ABIM Will Discontinue Requirement for Maintaining Underlying Board Certification for Interventional Cardiology and 14 Other Subspecialties

July 1, 2015—The American Board of Internal Medicine (ABIM) announced that the ABIM Council has unanimously approved policy changes so that diplomates certified in nine subspecialties of internal medicine, including interventional cardiology, will no longer need to maintain underlying certifications to stay certified in those areas. With this policy change, no disciplines in ABIM's Maintenance of Certification (MOC) program will require underlying certification. All ABIM diplomates will be able to choose the certifications they wish to maintain.

The new policy goes into effect on January 1, 2016, and removes requirements of underlying certification in the following disciplines:

• Maintaining Cardiovascular Disease certification will no longer be required to maintain certification in Advanced Heart Failure & Transplant Cardiology, Clinical Cardiac Electrophysiology, Interventional Cardiology, and Adult Congenital Heart Disease.
• Maintaining Gastroenterology certification will no longer be required to maintain certification in Transplant Hepatology.
• Maintaining another certification will no longer be required to maintain certification in Adolescent Medicine, Hospice & Palliative Medicine, Sleep Medicine, and Sports Medicine.

This policy will not change the requirements for initial certification in these subspecialties. Physicians still need to be certified in a foundational discipline in order to initially certify in a subspecialty, advised the ABIM.

Physicians scheduled for a fall 2015 MOC exam in an underlying certification area will no longer need to take the exam to remain certified in an overlying subspecialty. ABIM's exam cancelation policy will apply to diplomates who choose to cancel their exam registration. Over the next few weeks, ABIM will reach out directly to all diplomates affected by this policy change.

In the announcement, ABIM’s President and CEO Richard J. Baron, MD, commented, “While those underlying disciplines are important in building the foundation of knowledge for initial overlying subspecialty certification, keeping the underlying certification MOC requirement in place did not account for the increased specialization of these physicians’ practices over their careers. As we work to increase the relevancy of the MOC program for physicians, we want to give them greater flexibility to choose to recertify in those areas that best reflect what they are doing in practice.”

According to ABIM, 15 medical specialty societies—among which were the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions (SCAI)—offered feedback on the proposed policy and were generally supportive of the change. The ABIM Council reviewed society feedback, as well as feedback from ABIM diplomates asking that the requirement be changed.

Jeanne M. Marrazzo, MD, Chair of the ABIM Council, stated in the press release, “Working with the specialty societies and ABIM Board Certified physicians was a critical part of this process. Their feedback made it clear that the MOC policy on underlying certifications needed to change. This collaborative approach helped us reach a decision that more accurately corresponds to the way physicians actually practice, allowing them the option to focus only on MOC activities relevant to their practice. We know that some physicians practice in more than one area and may choose to maintain both—but now all physicians have a choice.”

In a letter addressed to SCAI membership and available online, the society’s 2015–2016 President James C. Blankenship, MD, stated that these “significant and far-reaching changes” mean that interventional cardiologists will not need to take general cardiology boards to recertify in interventional cardiology.

Dr. Blankenship noted that SCAI has aggressively advocated for MOC improvements, and that with these changes, ABIM has now accepted all four points SCAI said were essential to changing MOC requirements that were “unnecessarily burdensome and costly.”

As outlined by Dr. Blankenship in the President’s Message, these changes include:

• Streamlining recertification for tertiary subspecialists, which previously required interventional cardiologists and other subspecialists to retake and pass multiple examinations. 
• Eliminating punitive labels from the ABIM website, such as “not meeting MOC requirements.” 
• Changing Part IV MOC requirements; ABIM has suspended Part IV for 2 years and plans to revamp the requirements.
• Accepting different types of traditional CME as counting for MOC points.

Dr. Blankenship commented, “The society recognizes that additional changes are needed, but is encouraged by the overall course of recent developments at the ABIM. SCAI will continue to work with ABIM while continuing to explore multiple pathways to recertification options to ensure our members have appropriate and suitable options for maintaining certification.”

“As MOC evolves, SCAI’s Quality Improvement Committee is working to develop MOC-compatible tools to help members continuously improve practices while earning MOC credits,” stated Dr. Blankenship in the President’s Message to SCAI members.