Eligibility for Certification and Board Policies

The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, December 2013 (pdf), governs ABIM's decision about eligibility for certification. The December 2013 edition supersedes all previous publications. ABIM reserves the right to make changes in fees, examinations, policies and procedures at any time without advance notice. Admission to ABIM's certification process is determined by policies in force at the time of application. ABIM is a member of the American Board of Medical Specialties (ABMS).

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Nephrology Policies

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General Requirements

To become certified in the subspecialty of Nephrology, physicians must:

  • At the time of application, be previously certified in Internal Medicine by ABIM
  • Satisfactorily complete the requisite graduate medical education fellowship training
  • Demonstrate clinical competence, procedural skills, and moral and ethical behavior in the clinical setting
  • Hold a valid, unrestricted and unchallenged license to practice medicine
  • Pass the Nephrology Certification Examination

Nephrology fellowship training must be accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada, or the Professional Corporation of Physicians of Quebec.

No credit will be granted toward certification in a subspecialty for training completed outside of an accredited U.S. or Canadian program.

Fellowship training taken before completing the requirements for the MD or DO degree, training as a chief medical resident, practice experience, and attendance at postgraduate courses may not be credited toward the requirements for subspecialty certification.

To be admitted to an examination, candidates must have completed the required training in the subspecialty, including vacation time, by October 31st of the year of examination.

Candidates for certification in the subspecialties must meet ABIM's requirements for duration of training as well as minimum duration of full-time clinical training. Clinical training requirements may be met by aggregating full-time clinical training that occurs throughout the entire fellowship training period; clinical training need not be completed in successive months. Time spent in continuity outpatient clinic, during non-clinical training, is in addition to the requirement for full-time clinical training. Educational rotations completed during training may not be double counted to satisfy both internal medicine and subspecialty training requirements. Likewise, training which qualifies a diplomate for admission to one subspecialty exam cannot be double-counted toward certification in another subspecialty, with the exception of formally approved pathways for dual certification.

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Training and Procedural Requirements

The total months of training required, including specific clinical months, and requisite procedures are outlined below.

Minimum Months
of Training
Clinical Months
Required
Procedures

* 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.

24* 12
  • Placement of temporary vascular access for hemodialysis and related procedures
  • Acute and chronic hemodialysis
  • Peritoneal dialysis (excluding placement of temporary peritoneal catheters)
  • Continuous renal replacement therapy (CRRT)
  • Percutaneous biopsy of both autologous and transplanted kidneys
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Clinical Competence Requirements

ABIM requires documentation that candidates for certification are competent in: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.

Through its tracking process, FasTrack, ABIM requires verification of fellows' clinical competence from the training program director.

As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence and moral and ethical behavior in each of the required years of training. In addition, fellows must receive satisfactory ratings in each of the components of clinical competence and the requisite procedures during the final year of required training. It is the fellow's responsibility to arrange for any additional training needed to achieve a satisfactory rating in each component of clinical competence.

Program Director Ratings of Clinical Competence

Overall Clinical Competence
Ratings Fellows (any year)
Satisfactory or Superior Full credit
Unsatisfactory No credit, must repeat year
Moral and Ethical Behavior
Ratings Fellows (any year)
Satisfactory Full credit
Unsatisfactory No credit, must repeat year or, at the request of the program director and at ABIM’s discretion, a successful period of observation can be arranged in lieu of repeating the year to be granted credit
Evaluation of Individual General Competencies*
Ratings Fellows (any year)
* The six required competencies are: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.
Satisfactory or Superior Full credit
Unsatisfactory Must repeat year if during final year of required training
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Candidates for Special Consideration

ABIM diplomates in internal medicine may be proposed for special consideration for admission to a subspecialty examination by the program director of an accredited fellowship program if they:

  1. Have completed the full training required by ABIM in the subspecialty in another country and have met all current applicable ABIM procedural requirements.
  2. 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 at the time of proposal.
  3. Have served eight years, after formal training, as a clinician-educator or clinical investigator with a full-time appointment on a medical school faculty.
  4. Possess a valid, unrestricted license to practice medicine in a state, territory, commonwealth, province or possession of the United States or Canada.

Guidelines for proposals are available in Proposing Candidates for Special Consideration.

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Certification Using the Research Pathway

The ABIM Research Pathway is designed to integrate training in research and clinical internal medicine for those physicians who are seriously pursuing careers in basic science or clinical research. The value of the ABIM Research Pathway is that while it requires core clinical training, it concentrates on fostering a research experience that is comprehensive in terms of time, formal curriculum, and structured evaluation and feedback. These components are essential for professional growth and development and to promote continuous quality improvement.

Guidelines for certification using the research pathway are available in Research Pathway.

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