The Critical Care Medicine Board held its fall meeting on November 12, 2025. Representatives from the American Association of Critical-Care Nurses (AACN), 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*.
The following is a summary of the fall meeting. Visit the ABIM Blog for reports of prior meetings.
ABIM Leadership Update*
Furman S. McDonald, MD, MPH, President and CEO of ABIM and the ABIM Foundation, discussed progress on ABIM’s strategic initiatives, including:
- Enhancements to the Longitudinal Knowledge Assessment (LKA®), such as the possibility of expanded eligibility, developing focused versions in some specialties that will launch in 2026 and exploring additional focused versions in other specialties for the future
- Advancing and expanding ABIM’s research strategy with the appointment of Eric J. Warm, MD, MACP, as the inaugural Vice President of Research Strategy
- Supporting early career physicians and international medical graduates (IMGs) with the needs-based certification exam fee assistance program and the competency-based medical education (CBME) special consideration pathway pilot for IMGs
- Recognizing board-certified physicians at key career milestones, such as attaining more than 30 years of certification, and an end-of-year wrap-up for LKA participants
- Advancing innovation in assessment through new technology and society collaboration
Dr. McDonald explained ABIM’s plans to explore expanding access for LKA participation, particularly to benefit early-career physicians previously constrained by timing requirements. He also addressed concerns about the integrity of ABIM’s exams considering increased use of artificial intelligence (AI), reiterating ABIM’s reliance on professional honesty paired with appropriate mitigation efforts to address item sharing or misuse of tools. In response to questions about the burden faced by multiple certificate holders, Dr. McDonald noted that ABIM is exploring solutions but combining questions remains analytically and psychometrically complex.
A discussion followed regarding out-of-date items and new item development, with some emphasizing the need for more systematic turnover of content to improve exam quality. Dr. McDonald affirmed that dedicated teams continuously review relevance and performance of items on all ABIM exams, including feedback submitted by physicians taking the exams. ABIM discards items that are out of date or otherwise do not meet standards as part of this rigorous process.
Health Equity Update*
ABIM remains firmly committed to advancing health equity, as reflected in a joint statement by the ABIM Board of Directors and the ABIM Foundation Board of Trustees dated June 2025. ABIM continues to work in the areas outlined in the Equity Statement: developing health equity content for assessments, ensuring that assessments are fair and researching to advance assessment strategies. ABIM also maintains collaborations with medical specialty societies working to advance health equity. During this session, staff highlighted both the progress achieved and the challenges that remain in ABIM’s ongoing health equity efforts.
Members expressed enthusiasm for the Needs-Based Certification Exam Fee Assistance Pilot, with some noting how financial barriers can discourage fellows from pursuing ABIM certification. A total of 856 applicants received fee credits during the pilot’s initial cycle.
The conversation turned to the difficulty of testing equity-related constructs in a valid, actionable manner. One participant noted that disparities often arise before patients arrive in intensive care settings and, therefore, may not lend themselves to traditional question formats. Specialty Board members highlighted related issues, including family burden, financial strain and inequitable access to post-critical-illness care, all of which may indirectly relate to assessment domains.
Diplomate Professional Profile*
The Critical Care Medicine Board reviewed the status of ABIM’s Diplomate Professional Profile (DPP), a survey that ABIM Board Certified physicians are asked to complete every five years via the Physician Portal. Data gathered from the DPP will inform exam blueprint updates and help Specialty Boards understand what physicians are doing in practice.
ABIM staff asked for suggestions from the Specialty Board and society guests about modifications to the DPP that would add to the value of the information collected through completion of the survey. Specialty Board members discussed the gap in responses from early-career physicians, particularly those who have not yet begun LKA participation. Lorna Lynn, MD, Vice President for Medical Education Research, acknowledged this challenge and noted ongoing efforts to determine targeted outreach strategies. The Specialty Board raised questions about the meaning of “full-time equivalent” in the DPP and about how clinical weeks differ across institutions, with Laura E. Evans, MD, MSc, Chair of the Critical Care Medicine Board, emphasizing the lack of a standard national definition of clinical workload in critical care.
Critical Care Medicine Board members emphasized the importance of capturing variability in practice models, open versus closed units, community versus academic hospitals, per-diem arrangements and multisite work patterns, as these distinctions meaningfully affect workforce capacity and burnout. Specialty Board members also suggested including more context on work environments, such as staffing models or cross-coverage across ICUs, particularly because practice patterns can influence patient safety, well-being and professional satisfaction. Siddharta Reddy, MPH, Senior Research Associate, noted that the DPP already captures specific procedural data, with additional options potentially integrated based on Specialty Board priorities.
Career Stage Needs and Workforce Challenges*
In an open discussion on specialty-specific issues, Dr. Evans raised the growing complexity of critical care careers and the persistent gap between regional workforce needs and fellowship training capacity. Leonard Stallings, MD, FCCP, described how career development varies dramatically across practice settings, noting that community physicians may lack access to mentorship and professional networks. He encouraged ABIM to consider mechanisms to connect physicians, especially early-career intensivists, with mentors who can offer guidance on certification, subspecialization and leadership pathways.
