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General Policies & Requirements

Special Training Policies

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Disclosure of Performance Information

Trainees planning to change programs must make requests to their current program and ABIM to send written evaluations of past performance to the new program. These requests must be made in a timely manner to ensure that the new program director has the performance evaluations for review before offering a position. A new program director may also request performance evaluations from previous programs and from ABIM concerning trainees who apply for a new position. ABIM will respond to written requests from trainees and program directors by providing any performance evaluations it has in its possession and the total credits accumulated toward ABIM's training requirements for Certification. This information will include the comments provided with the evaluation.

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Due Process for Evaluations

The responsibility for the evaluation of a trainee's clinical competence and moral and ethical behavior rests with the program, not with ABIM. ABIM is not in a position to re-examine the facts and circumstances of an individual's performance. As required by ACGME in its Essentials of Accredited Residencies in Graduate Medical Education, the educational institution must provide appropriate due process for its decisions regarding a trainee's performance.

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Leave of Absence and Vacations

Up to one month per academic year is permitted for time away from training, which includes vacation, illness, parental or family leave, or pregnancy-related disabilities. Training must be extended to make up any absences exceeding one month per year of training. Vacation leave is essential and should not be forfeited or postponed in any year of training and cannot be used to reduce the total required training period. ABIM recognizes that leave policies vary from institution to institution and expects the program director to apply his/her local requirements within these guidelines to ensure trainees have completed the requisite period of training.

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Deficits in Required Training Time

For deficits of less than one month in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf.

Examples:

  • A rheumatology trainee who initiated training July 1, 2009 and anticipated completion by June 30, 2011 exceeds the total time permitted for leave over the 24 month training period by less than one additional month. If the program director and the institution's promotions or competency committee deem the trainee competent and attest to the competency on the ABIM FasTrack evaluation, the trainee could complete his or her training on the June 30, 2011 completion date.
  • An internal medicine trainee who initiated training on July 15, 2008 (two weeks off cycle) has a scheduled completion date of July 14, 2011. The program director and the institution's promotions or competency committee deem the trainee competent on June 30, 2011 and attest to the competency on the ABIM FasTrack® final evaluation, documenting the reasons for the earlier completion date.

In either of these scenarios, if the program director and the competency or promotions committee deem the trainee competent, training does not need to be extended.

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Definition of Full-time Training

Full-time training is defined as daily assignments for periods of no less than one month to supervised patient care, educational or research activities designed to fulfill the goals of the training program. Full-time training must include formative and summative evaluation of clinical performance, with direct observation by faculty and senior trainees.

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Interrupted Full-Time Training

ABIM approval must be obtained before initiating an interrupted training plan. Interrupted full-time training is acceptable, provided that no period of full-time training is less than one month. In any 12-month period, at least six months should be spent in training. Patient care responsibilities should be maintained in a continuity clinic during the non-training component of the year at a minimum of one-half day per week. Part-time training, whether or not continuous, is not acceptable.

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Other Policies

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ABIM's Evaluations and Judgments

Candidates for certification and Maintenance of Certification agree that their professional qualifications, including their moral and ethical standing in the medical profession and their competence in clinical skills, will be evaluated by ABIM, and ABIM’s good faith judgment concerning such matters will be final.

ABIM may make inquiry of persons named in candidates' applications and of other persons, such as authorities of licensing bodies, hospitals, or other institutions as ABIM may deem appropriate with respect to such matters. Candidates agree that ABIM may provide information it has concerning them to others whom ABIM judges to have a legitimate need for it.

ABIM makes academic and scientific judgments in its evaluations of the results of its examinations. Situations may occur, even through no fault of the candidates, that render examination results unreliable in the judgment of ABIM. Candidates agree that if ABIM determines that, in its judgment, the results of their examination are unreliable, ABIM may require the candidates to retake an examination at its next administration or other time designated by ABIM.

ABIM also may evaluate candidates' or diplomates' fitness for Board Certification – including their professionalism, ethics and integrity – in disciplinary matters, and ABIM's good faith judgment concerning such matters will be final.

