Longitudinal Knowledge Assessment

In Cardiovascular Disease, Advanced Heart Failure and Transplant Cardiology, Clinical Cardiac Electrophysiology and Interventional Cardiology, the ACC Collaborative Maintenance Pathway will be available.

All diplomates will continue to have the traditional, 10-year MOC exam available.

Once the LKA launches in your specialty, you will be eligible to start.

• All board certified physicians, except those in a grace year, can start participating in the LKA in their assessment due year. As long as they are already certified, physicians will continue to be reported as “Certified” as long as they are meeting the Participation Requirement, and a decision on their performance is made in the 5^th year. You won’t be able to start LKA before your assessment due year.
• Physicians who earned their certificate prior to 1990 can use the LKA to help them meet their MOC Participation Requirement. No physician with a lifetime certification will ever lose certification due to not meeting an assessment requirement.
• The LKA can be used to regain certification if it is available in your specialty; however, please note that because a decision on performance is not made until the end of the 5^th year of participation, a physician will be reported as “Not Certified” until that time. Your status will only change at that time if you pass the LKA and are meeting all other MOC requirements. A physician whose certification has lapsed may use the traditional, 10-year MOC exam to restore certification more quickly.
• Any physician in their grace year is ineligible for the LKA and must pass the traditional, 10-year MOC exam by the end of their grace year to continue to be reported as “Certified.”
• Diplomates from co-sponsored ABMS Member Boards will be able to participate in the LKA if it is available in their specialty.

Enrollment for the 2025 LKA opened 12/1/24. Please note that since LKA questions are delivered on a quarterly basis, delaying enrollment may mean less time to answer questions, or that some questions expired at the end of the previous quarter. The absolute last day to enroll in the 2025 LKA is 6/30/25. If you’re a diplomate from a co-sponsored board, please contact your certifying board to confirm if LKA will be offered as an assessment option.

Physicians whose certification has lapsed can meet their assessment requirement by passing one traditional, 10-year MOC examination or by successfully participating in the Longitudinal Knowledge Assessment (LKA^®) if it is available in your specialty. However, because a decision on performance is not made until the end of the 5th year of the LKA cycle, such physicians choosing the LKA cannot regain certification for at least 5 years. Your status will only change at that time if you pass the LKA and are meeting all other MOC requirements.

ACC Collaborative Maintenance Pathway will remain an option for those currently board certified in cardiovascular disease or a cardiology subspecialty to meet their assessment requirement.

In addition to the Collaborative Maintenance Pathway, general cardiologists and cardiology subspecialists will be able to take the traditional, 10-year MOC exam in Cardiovascular Disease, Clinical Cardiac Electrophysiology, Interventional Cardiology and Advanced Heart Failure and Transplant Cardiology.

Sign in to your personalized Physician Portal to view requirements, due dates and assessment options.

As an ABIM physician certified in Sleep Medicine, you have two LKA options:

1. The general Sleep Medicine LKA
2. The Sleep Medicine LKA: Obstructive Sleep Apnea (OSA) Emphasis
   • This option has a greater number of questions on OSA. It also includes additional questions on bruxism, snoring, GERD, and home sleep apnea testing. Overall, there is about a 70% overlap with the current general Sleep Medicine blueprint.

Learn more about how the Sleep Medicine LKA: OSA Emphasis works.

Once you’re enrolled in the LKA, as long as you’re already certified and continue to meet the LKA Participation Requirement and any other MOC requirements, you’ll continue to be publicly reported as Certified for your entire 5-year cycle. But if you’re finding that LKA isn’t working for you and you’d prefer to take the traditional, 10-year MOC exam sooner, you can unenroll and register for an exam through your personalized ABIM Physician Portal.

No. You will not be able to enroll in the LKA while your exam results are pending. Once the exam results have been released, if you happen to be unsuccessful and wish to switch to the LKA, you can do so as long as it is not beyond the June 30 LKA enrollment deadline. Exam results can take up to three months to be released. This means that the exam results could be pending beyond the aforementioned deadline, and you could not switch to the LKA. In this case, you would still have the opportunity to take the traditional, 10-year MOC exam or Collaborative Maintenance Pathway (CMP) in cardiovascular disease or a cardiology subspecialty.

Use the LKA to meet your MOC assessment requirement and earn MOC points.

* Participation Requirement includes built-in flexibility to allow for life’s circumstances, such as short-term medical issues, vacations, weddings, funerals, or other personal events.

As a longitudinal assessment, the LKA is designed to help you measure your medical knowledge over time. This means you’ll have the opportunity to change your approach and improve your performance during your 5-year cycle if you find you're not performing at the level you expected.

