Longitudinal Knowledge Assessment

ABIM offers multiple ways to maintain your certification. Use the interactive tool below to select your specialty from the dropdown, then find your due year to learn more about your assessment options. Once you select a specialty, a second tool will display, making it easy to compare two or more specialties at a time if you maintain multiple certificates.

To find your specific due dates, please sign into your personalized Physician Portal.

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	Active Year

 

Three specialties—Critical Care Medicine, Infectious Disease, and Pulmonary Disease—will launch in 2023. Recruitment for volunteers to help write ABIM test questions typically starts in the spring, which would have occurred during the early phases of the COVID-19 pandemic. ABIM leadership consulted with physicians currently serving on its Exam Committees and Item Writing Task Forces in these disciplines, and recognizing the increased clinical obligations they were facing, decided that it was not the right time to pull them away from patient care to help with question development. Any currently certified physician in these three specialties who had an assessment due in 2020, 2021 or 2022 can wait and enroll in the longitudinal assessment when it becomes available to them in 2023.

Diplomates in the Focused Practice in Hospital Medicine (FPHM) program who had an assessment due in 2020, 2021 or 2022 can also wait to take an assessment in 2023, however their assessment options may be changing. Learn more here.

The LKA requires substantially more items compared to the traditional, 10-year MOC exam and won’t be available in certain specialties (Adult Congenital Heart Disease, Advanced Heart Failure and Transplant Cardiology and Transplant Hepatology) because there are fewer physicians maintaining certification in these highly specialized areas. Clinical Cardiac Electrophysiology will not be available at launch but will be revaluated for 2024.

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. 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.

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.

Due to the unprecedented demands of COVID-19, ABIM announced that physicians with an MOC requirement, including assessments, attestations or points due in 2020 or 2021, will have until 12/31/22 to complete them. NOTE: The 2-year Knowledge Check-In is no longer offered. Learn more about your assessment options. 

Sign in to your personalized Physician Portal to view upcoming requirements and due dates.

Due to the unprecedented demands of COVID-19, ABIM announced that physicians with an assessment, attestation or points due in 2020 or 2021 will have until 12/31/22 to complete them. 

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. Please note that ABIM is in the process of updating due dates in your portal to reflect the extension.

As an ABIM physician certified in Sleep Medicine, in 2023 you’ll 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.

• If you had an MOC requirement due in 2020 or 2021—including points, assessments or attestations—you have until 12/31/22 to complete these requirements in light of COVID-19. This means you can choose not to take an assessment in 2021 and participate in the LKA beginning in 2022, pending availability.
• If you are currently ABIM Board Certified in Critical Care Medicine, Infectious Disease or Pulmonary Disease and you are due for an assessment in 2020, 2021 or 2022, you can wait and participate in the LKA when it launches in your specialty in 2023 if you’d like. You can also choose the traditional, 10-year MOC exam at that time. More information for diplomates in the FPHM program can be found here.
• The Knowledge Check-In is no longer offered, and the new LKA has taken its place as an alternative to the traditional, 10-year MOC exam, which will continue to be an assessment option.

Enrollment for the 2023 LKA is currently open. 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 2023 LKA is 6/30/23. 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.

Once you’re enrolled in the LKA, as long as you’re meeting 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, 2023 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).

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 score 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.

ABIM understands that “life happens,” sometimes unexpectedly. 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 personal events.

Over the course of 5 years, you’ll be offered 600 questions and must open at least 500 to meet 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 four 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.

If 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 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. While you will receive formative feedback on how you are doing along the way, including how you are performing relative to the performance standard, a summative determination is made at the end of the 5^th year.

If your score meets or exceeds the performance standard, 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.

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.

• If you earned your certificate prior to 1990 you will be issued a new printed certificate of appreciation after successfully completing your first year of LKA participation. As a reminder, if you were certified prior to 1990 your certificate is valid indefinitely.
• 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.

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 four 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.

Reminder: The last day to enroll in LKA in 2022 is 6/30/22. If you are planning to participate in the LKA, it is a good idea to start early so you don’t miss any questions. Questions expire at the end of each quarter and you can’t go back to answer them later. Any unopened questions will count against the 100 you can choose not to open over 5 years.

Reminder: The last day to enroll in LKA in 2023 is 6/30/23. If you are planning to participate in the LKA, it is a good idea to start early so you don’t miss any questions. Questions expire at the end of each quarter and you can’t go back to answer them later. Any unopened questions will count against the 100 you can choose not to open over 5 years.

You'll receive 0.2 MOC points for every question you answer correctly. You’ll be offered 600 questions per 5-year assessment cycle, so over time you could potentially meet your MOC point requirement through LKA participation alone. Points you’ve earned will be awarded and added to your personalized ABIM Physician Portal quarterly.

If you participate in the LKA for more than one of your certificates 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.

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.

You'll have four minutes to answer a question and, each year, have access to a 30-minute time bank you can draw from if you need extra time on a particular question. This time allotment per question was derived by analyzing data from previous ABIM exams that allowed physicians to access an external resource. It also aligns with the construct of a longitudinal assessment in that it measures what physicians should know to provide high-quality patient care and emulates the finite time they have to look up information in practice.

If the question time expires before an answer is selected, the question will be marked incorrect and you will be directed to the post-question survey 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.

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.

For the majority of questions, you will receive feedback immediately after responding to each question. For a small portion of pre-test questions, immediate feedback is not provided.

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 score 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 score reports will let you know how you are performing relative to the overall 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 about frequency/importance/confidence so you can later filter your item history and pinpoint areas to focus your review. In addition, we use these data to better understand how pertinent each question is to your practice. 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 score 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 score report:

1. Your Timeline:
   • Shows the examinee what quarter the current score 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 score 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 score report may change during the course of your five-year cycle. When this occurs, ABIM will update the passing score on your score 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. 

The last section on the LKA quarterly score report shows Recent Content Area Performance. This section provides an overview of the examinee’s performance within the past year, broken down by the primary medical content areas covered on the assessment. This section displays how many questions an examinee has answered correctly or incorrectly within each content area, within the past year. In addition, this section displays information about how confident the examinee was in their response to the question.

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.

An examination blueprint is a table of specifications that defines the content of each exam. Content in the LKA is selected to conform to the MOC Blueprint within the discipline. Each Blueprint is developed by ABIM governance within the discipline guided by data collected from the examinee population. You can review the blueprint for your discipline on the ABIM website.

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.

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.

Physicians requesting special testing accommodations under the ADA should indicate as such through the examination application and submit a complete request by the published deadline. All required documentation to be approved for the assessment must be received by the enrollment deadline in order for staff to review and set the appropriate accommodations.

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.

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 four 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.