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Board Eligibility

As of July 2012, the American Board of Internal Medicine considers all residents and subspecialty fellows who have successfully completed the training for initial certification in general internal medicine or any of its subspecialties to be “Board Eligible” in the relevant specialty for a period of 7 years. The 7-year period of Board Eligibility shall begin upon the candidate's successful completion of training or July 1, 2012, whichever is later. During the period of Board Eligibility, the candidate may apply for the certifying examination in the relevant specialty. If the candidate does not become Board Certified during the 7-year period of Board Eligibility, the candidate will no longer be deemed “Board Eligible” and may no longer represent himself or herself as “Board Eligible.”

A candidate who is no longer Board Eligible may nevertheless apply for a certifying examination, but only if the candidate has: (i) completed a year of retraining in the relevant specialty after the expiry of the candidate's period of Board Eligibility, but no more than 7 years before the application; and (ii) met all other requirements for Board Certification in effect at that time. Retraining will require the successful completion of one year of additional residency/fellowship training in an ACGME-accredited US training program or an RCPSC-accredited Canadian training program and an attestation from the program that the candidate has demonstrated the requisite competency for unsupervised practice. The Board Eligibility policy may be subject to other ABIM policies, including the Re-examination policy.

Exceptions

The Board recognizes that extraordinary circumstances - such as military deployment or illness - may prevent a trainee from completing the requirements for Board Certification in the 7-year period of Board Eligibility. In such extraordinary cases the candidate may appeal for an extension of the 7-year period. Any such appeal will be adjudicated by the Staff Credentials Committee of the Board, and the decision of the Staff Credentials Committee will be the final decision of the Board.

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Re-examination

Beginning in 2011, candidates who are unsuccessful on an examination may apply for re-examination as set forth below. To be granted admission, candidates must meet all applicable licensure, professional standing, underlying certifications and procedural requirements. Only exam failures occurring beginning in 2011 and thereafter will count toward the three examination limit. The Re-examination policy may be subject to other ABIM policies, including the Board Eligibility policy.

Candidates who fail three consecutive initial certification exams in the same discipline over three years will not be permitted to take an exam in that discipline during the next annual exam administration.

For example:

  • A candidate who is unsuccessful on the Internal Medicine Certification Exam in 2011, 2012, and 2013 would need to wait until the 2015 administration of the exam to re-apply for admission.

Candidates who fail one or two consecutive initial certification exams in the same discipline and do not register for the exam in the third consecutive year will not be subject to this policy. They will be able to register for the exam the next time it is offered, and the three consecutive attempt cycle will begin again.

For example:

  • A candidate who is unsuccessful in passing the Internal Medicine Certification Exam in 2011 and 2012 and does not register or cancels the exam in 2013 will be able to register for the exam in 2014.

This policy applies only to ABIM initial certification exams offered annually; it does not apply to:

  • Certification exams offered every other year - Sleep Medicine, Hospice & Palliative Medicine, Transplant Hepatology or Advanced Heart Failure and Transplant Cardiology
  • Maintenance of Certification exams
  • Certification and MOC exams offered by other ABMS boards - Sports Medicine and Adolescent Medicine
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Reporting Certification Status

Beginning January 2014, ABIM is changing the way we report a physician's certification status. For all diplomates, regardless of when they were initially certified, ABIM, in addition to reporting certification status, will report whether or not diplomates are “Meeting MOC Requirements.”

On a candidate's written request to ABIM, the following information will also be provided in writing: (1) that an application for certification or Maintenance of Certification is currently in process and/or (2) the year the candidate was last admitted to examination.

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Reporting Board Eligibility

ABIM does not confirm or report the Board Eligibility status of its candidates. Parties interested in a candidate's Board Eligibility status may wish to communicate directly with the candidate and/or with the appropriate training program.

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Representation of Board Certification and Board Eligibility Status

Physicians must accurately state their ABIM Board Certification or Board Eligibility status at all times. This includes descriptions in curriculum vitae, advertisements, publications, directories and letterheads.

Please note: ABIM does not authorize the use of its logo by others. Diplomates with expired time-limited certification or those whose certification is suspended or revoked may not claim ABIM Board Certification and must revise all descriptions of their qualifications accordingly. Additionally, a candidate who does not meet the requirements for Board Eligibility set forth above may not represent himself or herself as Board Eligible. Diplomates who have multiple certifications and allow one of them to lapse should revise their public materials (letterhead, business cards, advertisements, etc.) to reflect those certifications that are currently valid.