While the LKA is intended to be both a learning tool and an assessment focused on medical knowledge that a physician typically wouldn’t need to research extensively in day-to-day practice, you should still take it seriously and treat it like an assessment. Some physicians may find that their typical approach to keeping current with medical knowledge is effective and no additional studying is required. Others may want to use the feedback provided as part of the LKA to address knowledge gaps to ensure that their knowledge remains broad and current. This feedback includes the correct answer to the question, the rationale for the right and wrong answers, and references.

In addition, your interim progress report (offered at the end of the first quarter of the second year of your LKA participation, and every quarter afterwards) will give you helpful information to re-adjust your approach and focus your studies as needed. You are encouraged to try the LKA and see what works best for you.

And remember, because a pass/fail decision isn’t made until the end of 5 years, as long as you continue to meet the LKA Participation Requirement (open at least 500 out of 600 questions over 5 years) your certification status won’t be affected before then. Learn more about what happens at the end of your five-year cycle.

We know sometimes you’re needed elsewhere in your life, or that it’s simply not the best time for you to focus on LKA questions. That's why the LKA Participation Requirement includes built-in flexibility to allow for life’s circumstances, such as short-term medical issues, vacations, weddings, funerals, or other events. Whatever the reason, we encourage you to take a break and not open questions when “life happens,” and come back when you’re ready.  

As long as you open at least 500 out of the 600 questions offered over the course of your 5-year LKA cycle, you’ll have met the LKA Participation Requirement.  

You’ll receive 30 questions at the start of each quarter, and can answer them any time before the end of that quarter. You’ll have five minutes per question, and can answer one at a time, in batches, or whatever works best for you.

At the end of each quarter:

• Questions you have opened will be scored.
• Questions you have not opened will count toward the maximum of 100 total questions you don’t have to open over 5 years.

Please note any unopened questions will not be scored and expire at the end of the quarter, meaning you can't come back to them later.

When you need a break, simply don’t open the questions – up to 100 over your 5-year LKA cycle – because once you open a question, it will be scored even if you don't answer it. And don't worry, you'll get notifications about how many questions you’ve opened and how many are remaining in your 5-year LKA cycle to help you stay on track.

If you don't meet the LKA Participation Requirement ABIM will let you know, and you'll be able to take the traditional, 10-year MOC exam to stay certified.

The LKA performance standard indicates the score you must meet at the end of your 5-year cycle to maintain your certification, also referred to as the Passing Score. Although you will receive formative feedback on how you are doing along the way, including how you are performing relative to the current Passing Score, a summative determination is made at the end of the 5th year.

If your score meets or exceeds the Passing Score at the end of your 5-year cycle, you can continue with the LKA. Failure to meet the performance standard does not result in loss of certification, however, you must pass the traditional, 10-year MOC exam the following year to remain certified.

In accordance with best practice in assessment, ABIM periodically consults with practicing physicians in your discipline to review and update the Passing Score. This allows ABIM to ensure that the passing scores reflect appropriate and current expectations for examinee performance in the discipline. As a result, the Passing Score shown on your quarterly progress report may change during the course of your 5-year cycle. When this occurs, ABIM will update the passing score on your progress report before the summative decision is made at the end of the 5-year cycle.

A summative, pass/fail decision is made at the end of your 5-year cycle.

If you pass:

• You can choose to continue the LKA, and would begin your next 5-year cycle the following year. You would continue to be reported as certified throughout that 5-year cycle as long as you are meeting any other MOC requirements.
• Or, you could choose to take the traditional, 10-year MOC exam the following year instead. You will be reported as certified during that year, and if you pass, your next assessment will be due in 10 years.

If you do not pass:

• You will enter the grace period, meaning you will have one year to take and pass the traditional, 10-year MOC exam. You will continue to be reported as certified during the grace period as long as you are meeting all other MOC requirements.

We understand many physicians maintain certification in more than one discipline. At launch the number of questions offered through the LKA will be the same for all specialties. We are exploring models that may allow us to reduce the number of questions for disciplines that have overlapping content in the future.

One benefit of using LKA for multiple certificates is that you’ll still receive 0.2 MOC points for every correct answer, giving you even more opportunities to earn points. Remember: you only need to earn a total of 100 MOC points over 5 years, no matter how many certificates you’re maintaining. 

ABIM will continue to offer you choice in which assessment option works best for you: the traditional 10-year MOC exam or, depending on discipline, the LKA. Cardiologists will also have the ABIM/ACC Collaborative Maintenance Pathway available.

Whichever assessment option you choose, they all provide a way for you to know and demonstrate to your patients that you’re keeping your medical knowledge current.

