10-Year MOC Exam Approval Committee. The group unanimously voted to approve Ari Cedars, MD, Director, Adult Congenital Heart Disease and Associate Professor of Medicine and Pediatrics at the Johns Hopkins University School of Medicine, effective immediately.

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 Cardiovascular Board for terms beginning July 1, 2025: one for an adult congenital heart disease (ACHD) cardiologist and one for a general cardiologist. At the fall meeting, the Cardiovascular Board discussed the candidates they had interviewed and voted on those they planned to recommend to the Council. ABIM will announce the final appointees in spring 2025 prior to the start of their terms.

New Proposal for ABIM’s Approved Quality Improvement (AQI) Program*

The AQI Program is the process through which ABIM recognizes externally developed quality improvement activities that physicians are doing in practice. It also allows diplomates to earn MOC points for activities that support their local improvement priorities. Approved activities grant 20 MOC points to physicians who meaningfully participate in the activity. Rowlens M. Melduni, MD, Cardiovascular Board member, reviewed the following proposal for the program and provided his recommendation for approval:

  • “Improving Cardiac Outcomes and Quality,” sponsored by Wellstar Health System Cardiovascular Service Line. The recently established Kennestone Cardiac Quality Performance Improvement Committee encourages integration and coordination of care to reduce variation and promote a culture of excellence across the System Cardiac Service Line, including physicians from other service lines who are involved in caring for cardiac patients. Cardiovascular, internal medicine and critical care medicine physicians would receive MOC credit for participating.

After a brief discussion, the Cardiovascular Board voted to approve the AQI proposal for MOC credit. Any participant will be eligible to receive credit for this activity.

ABIM welcomes proposals from sponsors that may include medical specialty societies, hospitals or departments within hospitals, medical groups, clinics or other health-related organizations that wish to approve a single activity. Organizations with a quality improvement activity to submit to ABIM for MOC credit recognition are encouraged to take the following steps: 

  1. Download the ABIM AQI Program Guide (PDF). 
  2. Download and complete the AQI Application (PDF). 
  3. Email completed applications to mocprograms@abim.org.

Learn More

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

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