A physician who misrepresents his or her Board Certification or Board Eligibility status may be subject to disciplinary sanctions, including the revocation or suspension of the physician’s Board Certification or eligibility to participate in the certification or Maintenance of Certification processes.

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Errors and Disruptions in Examination Administration

Occasionally problems occur in the creation, administration and scoring of examinations. For example, power failures, hardware and software problems, human errors or weather problems may interfere with some part of the examination process. When problems occur and ABIM determines that they have compromised the integrity of the examination results, ABIM will provide affected candidates with an opportunity for re-examination. Re-examination shall be the candidate's sole remedy. ABIM shall not be liable for inconvenience, expense or other damage caused by any problems in the creation, administration or scoring of an examination, including the need for retesting or delays in score reporting. In no circumstance will ABIM reduce its standards as a means of correcting a problem in examination administration.

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Confidentiality Policy

ABIM considers the certification or recertification status of its candidates and diplomates to be public information.

ABIM provides a diplomate's certification status and personal identifying information, including mailing address, e-mail address and last four digits of a diplomate's social security number, to the Federation of State Medical Boards (FSMB), the American Board of Medical Specialties (ABMS) (which publishes The Official ABMS Directory of Board Certified Medical Specialists), and to other credential and licensure verification organizations. FSMB uses personal identifying information, including the last four digits of social security numbers, as unique internal identifiers and is required to maintain the confidentiality of this information. ABMS also uses the last four digits of social security numbers as unique internal identifiers, and publishes other personal identifying information (but not social security numbers) for purposes of The Official ABMS Directory of Board Certified Medical Specialists. ABMS contacts diplomates directly to verify the accuracy of the information published in the directory and to obtain consent to publish such information. However, as noted above, ABIM considers the certification status of diplomates to be public information, and thus information relevant to basic reporting of certification status (including your name) may not be omitted from the ABMS Directory or from ABIM's Check a Doctor's Certification Tool on ABIM's website. ABIM may provide a diplomate's certification status and address to professional medical societies and other organizations that provide ABIM-sanctioned educational resources and products used for Self-Evaluation of Medical Knowledge or Practice Assessment in the Maintenance of Certification program.

ABIM provides residency and fellowship training program directors with information about a trainee's prior training and pass/fail status on certifying examinations. If a trainee has granted permission, ABIM will provide the program director with the trainee's score on his/her first attempt at the Certification examination for that area of training. ABIM uses examination performance, training program evaluations, Self-Evaluation of Medical Knowledge and Practice Assessment, and other information (including demographic variables such as physician gender, age and medical school graduation country, as well as practice characteristics such as location and type of medical practice) for research purposes, including collaboration with other research investigators and scientific publications. In presenting or publishing the results of such research, ABIM will not identify specific individuals, hospitals or practice associations. Any practice performance data that includes Protected Health Information is maintained in a HIPAA-compliant manner.

ABIM reserves the right to disclose information it possesses about any individual whom it judges has violated ABIM rules, engaged in misrepresentation or unprofessional behavior, or shows signs of impairment.

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Licensure

ABIM candidates and diplomates for certification and Maintenance of Certification must possess a permanent, valid, unrestricted, and unchallenged medical license in the United States, its territories or Canada. Physicians practicing exclusively abroad and who do not hold a U.S. or Canadian license must hold a license where they practice and provide documentation from the relevant licensing authority that their license is in good standing and without conditions or restrictions. Restrictions include but are not limited to conditions, contingencies, probation, limitations and stipulated agreements.

A physician with a restricted, suspended, revoked or surrendered license in any jurisdiction is not eligible to be certified, recertified or admitted to a certification or maintenance of certification examination. ABIM will suspend or revoke the Board Certification of any diplomate who has a suspended, revoked or surrendered license in one or more jurisdictions and no valid license in any jurisdiction. A diplomate who has a suspended, revoked, or surrendered license in one or more jurisdictions but who continues to hold a valid license in another jurisdiction – or a diplomate whose license in any jurisdiction has been restricted – may be subject to disciplinary sanctions, including the suspension or revocation of the physician's Board Certification.

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Disabled Candidates

ABIM recognizes that some candidates have physical limitations that make it impossible for them to fulfill the requirement for proficiency in performing procedures. For such individuals, the procedural skills requirement may be waived. Program directors should write to ABIM for an exception before the individual enters training or when the disability becomes established.