While you will earn 0.2 MOC points for every correct answer, please note your 5-year assessment cycle and your 5-year points cycle may or may not align. You can still earn MOC points outside the LKA through thousands of activities eligible for both CME and MOC. Learn more at abim.org/points.

• If your certificate is not lapsed and has an expiration date on it, you will be issued a new printed certificate after successfully completing your first year of LKA participation so long as all other MOC requirements are up to date. Your new certificate will remain valid as long as you meet MOC requirements.
• If you
  • earned your Focused Practice in Hospital Medicine certificate in 2010 or later;
  • earned your initial certification in any other discipline in 2013 or later; or,
  • completed MOC requirements (recertified) in 2014 or later;

  your certificate is valid as long as you meet MOC requirements, and you will not be issued a new printed certificate.

• If you earned your certificate prior to 1990 you can request a printed certificate of appreciation after successfully completing your first year of LKA participation by emailing us at request@abim.org. As a reminder, if you were certified prior to 1990 your certificate is valid indefinitely.

Offering pretest questions is the best practice in assessment development and allows testing of new questions without risk to the candidate. These pretest questions are not counted in your score. Each pretest question is assessed according to statistical performance criteria. If these questions have acceptable statistics, they can be used in the future as live, scoreable questions.

You'll receive 30 questions at the start of each quarter, and can answer them any time before the end of that quarter. You'll have five minutes per question, and can answer one at a time, in batches, or whatever works best for you.

At the end of each quarter:

• Questions you have opened will be scored.
• Questions you have not opened will count toward the maximum of 100 total questions you don’t have to open over 5 years.

Please note any unopened questions will not be scored and expire at the end of the quarter, meaning you can't come back to them later.

Over the course of 5 years, you'll be offered 600 questions and must open at least 500 to meet the LKA Participation Requirement.

Questions are multiple choice, single best answer like those on the traditional, 10-year MOC exam. The number of questions is the same for all specialties.

participants complete all of their questions each quarter

The last day to enroll in the LKA in 2025 is 6/30/25. 

Once you open a question, you’ll have five minutes to answer it. If the time expires before an answer is selected, the question will be marked incorrect and you will be directed to the confidence rating and immediate feedback. If you select an answer but question time expires before you are able to click submit, the selected response will be recorded.

is spent on average per question

The LKA will use the existing MOC exam blueprints to inform its content. In other words, the major medical content categories in any given specialty will be the same for all MOC assessments.

ABIM assessments are confidential, in addition to being protected by federal copyright and trade secret laws. Candidates and diplomates who undertake assessments agree that they will not copy, reproduce, adapt, disclose or transmit assessments, in whole or in part, before or after taking an assessment, by any means now known or hereafter invented. They further agree that they will not reconstruct assessment content from memory, by dictation, or by any other means or otherwise discuss assessment content with others.

ABIM uses an Automated Test Assembly (ATA) program to build its assessments. This program ensures a fair balance of content is administered to examinees throughout their 5-year cycle. The ATA program takes multiple criteria into consideration when selecting questions to be administered each quarter, including the content blueprint of the assessment.

You will receive feedback immediately after responding to each question. Once you close the feedback for a particular question, you will not have access to the feedback again until the question is retired and appears in your question history on your Review Tab, about three months after the quarter closes for scored questions. Pretest questions are not included in your question history.

You will have access to your question history, which lists your questions with answers, rationales and references, about six months after you start the assessment and then quarterly thereafter. All live questions will show up in your question history about three months after the quarter closes, and will be available for one year.

Access to an interim formative progress report will be available after you have answered enough questions. For most physicians that will happen at the end of the first quarter of the second year of taking the LKA. The quarterly progress reports will let you know how you are performing relative to the current passing standard, helping you understand areas you are performing well in, as well as those in which you may want to focus on for future study.

We ask you to rate your confidence so you can later filter your item history and pinpoint areas to focus your review. Please note, your feedback will never be used toward your score and will remain anonymous.

Immediate feedback (answer, rationale and references) is currently provided for some pretest questions, and not for a small number of others, so that ABIM can evaluate the best way to administer new questions in the future.

ABIM is aware that, on occasion, for a small number of questions, changes in medicine (e.g., new practice guidelines) occur late in the examination publishing process and may alter what was previously the correct answer. Do your best to answer all questions according to your understanding of current clinical principles and practice. If ABIM determines that what was designed to be the correct answer has been changed by new information and there is no longer a single best response, this question will not be counted in the overall score.

