Laura E. Evans, MD, MSc, is a Professor of Medicine at the University of Washington in Seattle, as well as Medical Director of Critical Care and Associate Medical Director at the University of Washington Medical Center. Dr. Evans maintains board certification in Critical Care Medicine, Hospice and Palliative Medicine, Internal Medicine and Pulmonary Disease.
Dr. Evans is Chair of ABIM’s Critical Care Medicine Board, which she joined in 2014; she is also Chair-elect of the ABIM Council. She is currently participating in the Longitudinal Knowledge Assessment (LKA®) for her certificates in Internal Medicine, and Hospice and Palliative Medicine.
When it comes to maintenance of certification (MOC), there is enormous value in being able to demonstrate that you are keeping up within your field; there are also a lot of considerations to take into account when choosing the best option. I am maintaining four certificates, with two of them—Internal Medicine, and Hospice and Palliative Medicine—due this year. I’m familiar with the traditional, 10-year MOC exam and its demands on my time, but ABIM’s LKA that launched this year gives me a more flexible option.
One of the reasons I decided to try the LKA was the ability to do it on my own terms and work it into my schedule. I don’t have to go through the arrangements of making an appointment at a testing center, or spend months in the preparatory phase studying for an exam that feels higher stakes. Instead, I can sit in my office once a quarter and answer questions with resources right in front of me. It feels lower stakes to do it in smaller increments like that.
Since my practice is now entirely focused on inpatient care, I have found that the LKA triggers me to brush up on my knowledge gaps in outpatient internal medicine, and I am reading up on newer developments in the field. It’s even helped me answer medical questions that arise in my own family. In terms of my inpatient practice, the LKA has improved my knowledge base, for instance giving me greater familiarity with the medications my patients come in with, and what we need to do in the context of critical illness and adverse effects.
One of the things I like about the LKA is the rapid feedback for nearly every question, with references and rationales to back up the answer. Those explanations are helpful in directing me towards additional resources where I can learn more about a given subject. I think it also appeals to me as a critical care physician because the timeline in which we have to make decisions on the job is very compressed, and we respond well to that kind of instant feedback. In general, the flexibility and autonomy of the LKA are helpful to critical care physicians, who as a whole have been under enormous stress throughout the COVID-19 pandemic.
For those of us with multiple certifications, there are a lot of options to consider in terms of how to maintain our certificates, and even whether to maintain all of them. There’s a great deal of individualism in deciding what best serves your practice, and having different options to pursue is a huge advantage.
For me, I maintain all four because it gives me flexibility over what my career might look like. I chose the LKA for the two certificates in which it was available because it also gives me flexibility. There are many demands on us as physicians, but we have a professional obligation to keep up with the latest medical knowledge and practices. The LKA has proven to be a useful tool in my practice and my pursuit of lifelong learning.
LKA enrollment for the 2023 assessment year opens December 1, 2022. Physicians participating will continue to be reported as certified throughout their five-year cycle as long as they are meeting the LKA Participation Requirement and any other Maintenance of Certification requirements. A question history will be provided after six months of participation, and quarterly score reports offered after five quarters.
The LKA is available in 12 disciplines, and three more will go live in 2023: Critical Care Medicine, Infectious Disease and Pulmonary Disease.