The vast majority of board-certified internal medicine physicians are choosing a newer ongoing assessment option over the traditional 10-year recertification exam.
The data were shared in a viewpoint published by the American Board of Internal Medicine (ABIM) in JAMA. It said that 80% of ABIM-certified doctors are choosing the longitudinal knowledge assessment (LKA) over the long-form maintenance of certification exam. The LKA certification covers several subspecialties including gastroenterology, cardiology and rheumatology.
Across all disciplines, 70% of diplomates agree that the LKA is a fair assessment of their clinical knowledge, the viewpoint shared. Since its launch, the LKA has also attracted more than 1,000 additional volunteers to generate exam content, including practicing physicians across a wide range of settings.
In the first two years LKA was available (2022 and 2023), physicians used the LKA to maintain more than 51,300 certificates while the traditional MOC exam was used to maintain more than 13,600 certificates, a spokesperson told Fierce Healthcare.
Back in 1990, ABIM first transitioned to the 10-year recertification exam. “It became clear back then that medicine was evolving at a pretty rapid rate," Robert Roswell, M.D., the op-ed’s corresponding author and chair-elect of ABIM’s board of directors, told Fierce Healthcare. “And if you look at it today, it’s even more rapid.”
At a time of increasing administrative burden on physicians, plus the ongoing stress of recovering from COVID-19, some doctors have begun to question the benefits of certification, Roswell noted. Based on feedback, ABIM launched the LKA in early 2022 to provide more flexibility, allowing docs to maintain their certification on a five-year cycle.
The LKA can be taken anywhere, as one’s schedule allows, with 30 questions to be answered each quarter. The assessment also generates a variety of savings over the traditional 10-year certification exam, according to ABIM.
Studies show that patients who are cared for by board-certified physicians have better outcomes, the viewpoint said, including lower mortality from cardiovascular disease, fewer emergency department visits, fewer unplanned hospitalizations, better adherence to medical guidelines and fewer state medical board disciplinary actions. They also generate notable savings ($5 billion annually) for Medicare beneficiaries, according to one 2014 study cited in the paper.
“Those who are keeping up, those patient outcomes are just amazing—and that’s why we want everyone to know about saving lives,” Roswell explained, adding he doesn’t think this has always been communicated properly to doctors and patients alike.
Health equity was recently approved as a new content area on ABIM assessments. “You have to understand health disparities, and you have to understand how care is delivered disparately in America,” Roswell said. The organization also has fairness reviews of its questions on several exams to identify and remove bias if any is found.