WASHINGTON -- Internists will have a new option for board certification starting in 2018, the American Board of Internal Medicine (ABIM) announced Thursday.
"In an effort to provide options and alternatives to the once-every-10-year exam, beginning in January of 2018, ABIM will offer two assessment options,", president and CEO of ABIM, said here at the annual meeting of the American College of Physicians. "One will continue to be the long-form assessment taken every 10 years ... but the new track is a more frequent assessment, with fewer questions, completed outside a testing center."
The frequency of the shorter exam will be more often than every 10 years but no more than annually, according to an . As to the exact interval, that is something "we need to be discussing with all of you about what feels right," Baron told the audience. ABIM will also be using some version of remote proctoring, "which is another term for the ability to verify that the person doing the assessment is the person we think it is, and the resources they're accessing are the same resources anybody taking it is accessing," he added.
"The idea behind this track is that physicians who perform at an expected level of performance will test out of the longer-form 10-year assessment, so they could stay on this track pretty much indefinitely as long as they are maintaining a level of engagement and performance, and continuing acquisition of knowledge and skills," Baron explained. "This track will have also feedback to enhance physician learning, [which] we're already doing in the regular 10-year exam."
The announcement of the new track came during a session apparently aimed at quelling the controversy over the board's maintenance of certification (MOC) program. Although the board announced last year that it was reducing fees, suspending performance projects, and making other changes to the MOC process, board members clearly seemed to want to do more.
"The point is for you to understand the board hears you -- we know you have frustration, anger, concern, and many of you have questions," said , a member of ABIM's Internal Medicine Board. "Coming out of that feedback was to embark on community centered design; we're going to listen to you all and hear what works for them to help us all achieve a common goal."
, chair-elect of ABIM's board of directors, announced several other steps the board was taking to make MOC easier. "One thing we heard loud and clear is the issue of redundancy," she said, referring to the idea that internists had to get continuing medical education (CME) credits separately from performing their MOC activities, even if the subjects covered by the two were similar. "Indeed, we've expanded types of CME accredited under MOC; currently there are more than 1,000 activities approved" that will qualify for both.
The ABIM "recently formed a partnership with the Accreditation Council for Continuing Medical Education (ACCME) to create a list of activities that count for CME and MOC, so the [MOC] program automatically notifies ACCME" that a qualifying activity has been completed, saving internists the step of having to send a certificate to the college in order to get the CME credit, she said.
And, because people often wait until year 10 to take their exam, the board is giving those who don't pass an additional year of board certification, allowing them an opportunity to retake the exam; the cost of the retake will be only 50% of the normal exam price, Connolly said.
The board also announced that it was taking steps to increase its financial transparency. "We felt one way to help everyone understand the cost [of the exam] was to be more transparent. As a result, , our audited financial statements and our IRS 990 forms are available," she said.
During a question-and-answer session, some audience members seemed skeptical of some of the changes. "It is very easy to misread the 990, and I did misread the ABIM 990," said , an internist in East Norriton, Pa. "There was a huge expense item that turned out to be a paper loss but not an actual expense. I don't think the 990 [form] is really adequate for diplomates to really know what's going on with the ABIM and their expenses .... What we all want to hear is that our money is being judiciously spent, and it's impossible at this point to really see that."