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Initial Certification indicates that physicians have met rigorous standards through intensive study, accredited training and evaluation and that they have the clinical judgment, skills and attitudes essential for the delivery of excellent patient care.

MOC is a professionally determined standard that attests that an internist is staying current in knowledge and practice throughout his/her career.

For more than 75 years, Certification by ABIM has stood for the highest standard in internal medicine and its 20 subspecialties.

Section: Proposing Candidates for Special Consideration


ABIM diplomates in Internal Medicine may be proposed for special consideration for admission to a subspecialty examination if at the time of the proposal they fulfill all of the following criteria:

  • Have completed the full training required by ABIM in the subspecialty in another country.
  • Are a full-time associate professor or higher in the specified subspecialty division of the Department of Medicine in an LCME-accredited medical school or an accredited Canadian medical school.
  • Have served eight years, after formal training, as a clinician-educator or clinical investigator with a full-time appointment on a medical school faculty.
  • Possess a valid, unrestricted license to practice medicine in a state, territory, commonwealth, province or possession of the United States or Canada.

The proposer must:

  • Be the program director of an accredited fellowship program in the subspecialty.
  • Have personal knowledge of the qualifications of the candidate.
  • Be certified by ABIM in the subspecialty for which the candidate is being proposed.
  • Have observed the candidate’s clinical competence during the past year.

The proposal must:

  • Describe the candidate’s professional training and experience in the subspecialty.
  • Document the reasons the candidate merits consideration as a Special Candidate.
  • Substantiate the candidate’s clinical competence as a subspecialty consultant.
  • Include a copy of the candidate’s curriculum vitae and bibliography with current address, phone numbers and e-mail address. This information must clearly list the exact from-to dates of the candidate's training.
  • Be accompanied by letters of endorsement documenting observations of the candidate’s satisfactory clinical competence during the year prior to the proposal from the chief or chairman of the department of medicine at the institution where the candidate holds a current principal staff appointment and from two diplomates of ABIM in the subspecialty.

The guidelines above do not define pathways or reduce the requirements for admission to the subspecialty certification examination. Please ensure that all required documents are included with the proposal. Failure to include all documents will delay the review process.

Completed proposals for special consideration should be received by ABIM by January of the year of examination. Review of the proposal may require several months. A non-refundable fee in the amount of $300 must be submitted with the completed proposal.

The complete proposal should be mailed to:

American Board of Internal Medicine
510 Walnut Street, Suite 1700
Philadelphia, PA 19106-3699

Note: Receipt of a proposal does not imply its approval, and review of a proposal may require several months.