The intention of the LKA quarterly progress report is to offer physicians continuous feedback about their performance on the LKA as they progress through a 5-year cycle. There are four sections on the LKA quarterly progress report:

1. Your Timeline:
   • Shows the examinee what quarter the current progress report is covering.
2. Your Performance:
   • Displays the examinee’s current score including that quarter.
   • Previous scores are also displayed.
   • The current passing score is displayed to allow the examinee to examine where their current score is relative to the passing score used during that quarter.
3. Group Performance:
   • Displays a distribution of scores for all examinees who received a score for that quarter.
   • Shows the examinee where their current score, the passing score, and the average score fall in the distribution.
4. Recent Content Area Performance:
   • Shows the examinee how many items they got correct and incorrect within each content area over the past year.
   • Shows the examinee how many items they were confident or not confident about, for items they got correct and incorrect, within each content area over the past year.

For additional information, please watch the LKA quarterly progress report video.

Your performance determines your examination pass-fail decision at the end of your 5-year cycle. Overall performance is reported on a standardized score scale ranging from 100 to 150, with a mean of 125. Examinees who have demonstrated equal ability on the assessment will achieve the same standardized score.

Because the LKA and traditional, 10-year MOC exam are separate assessments whose scores are not comparable, it is best practice to report LKA scores on their own, separate score scale. Therefore, rather than report scores ranging from 200-800 like the traditional 10-year MOC exam, LKA scores are reported on a standardized score scale that ranges from 100-150, with a mean of 125 and standard deviation of 8 on the base form of the assessment.

The Passing Score, also known as the Performance Standard, is the score that examinees must meet or exceed to pass the assessment. During their summative decision in LKA, examinees who score at or above the passing score will pass; examinees who score below the passing score will not. Passing scores at ABIM are absolute, meaning there is no predetermined pass rate. Instead your pass/fail decision is driven entirely by your performance relative to the Passing Score.

In accordance with best practice in assessment, ABIM periodically consults with practicing physicians in your discipline to review and update the Passing Score. This allows ABIM to ensure that the passing scores reflect appropriate and current expectations for examinee performance in the discipline. As a result, the Passing Score shown on the progress report may change during the course of your five-year cycle. When this occurs, ABIM will update the passing score on your progress report before the summative decision is made at the end of the five-year cycle.

More information on Standard Setting is available on the ABIM website.

Quarterly interim progress reports that include items through the end of a given quarter are released three to four months after that quarter has ended. To ensure the accuracy and integrity of the scores, ABIM conducts a rigorous multi-step scoring and quality assurance process. This quality assurance process includes, but is not limited to: item analysis, key validation, item calibration, equating, and scoring. Please be assured that ABIM recognizes the importance of receiving progress reports quickly for diplomates, and continues to make every effort to provide progress reports in a timely manner.

Yes. ABIM will offer LKA accommodations in compliance with Title III of the Americans with Disabilities Act (ADA) for individuals with documented disabilities who demonstrate a need for accommodation. Given the format of the LKA, some common testing accommodations may not be available.

Physicians requesting special testing accommodations under the ADA should submit a completed request by the deadline. All required documentation to be approved for the assessment must be received by deadline in order for staff to review and set the appropriate accommodations.

All physicians should review the Disability Accommodations Request policy in its entirety to ensure that they understand their rights and obligations when requesting a testing accommodation.

Learn more about ABIM’s evaluation of accommodations requests.

Note: Accommodation requests will only be considered with appropriate documentation. After the deadline, requests with insufficient information, or that are incomplete for any reason, will not be processed and the physician may begin the LKA under normal conditions or withdraw their request.

To request a testing accommodation for the LKA, the request forms and supporting documentation must be submitted to accommodations@abim.org in writing one month prior to the enrollment deadline for the upcoming quarter.

Please note, due to its format, certain accommodations may not be available for the LKA. ABIM will ensure that physicians with a disability have access to auxiliary aids and services in accordance with Title III, but devices and services of a personal nature must be provided by the physician. For example, the availability of a computer with broadband access is necessary for the LKA, but these would be considered personal devices or services that the physician is responsible for arranging.

If approved for additional testing time, the time will be added to the standard five minutes that physicians have to answer each question as well as the 30-minute time bank physicians may access each year, if more time is needed on a particular question.

Accommodations previously approved by ABIM may not automatically apply to the LKA due to the format. Upon enrollment in the LKA, ABIM’s accommodations team will review the approval history and provide a new determination for this assessment only.

If you are approved for accommodations after completing questions prior to your request, you may not begin the assessment from the start. The accommodation approval covers all remaining unanswered questions during your complete 5-year cycle.

The LKA is designed to work with most text-to-speech and screen magnification programs. You may also adjust the font size with your keyboard:

For additional information, please contact accommodations@abim.org and our accommodations team will provide any assistance.