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Laura Dingfield, MD, MSEd, FAAHPM
Chair, Hospice and Palliative Medicine Advisory Committee

The Hospice and Palliative Medicine Advisory Committee, which meets twice a year and is responsible for oversight of policy and assessment in the specialty, held its spring meeting on April 16, 2025. Representatives from the American Academy of Hospice and Palliative Medicine (AAHPM) joined for a portion of the meeting.*

The following is a summary of the spring meeting. Visit the ABIM Blog for reports of prior meetings. To share your feedback with the Hospice and Palliative Medicine Advisory Committee on this report or other issues that are important to you, please complete this brief survey.

The cosponsoring boards and the Hospice and Palliative Medicine Advisory Committee gratefully acknowledge the service of Christine Kistler, MD, MASc, Michael McDuffie, Ph.D., and Martha Twaddle, MD, whose terms on the Advisory Committee ended June 30, 2025.

Contents:

Advisory Committee Composition

The Advisory Committee comprises physician representatives of five American Board of Medical Specialties (ABMS) Member Boards (referred to as the “cosponsoring boards”) as well as two public members: one with a patient or caregiver background in the field and one with healthcare team member experience in the field. For more detailed information about the history and composition of the Advisory Committee, visit the ABIM Blog. The Advisory Committee members are:

The qualifying boards for certification in hospice and palliative medicine are the American Board of Obstetrics and Gynecology (ABOG), the American Board of Physical Medicine and Rehabilitation (ABPMR), the American Board of Psychiatry and Neurology (ABPN), the American Board of Radiology (ABR), and the American Board of Surgery (ABS) and other ABMS surgical boards.

ABIM Leadership Update*

Richard G. Battalia, MD, FACP, ABIM’s Chief Medical Officer, joined the Advisory Committee to discuss progress on key initiatives and ongoing areas of focus for ABIM (the administrative board for the Hospice and Palliative Medicine Certification and Maintenance of Certification Exams) including:

  • Exploring the alignment of ABIM Maintenance of Certification (MOC) requirement due dates with the five-year Longitudinal Knowledge Assessment (LKA®) cycle to help make the MOC program more reliably predictable.
  • Enhancements made to the LKA in response to feedback from physicians who identified areas for improvement, which are intended to keep the program relevant and effective.
  • Expanding ABIM’s engagement with stakeholder communities such as early career physicians, specialty societies and patient-focused organizations.
  • Upgrades to the ABIM website and Physician Portal for 2025, designed to make it easier for both physicians and the public to find information.

Dr. Nowels asked for more information about ABIM’s explorations of artificial intelligence (AI) in assessment, and whether ABIM had plans to coordinate some of this work with the other ABMS Member Boards. Dr. Battaglia explained that different Member Boards have varying perspectives on integration of AI in assessment. ABMS has formed an advisory group comprising representatives from multiple the Member Boards to work together on using new technologies in the Boards’ work.

Advisory Committee Oversight of Assessment*

Each spring, ABIM’s 12 Specialty Boards and the two cosponsored Advisory Committees review data related to certification and assessment trends in their disciplines to help guide their decisions on assessments. At this meeting, the Hospice and Palliative Medicine Advisory Committee received statistics on the current state of active certification in the discipline, assessment enrollment, demographics and pass rates, and data from post-assessment surveys. (Some data, such as exam pass rates and resident and fellow workforce trends, are publicly available on ABIM’s website.)

Dr. Hays pointed out that LKA enrollment is higher for physicians certified by cosponsoring boards. The group also discussed responses to the LKA end-of-year survey and how physicians rate the fairness of the assessment. Currently, the measure of fairness is broad, which has prompted ABIM to study how physicians define fairness with the goal of better understanding the rationale behind participants’ responses and ultimately make improvements to the assessment.

Initial Certification and Training Data in Hospice and Palliative Medicine*

The Advisory Committee also reviewed new data from the National Resident Matching Program (NRMP), Board Eligibility data, outcomes for candidates requiring retraining, ABIM faculty pathway pass rates and approved Advancing Innovation in Residency Education (AIRE) programs in hospice and palliative medicine.

There was particular interest in the AIRE programs and the ability of physicians from cosponsored boards to access them. The University of Colorado offers an AIRE program for any cosponsoring board certified physician. The University of Pennsylvania offers an AIRE program for ABIM, ABEM and ABFM Board Certified physicians as well as qualifying board certified physicians. The American Society of Clinical Oncology offers one for ABIM Board Certified physicians only.

Diplomate Professional Profile*

The Diplomate Professional Profile is a questionnaire built into the ABIM Physician Portal and required of all ABIM Board Certified physicians every five years. (It is not currently available to physicians certified by the cosponsoring and qualifying boards.) The questionnaire gathers information about clinical work and practice patterns, and ABIM uses the information to help update assessment blueprints, develop policies for initial certification and MOC, and ensure diverse representation of the profession in research. To date, 44% of ABIM Board Certified physicians have completed the Diplomate Professional Profile. Lorna A. Lynn, MD, Vice President for Medical Assessment Engagement, reviewed aggregate data gathered so far related to hospice physicians, including practice setting, practice size and physician ownership of practices. 

Community Practice in Governance*

Erica N. Johnson, MD, FACP, FIDSA, Senior Vice President for Academic and Medical Affairs, led a discussion with the Advisory Committee about the definition of community practice in the specialty to create a more inclusive understanding of its role and scope. She also sought input on overlapping aspects of community practice across the disciplines of internal medicine to inform ABIM’s recruitment efforts for broad physician representation in governance roles.