ABIM is committed to offering suitable examination accommodations for all candidates, including individuals with disabilities. When necessary, alternative arrangements under conditions comparable to those provided for other candidates are offered to disabled individuals. Candidates who need accommodation for a disability during an examination must provide a written request to ABIM and documentation must be received by ABIM no later than the examination registration deadline. Reapplication for special accommodation is not required for each examination administration unless a new accommodation is requested. ABIM treats requests for accommodations as confidential. For additional information about the process and documentation requirements, please contact ABIM at accommodations@abim.org, or refer to Take the Exam: Accommodation for Test Takers with Disabilities.

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Substance Abuse

If a candidate or a diplomate has a history of substance abuse, documentation of at least one year of continuous sobriety from a reliable monitoring source may be required for admission to an examination or to receive a certificate. ABIM treats such information as confidential.

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Examination Ethics

Those who take ABIM examinations have a continuing obligation to maintain examination confidentiality. See Copyright and Examination Non-Disclosure Policy on the inside cover of this document.

All ABIM examinations are administered in secure testing centers by test administrators who are responsible for maintaining the integrity and security of the certification process. Test administrators are required to report to ABIM any irregular or improper behavior by a candidate, such as giving or obtaining information or aid, looking at the test material of others, removing examination materials from the test center, taking notes, bringing unauthorized items, including electronic devices (e.g., beepers, pagers, cell phones, etc.), into the examination, failing to comply with time limits or instructions, talking or other disruptive behavior. Test administrators may intervene to stop any of the foregoing. In addition, as part of its effort to assure exam integrity, ABIM utilizes data forensic techniques that use statistical analyses of test-response data to identify patterns of test fraud, including cheating and copyright infringement. ABIM investigates all irregularity reports.

Irregular or improper behavior in examinations that is observed, made apparent by data forensics or statistical analysis, or uncovered by other means will be considered a subversion of the certification process and will constitute grounds for invalidation of a candidate's examination and subject the candidate to disciplinary sanctions, including suspension or revocation of Board Certification or eligibility to participate in the certification or Maintenance of Certification processes. Failure to fully cooperate with an ABIM investigation also may be considered unprofessional conduct and constitute grounds for disciplinary sanctions.

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Disciplinary Sanctions and Appeals

ABIM may, at its discretion, rescind a diplomate's Board Certification if the diplomate was not qualified to receive the certificate at the time it was issued, even if the certificate was issued as a result of a mistake on the part of ABIM.

ABIM may impose disciplinary sanctions, including the suspension or revocation of Board Certification or participation in the certification or Maintenance of Certification processes, invalidation of an examination, or other professional sanctions, if ABIM obtains evidence that in its judgment demonstrates that a candidate or diplomate: (1) has had a license to practice medicine restricted in any jurisdiction, has surrendered a license but continues to hold a valid license in another jurisdiction, or has had one or more licenses suspended or revoked but continues to hold a valid license; (2) engaged in irregular or improper behavior or other misconduct in connection with an ABIM examination; (3) made a material misstatement of fact or omission in connection to ABIM with an application, or misrepresented his or her Board Certification or Board Eligibility status to anyone; (4) failed to maintain moral, ethical or professional behavior satisfactory to ABIM; or (5) engaged in misconduct that adversely affects professional competence or integrity.

In the event ABIM obtains such evidence, it shall so notify the physician in writing. Such notification shall: (1) advise the physician that the ABIM Credentials and Certification Committee (“CCC”) will determine on behalf of ABIM, no fewer than forty-five days after the date of the notice, whether to recommend any disciplinary sanction; (2) summarize the evidence in ABIM's possession; (3) include copies of any documentary evidence in ABIM's possession; (4) provide the physician an opportunity to make a written submission to the CCC; (5) disclose the policy(ies) and/or procedure(s) pursuant to which ABIM may recommend a sanction, and the possible sanction(s); (6) advise the physician that the failure to respond timely to the notice may be considered unprofessional and weighed against the physician by the CCC; and (7) advise the physician that if the CCC recommends a sanction, the physician would have a right of appeal with an in-person or telephonic hearing before a panel designated by ABIM's Board of Directors.

