American Board of Internal Medicine

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The American Board of Internal Medicine (ABIM) is a non-profit, independent physician evaluation organization committed to continuously improving the profession for the public good by certifying physicians who practice internal medicine and its sub-specialties. It is not a membership society, educational institution or licensing body but an organization that assess the clinical judgment, skills and attitudes essential for the delivery of quality patient care. More than 200,000 physicians are ABIM Board certified – about one out of every four physicians practicing in the United States. Christine K. Cassel, MD is ABIM's current President and CEO.

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History [edit]

ABIM, the largest of 24 member certifying boards of the American Board of Medical Specialties was established in 1936 by the American Medical Association and the American College of Physicians to be an independent evaluator of physicians. Since that time, ABIM has worked to ensure a high level of competence in the American health system by certifying physicians who practice internal medicine in one or more of its 19 subspecialties.

Certification [edit]

ABIM Board Certification demonstrates that physicians have met rigorous standards through intensive study, self-assessment and evaluation. Additionally, certification encompasses the six general competencies established by the Accreditation Council on Graduate Medical Education (ACGME) and sets the stage for continual professional development through values centered on lifelong learning. Following regulations established by the ABMS, in order to be certified, a physician must:

  • Complete the requisite predoctoral medical education
  • Meet the training requirements
  • Meet the licensure requirements and procedural requirements
  • Pass a secure board certification examination

Physicians may become board certified when they have successfully completed residency or fellowship training and have passed a secure examination. Unlike licensure, board certification is not a requirement to practice medicine. However, board certification is widely accepted as a marker of excellence. Most hospitals require internists to be board certified in order to have admitting privileges, and many health plans require certification for contracting or eligibility for select networks.

A growing body of research suggests that physicians who are board certified deliver higher quality of care[1] than their non-certified colleagues and that board certification is correlated with:

  • Better outcomes and more reliable care[2]
  • Lower mortality rates
  • Higher rates of preventive services

Maintenance of Certification (MOC) [edit]

Research shows that in general, over time, knowledge deteriorates and practice habits and patterns fail to change in response to medical advances. Maintenance of Certification (recertification) promotes lifelong learning and enhancement of the clinical judgment and skills essential for high quality patient care. Every 10 years, some internists and subspecialists certified in or after 1990 renew their certifications through ABIM's Maintenance of Certification program, even though no data exists to suggest the program accomplishes its goals.

Fewer than 30 percent of physicians examine their own performance data, and physicians' ability to independently self-assess and self-evaluate is poor. Physicians value a framework that provides them with both guidance and trusted data to conduct self-evaluations so they can see what changes they need to make to improve the quality of care they deliver, and MOC may provides a framework. Additionally, board certification is an important factor when patients choose a physician and a some patients expect their physicians to participate in Maintenance of Certification.

There are four elements to ABIM's Maintenance of Certification program:

  • Verification of Credentials: Physicians must have a valid, unrestricted license to practice medicine. An action against a license compromises the most basic professional credential.
  • Self-Evaluation of Medical Knowledge: Physicians use open-book, Web-based modules developed by ABIM or others to self-assess their own clinical area. These stimulate learning but also require that learning be documented. Medical knowledge and the technology essential to care are evolving at an incredible rate, and these modules provide physicians another way to keep current.
  • Self-Evaluation of Practice Performance: ABIM requires that physicians engage in a quality improvement activity. A variety of quality improvement pathways are available, including ABIM PIMs Practice Improvement Modules ™ and Approved Quality Improvement (AQI) programs. These are lso options available for those with access to quality data from external sources, for those who practice in academic settings and those who are clinically inactive.
    • Physicians use PIMs and AQI programs to assess their performance in a clinical area relevant to their practice, compare their performance to clinical guidelines, develop a plan to improve important aspects of their practice, and assess the impact of that improvement plan. Self-assessment of performance in practice helps physicians see that the quality of care they provide is not always what they expected, and establishes measurement and improvement as valuable parts of practice (rather than externally imposed requirements).
  • Secure Examination: Physicians are required to pass a closed-book, proctored, computer-based exam. The exam includes questions that are pre-tested for relevance, and create a simulated environment in which critical aspects of clinical knowledge and judgment can be evaluated. It is not just what physicians know—but how they use what they know to diagnose and treat illness effectively and efficiently—that matters.

See also [edit]

References [edit]

  1. ^ Holmboe ES, Wang Y, Meehan TP, Tate JP, Ho SY, Starkey KS, Lipner RS (2008). "Association between maintenance of certification examination scores and quality of care for medicare beneficiaries". Arch Intern Med. 168 (13). pp. 1396–1403. 
  2. ^ Wenghofer E, Klass D, Abrahamowicz M, Dauphinee D, Jacques A, Smee S, et al. (2009). "Doctor scores on national qualifying examinations predict quality of care in future practice". Med Educ. 43. pp. 1166–1173. "Association between maintenance of certification examination scores and quality of care for medicare beneficiaries." 

External links [edit]
ABMS
AOABOS
ABPS
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