The Hospice and Palliative Medicine Advisory Committee is composed of representatives of the cosponsoring boards (ABA, ABEM, ABFM, ABIM and ABP), each of which appoints at least one physician member. ABFM and ABIM appoint two seats because of the proportion of physicians they certify. The Advisory Committee recommends various perspectives needed to contribute to the committee’s composition, including community practice, for each board to consider when appointing members. Community practice is defined broadly in applications as “clinical practice in a non-university, community setting.” An ABIM workgroup convened in 2020 found that the existing practice categories candidates could choose did not fully capture the scope of community practice, and proposed updates drawn from the American Medical Association and the ABIM Diplomate Professional Profile.

Advisory Committee members discussed the nuances and challenges of defining community practice within the complex system of hospice and palliative medicine. For instance, several Advisory Committee members serve in multiple roles or in institutions that could be categorized in different ways. They requested greater clarity in defining community practice to distinguish whether it refers to differences in clinical settings (inpatient, outpatient; rural, urban) or strictly non-academic practice. Dr. Dingfield pointed out that hospice (and the distinction between home-based hospice and home-based palliative care) was missing from available categories.

Kristina Newport, MD, HMDC, FAAHPM, Chief Medical Officer for AAHPM, mentioned that AAHPM is also exploring how to define practice categories and offered to collaborate with the Advisory Committee on a consistent, standardized approach for the discipline in general.

Hospice and Palliative Medicine Fellowship Program Requirements*

In fall 2023, the Advisory Committee discussed plans of the Review Committee for Family Medicine (RC-FM) to significantly revise existing Accreditation Council for Graduate Medical Education (ACGME) program requirements for hospice and palliative medicine. Dr. Nowels, who sits on both the Advisory Committee and the RC-FM, provided an update on the status of the revision project, which was planned for completion by July 2025.

The group briefly discussed details about the proposed revisions and how the new requirements would be publicized with program directors. Julie Bruno, Chief Learning Officer for AAHPM, offered help with messaging and connecting program directors to ACGME.

Update from the American Academy of Hospice and Palliative Medicine*

Dr. Newport updated the Advisory Committee on AAHPM’s membership, leadership changes, research, advocacy and other initiatives. AAHPM is also involved in advocacy efforts focused on improving care access and quality, including telehealth flexibility, National Institutes of Health funding, Medicaid and the Department of Health and Human Services, and workforce challenges in hospice care. AAHPM’s Serious Illness Research Consultant Center (SIRCC), launched in May 2024, supports early- and mid-career research conducted by interprofessional researchers and clinicians. In addition, AAHPM hosted the Hospice Super Forum in November with the Hospice Medical Director Certification Board.

Society representatives departed at this point in the meeting.

Supporting Research and Important Issues in Hospice and Palliative Medicine

Dr. Johnson led the Advisory Committee in a discussion about how members can engage with key issues facing the discipline, particularly those related to research that highlights the value of board certification. She asked the Advisory Committee to identify current or emerging challenges in hospice and palliative medicine and to consider how the Advisory Committee might appropriately address these issues within its oversight role.

Several members identified equitable access to hospice and palliative care as a pressing concern. They noted that financial pressures have already led to hospice program closures, further limiting access for underserved populations. Committee members expressed concern that policy changes could worsen these disparities, particularly in a field already marked by significant barriers to care.

In response, Dr. McDuffie proposed establishing a research agenda to examine and demonstrate the public impact of policy changes, especially those related to hospice regulation and financing.

Innovations in Assessment

ABIM’s Research and Innovations Department has been leading a program of research on improving assessments through three main areas: supporting assessment staff efficiency, facilitating the item development process and enhancing the assessment experience for physicians. The Advisory Committee received an overview of the team’s current projects.

The group discussed the use of AI in assisting with creating assessments while noting that it is not intended to replace the traditional multiple-choice question structure. All assessment items are and will continue to be written by physicians. However, AI could be used in future as a tool for staff, Item-Writers and Approval Committees to assist with important work such as survey analysis, item-writing and blueprint mapping.

Updates from the Hospice and Palliative Medicine Approval Committees

Robert C. Macauley, MD, Chair of the Hospice and Palliative Medicine Traditional, 10-Year MOC Exam Approval Committee, updated the Advisory Committee on the current composition and recent meetings of the two Approval Committees as well as the Item-Writing Task Force. The group noted that currently, the Item-Writing Task Force is composed largely of internal medicine physicians. They suggested recruiting more Item-Writers through the cosponsoring boards to increase diversification.

Physicians interested in serving on the Item-Writing Task Force can apply on the ABIM website.

Candidates for the Hospice and Palliative Medicine Approval Committees

The Advisory Committee is responsible for selecting members and chairs of the Approval Committees annually and as needed. At the spring meeting, the Advisory Committee reviewed candidate materials and voted to approve the following appointments to the Hospice and Palliative Medicine Traditional, 10-Year MOC Exam Approval Committee:

  • Nathan Fairman, MD, as chair, effective July 1. Dr. Fairman, who is double boarded by ABIM and ABPN, has served on the Approval Committee since its inception in 2022 and served on the prior Test-Writing Committee for two years.
  • Christopher A. Jones, MD, FAAHPM, MBA, of Duke Health (ABIM Board Certified)
  • Vandana Nagpal, MD, of UMass Memorial Health (ABIM Board Certified)
  • Sandra H. Sacks, MD, MEd, of UCLA Health (ABA Board Certified)

Visit ABIM’s website for a full list of current openings.
Approval Committee openings are usually posted in the fall.

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*Indicates society representatives were present for discussion of this agenda topic.