Allison Greco, MD, noted that physicians participating in ABIM’s Early Career Summits indicated strong interest in structured mentorship opportunities and expressed support for an ambassador-style model replicated for critical care. Alexander Sy, MD, suggested ABIM may be able to help by creating individualized learning or career roadmaps to guide physicians through the first decade after fellowship, with Dr. Evans adding that such roadmaps could be valuable at mid- and late-career stages as well. Specialty Board members also reflected on geographic barriers, the role of visa constraints in shaping workforce distribution and how combined training could support workforce development in critical care medicine by expanding physicians’ skill sets and bringing in perspectives from other disciplines.
Nutrition in Assessment*
The Critical Care Medicine Board discussed the role of nutrition in patient care and assessment, emphasizing the importance of basing decisions to expand nutrition content in ABIM exams on sound scientific principles. Currently, the nutrition content in assessments varies across specialties.
One Specialty Board member noted that nutrition training is now less standardized than it was in the past, creating wide variability in trainee exposure. Several agreed that while critical care physicians may not significantly influence chronic disease prevention, nutrition remains essential to acute and post-ICU recovery, particularly in areas such as early enteral feeding, skin integrity and post-hospitalization outcomes. Another challenge noted was the community’s inconsistent understanding of the impact of nutrition on functional recovery, especially in vulnerable populations.
Specialty Board members noted that only a small percentage of the Critical Care Medicine Blueprint currently addresses nutrition, prompting discussion of whether this weighting is sufficient. They highlighted the limited training on supplements, macronutrients and potential interactions with medications, with Laura L. Sessums, JD, MD, ABIM’s Chief Medical Officer, noting that updated blueprint language about nutrition as a cross-content category could help address these knowledge gaps if training programs increased teaching on nutrition during fellowship.
Society representatives departed at this point in the meeting.
Critical Care Medicine Blueprint
Specialty Board members reviewed the proposed percentages for the Critical Care Medicine Blueprint presented by the chairs of the Critical Care Medicine Approval Committees. They acknowledged the extensive review process, medical society input and alignment with current practice and training expectations. The Specialty Board unanimously approved the new blueprint percentages as recommended by the Approval Committee. The new blueprint will be published in January 2026. Physicians certified in critical care medicine will be notified via email, and the new blueprint will go into effect for the 2026 initial certification and Maintenance of Certification (MOC) exam administrations.
Candidates for the 2026 Critical Care Medicine Board
ABIM issued a notice in June about openings for physician intensivists on the Critical Care Medicine Board for terms beginning July 1, 2026. Specialty Board members review applications and interview candidates, and at the fall meeting, voted on two to recommend to the ABIM Council, which makes the final appointments. Dr. Evans’ final term as chair will also end in June 2026 and sitting Specialty Board physician members are eligible to apply. ABIM expects to announce appointees, including the new chair, in July 2026.
Initial Certification Procedural Requirements
Staff facilitated a detailed review of proposed updates to procedural requirements for Board Eligibility in Critical Care Medicine. Specialty Board members discussed how point-of-care ultrasound (POCUS) should be described in future standards, agreeing that content should distinguish between diagnostic applications and procedural guidance. They also considered training expectations for continuous renal replacement therapy and extracorporeal membrane oxygenation, acknowledging that programs without on-site capabilities may need to establish external rotations to ensure adequate exposure. Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs, confirmed elective rotations would meet “opportunity to train” standards with documentation of competency.
Critical Care Medicine Board members emphasized the need to understand current fellowship capacity and practice patterns, including the frequency with which intensivists perform specific procedures. Dr. Lynn noted that DPP data already captures much of this and could inform future decision-making. The Specialty Board voted unanimously to approve the list of initial recommendations on procedural competencies for Board Eligibility, pending further input from program directors. The recommendations will also be shared for public comment prior to being finalized.
ABIM Approved Quality Improvement (AQI) Program
The AQI Program is the process by which ABIM recognizes externally developed quality improvement activities that physicians undertake in practice. It also allows physicians to earn up to 20 MOC points for meaningfully participating in activities that support their local improvement priorities. The Critical Care Medicine Board reviewed the following proposal and recommended it for approval:
- The Continuum Project: A Massachusetts General Hospital culture change initiative focused on developing a comprehensive strategy to care for patients and families facing serious illness.
After a brief discussion, the Critical Care Medicine Board voted to approve the AQI proposal for MOC credit. Any ABIM Board Certified physician who is a participant will be eligible to receive credit for this activity.
ABIM welcomes proposals from sponsors, including medical specialty societies, hospitals or hospital departments, medical groups, clinics, or other health-related organizations, which wish to sponsor a single activity. Organizations with a quality improvement activity to submit to ABIM for MOC credit recognition are encouraged to take the following steps:
- Download the ABIM AQI Program Guide (PDF).
- Download and complete the AQI Application (PDF).
- Email completed applications to mocprograms@abim.org.
Learn More
Subscribe to the ABIM Blog to stay on top of the latest news.
Apply to openings on ABIM Governance and the Item-Writing Task Forces and be part of shaping the future of ABIM’s assessments. Join the Community Insights Network to share feedback with ABIM through focus groups, surveys, user testing and more as we develop and refine our programs together.
*Indicates that society representatives were present for discussion on this agenda topic.