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Eligibility for Certification and Board Policies

The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, September 2018 (pdf), governs ABIM's decision about eligibility for certification. The September 2018 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).

General Requirements

To become certified in the subspecialty of hematology, 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; and
  • Pass the Hematology Certification Examination.

Hematology 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 Collège des médecins du Québec.

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 31 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

Training and Procedural Requirements

Training and Procedures Requirements Before Academic Year 2017-18

The total months of training required for fellows beginning their hematology fellowship before Academic Year 2017-18, including specific clinical months, and requisite procedures are outlined below.

Minimum Months

of Training
Clinical Months

Required
Procedures

* Requires minimum 1/2 day per week in continuity outpatient clinic.

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
  • Bone marrow aspiration and biopsy, including preparation, examination, and interpretation of bone marrow aspirates and touch preparations of bone marrow biopsies.
  • Interpretation of peripheral blood smears, including manual white blood cell and platelet counts.
  • Administration of chemotherapeutic agents and biological products through all therapeutic routes.
  • Management and care of indwelling venous access catheters; and management of methods of apheresis.

Training and Procedural Requirements In or After Academic Year 2018-19

The total months of training required for fellows beginning their hematology fellowship in or after Academic Year 2018-19, including specific clinical months, and requisite procedures are outlined below.

Minimum Months

of Training
Clinical Months

Required
Procedures

* Requires minimum 1/2 day per week in continuity outpatient clinic.

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

Must demonstrate competence in:

  • Performance of bone marrow biopsies and aspirations
  • Assessment and interpretation of complete blood counts
  • Interpretation of peripheral blood smears
  • Use of systemic therapies through all therapeutic routes

Must demonstrate knowledge and experience of:

  • Interpretation of bone marrow biopsies and aspirations
  • How to make bone marrow aspirate smears and/or touch preps
  • The indications, risks and the process of performing therapeutic phlebotomy
  • How to prepare peripheral blood smears
  • The functional characteristics, indications, risks, and process of using indwelling venous access devices
  • Indications, contraindications, risks and management of complications of methods of apheresis

Training programs are strongly encouraged to make additional training and experiences available for their trainees who anticipate the need to perform specified procedures in their post‐training careers (e.g., training to achieve competence in: interpretation of bone marrow biopsies and/or aspirates; lumbar punctures for diagnosis and/or administration of intrathecal chemotherapy; administering therapeutics through Ommaya reservoirs, etc.).

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 an ABIM certified program director (other ABMS Board and Canadian certification is acceptable, if applicable).

As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence. In addition, fellows must receive satisfactory ratings in each of the six ACGME/ABMS Competencies 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 of the six ACGME/ABMS Competencies and overall clinical competence.

Program Director Ratings of Clinical Competence

Six ACGME/ABMS Competencies:

The resident/fellow is demonstrating satisfactory development of the knowledge, skill and attitudes/behaviors needed to advance in training. S/he is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice that includes the delivery of safe, effective, patient-centered, timely, efficient and equitable care.

Six ACGME/ABMS Competencies*
Components and Ratings Residents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training

* 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.

At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six ACGME/ABMS competencies.

Yes Full credit Full credit
Conditional on Improvement Full credit No credit; must achieve satisfactory rating before receiving credit
No Full credit No credit; must repeat year

Overall Clinical Competence

This rating represents the assessment of the resident/fellow's development of overall clinical competence during this year of training:

Overall Clinical Competence
Components and Ratings Residents/Fellows:
Not Final Year of Training
Residents/Fellows:
Final Year of Training
* At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six general competencies.
Satisfactory or Superior Full credit Full credit
Conditional on Improvement Full credit No credit; must achieve satisfactory rating before receiving credit*
Unsatisfactory No credit; must repeat year No credit; must repeat year

Dual Certification Requirements - Hematology and Medical Oncology

Dual certification in hematology and medical oncology requires three years of accredited combined training which must include: a minimum of 18 months of full-time clinical training, of which at least 12 months are in the diagnosis and management of a broad spectrum of neoplastic diseases including hematological malignancies, and six months are in the diagnosis and management of a broad spectrum of non-neoplastic hematological disorders. If the combined training must be taken in two different programs, 24 continuous months must be in one institution, and both institutions must be accredited in both hematology and medical oncology.

During the entire three years, the fellow must maintain a continuity outpatient clinic structured in a way consistent with ACGME requirements for continuity clinic in the discipline. Time spent in continuity outpatient clinic, during non-clinical training, is in addition to the requirement for full-time clinical training.

Candidates must complete all three years of required combined training before being admitted to an examination in either subspecialty. Those who elect to take an examination in one subspecialty following only two years of fellowship training will be required to complete four years of accredited training for dual certification.

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.

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

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.