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 Board Certification. This information will include the comments provided with the evaluation.
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.
Leave of Absence and Vacation
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 unless the Deficits in Required Training Time policy is used and approved. 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.
ABIM views educational leave, which would include attendance at training-related seminars, courses, interviews for subsequent training positions, etc., as bona fide educational experiences or duties essential for the continuity of education from internal medicine to a subspecialty and, therefore, need not be counted as part of the one-month allocation for leave time in the academic year for purposes of tracking training time for ABIM.
Deficits in Required Training Time
ABIM recognizes that delays or interruptions may arise during training such that the required training cannot be completed within the standard total training time for the training type. In such circumstances, if the trainee's program director and clinical competency committee attest to ABIM that the trainee has achieved required competence with a deficit of less than one month, extended training may not be required. Only program directors may request that ABIM apply the Deficits in Required Training Time policy on a trainee's behalf, and such a request may only be made during the trainee's final year of training. Program directors may request a deficit in training time when submitting evaluations for the final year of standard training via FasTrack, subject to ABIM review.
- A rheumatology trainee beginning training on July 1, 2015 anticipates a completion date by June 30, 2017. A six week medical leave in the F1 year causes the total cumulative leave over the 24-month training period to exceed the 62 days of permitted leave by ten days and extending the completion date until July 10, 2017.
- An internal medicine trainee beginning training on July 27, 2014 (27 days off-cycle due to a visa delay) anticipates a completion date by July 26, 2017.
In each example, the trainee may complete training on June 30 if:
- The program attests to the trainee's achieving the required competence on June 30, 2017,
- The program documents the reasons for the deficit in training on the trainee's ABIM FasTrack® evaluation, and
- ABIM approves the program director's request to apply the Deficits in Required Training Time policy.
The Deficits in Required Training Time policy is not intended to be used to shorten training before the end of the academic year.
- An internal medicine trainee who initiated training on July 1, 2015 and anticipated completion by June 30, 2018 may not invoke the Deficits in Required Training Time policy in an effort to truncate his or her training (e.g., to enter a fellowship prior to July 1, 2018).
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.
Transition to the ACGME/AOA Single Accreditation System
Beginning in July 2015, for residents and fellows who begin training in an AOA-accredited program which receives ACGME accreditation before graduation, all satisfactorily completed years of training will be accepted towards ABIM’s initial certification eligibility requirements. To be granted admission to an ABIM certification examination, candidates must meet all applicable training, licensure, professional standing and procedural requirements.
Through its tracking process, FasTrack®, ABIM requires verification of trainees' clinical competence from an ABIM certified program director (other ABMS Board and Canadian certification is acceptable, if applicable). In support of the Single Accreditation System (SAS), ABIM recognized the need for a change in eligibility policies to allow program directors of newly accredited programs to become certified by ABIM and for a transition period (2015-2020) to allow them to do so. If the program director of a program achieving accreditation through the SAS is not currently certified by ABIM in the discipline for which he or she is program director, there is now a Special Consideration Pathway which will allow the program director to become certified by ABIM.
During the transition period for the SAS (2015 – 2020), ABIM will accept attestations for ABIM initial certification eligibility criteria from those who are program directors through the SAS, but who have not yet become ABIM certified. Beginning in 2021, all attestations to ABIM initial certification eligibility criteria will need to come from program directors who are ABIM certified. For additional information, please see the “Clinical Competence Requirements” section under each certification area.
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. During training periods, patient care responsibilities should be maintained in a continuity clinic consistent with ACGME program requirements for the discipline. Part-time training, whether or not continuous, is not acceptable.