In the event the CCC determines to recommend a disciplinary sanction, it shall so notify the physician in writing. Such notification will: (1) set forth the factual bases for such determination; (2) summarize the reasons for such determination; (3) advise the physician of his or her right to request an appeal of the CCC's determination; (4) advise the physician that any request for an appeal must be submitted to ABIM within thirty days of the date of the notice of the CCC's determination; (5) provide procedural information about the appeal process; (6) advise the physician that if a hearing is requested, ABIM will provide notice of the members of the appeal panel and the date, time, and if applicable, place of the hearing at least forty-five days in advance of the hearing; and (7) advise the physician that while a recommended sanction is not final and does not affect a physician's Board Certification status, a physician who is subject to a recommended sanction is not eligible to participate in the certification process. If a physician declines to appeal a recommended sanction, the recommended sanction determined by the CCC shall become the final decision of ABIM.

An appeal of a recommended sanction shall be determined by a panel consisting of three non-ABIM employee physicians designated by ABIM's Board of Directors and including at least one member of the Board of Directors (an “Appeal Panel”). An Appeal Panel shall have the discretion to affirm, rescind, or modify a recommended sanction, or impose an alternative sanction. In advance of each appeal hearing ABIM shall provide each member of the Appeal Panel and the physician appellant with copies of the documentary record for the physician's sanction and appeal proceeding. In its consideration of an appeal of a recommended sanction, an Appeal Panel shall not be bound by any technical rules of evidence, shall consider any information timely submitted by or on behalf of the physician at any stage of the proceeding, and shall hold a hearing. At an appeal hearing, the physician and/or the physician's counsel may present information and, subject to the Appeal Panel's discretion, witnesses. ABIM's counsel may ask questions of the physician, the physician's counsel, and any witnesses. Appeal hearings shall be transcribed by a professional stenographer. After reaching a decision, an Appeal Panel shall notify the physician of its decision in writing. Such written decision shall include the factual bases of the decision and a summary of the reasons for the decision. The decision of the majority of an Appeal Panel shall be the final decision of ABIM.

The foregoing sanction and appeal procedures shall apply to matters arising on or after July 1, 2013. Earlier arising matters will be handled in accordance with ABIM's policies and procedures previously in effect.

Notwithstanding these procedures, ABIM reserves the right to revoke or suspend a diplomate's Board Certification summarily in extraordinary circumstances.

ABIM, in its sole discretion, may notify local credentialing bodies, licensing bodies, law enforcement agencies, program directors, impaired physicians advocacy groups, or others of any final disciplinary sanctions.

To regain Board Certification after a suspension, the physician must comply with such conditions as ABIM may impose and successfully complete ABIM's Maintenance of Certification program.

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Copyright and Examination Non-Disclosure Policy

All ABIM materials are protected by the federal Copyright Act, 17 U.S.C. § 101, et seq. Access to all such materials, as further detailed below, is strictly conditioned upon agreement to abide by ABIM's rights under the Copyright Act and to maintain examination confidentiality.

ABIM examinations are confidential, in addition to being protected by federal copyright and trade secret laws. Candidates and diplomates who undertake examinations agree that they will not copy, reproduce, adapt, disclose, or transmit examinations, in whole or in part, before or after taking an examination, by any means now known or hereafter invented. They further agree that they will not reconstruct examination content from memory, by dictation, or by any other means or otherwise discuss examination content with others. Candidates and Diplomates further acknowledge that disclosure or any other use of ABIM examination content constitutes professional misconduct and may expose them to criminal as well as civil liability, and may also result in ABIM's imposition of penalties against them, including but not limited to, invalidation of examination results, exclusion from future examinations, suspension, revocation of certification and other sanctions.

With respect to ABIM's Maintenance of Certification (MOC) products, including its Medical Knowledge Modules and ABIM PIMs Practice Improvement Modules®, candidates agree that they will not copy, reproduce or make any adaptations of such materials in any manner; and will not assist someone else in the infringement or misuse of these or any other ABIM-copyrighted works.

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Competency in Technology

Consistent with the ABMS/ACGME General Competencies in Systems-Based Practice, ABIM requires its candidates and diplomates to possess sufficient competencies in information technology, including the use of personal computers, the Internet, and e-mail, for correspondence and completion of examinations and modules throughout their participation in ABIM Certification and Maintenance of Certification programs.