Internal Medicine Board Certification Facts
Background of ABIM
The American Board of Internal Medicine (ABIM) is a non-profit organization established
in 1936 to certify and recertify physicians of internal medicine and its subspecialties
in a standardized format and process through the utilization of self-evaluation
modules and secure examinations. The ABIM administers board examinations to members
of the American College of Physicians. Their mission is to set standards for clinical
competency, improve the quality of care delivered, and encourage continuing medical
education for post-graduate practitioners of internal medicine. Beginning in 1990,
ABIM granted certificates that were valid for 10 years. In order for physicians
to maintain their certification status, they must participate in the Maintenance
of Certification (MOC) program, which entails a self-evaluation component and a
secure examination (shorter than the initial exam). The majority of the internal
medicine community agrees that this process fosters a continued knowledge in up-to-date
medical practices, procedures, and treatment regimens.
Importance of Maintaining Certification
Research suggests that clinical skills and up-to-date medical knowledge diminishes
over time, even in the most experienced practicing physicians.
- While this may seem counterintuitive, evidence shows that the number of years a
physician has practiced is inversely proportional to the quality of care provided. As a result, physicians need a structured set
of criteria, as well as the tools required for self-assessment, in order to evaluate
the areas of clinical knowledge and current treatment plans/guidelines to help them
deliver the utmost in quality patient care.
Technology is changing continuously.
- Advances in technology lead to rapid changes in all aspects of health care delivery.
As such, physicians have an obligation to update their skills, knowledge base, and
outlook in order to maintain a high standard of quality in day-to-day clinical practice.
Physicians certified by the ABIM, on average, deliver a higher quality of health
- Certified physicians had a lower mortality rate for patients with acute myocardial
infarction than non-certified physicians.
- A decline in the quality of health care given to hypertensive patients has been
correlated with the time elapsed since a physician's most recent board certification.
- Preventative care services were provided to Medicare patients by certified physicians
more often than non-certified.
Employers and health plans require it, and patients prefer it.
- One-half of physicians report that their employer requires maintenance of certification.
- However, only one-third of these physicians recertified for the sole purpose of
employer requirement. Most recertify for positive professional reasons rather than
for monetary benefits or professional advancement.
- In many cases, physicians who did not recertify chose other fields.
- Many health insurance plans require physician board certification in order for the
physician to be considered "preferred" or "in network".
- Surveys suggest that patients prefer a board certified physician to a non-board
certified physician; they also expect physicians to periodically continue to build
on and update their knowledge base and current practices.[9,13]
Everybody is doing it.
- More than 75% of practicing internal medicine physicians recertify.
Residency In-training Examination as a Predictor of Performance on the ABIM Certification
- A resident's performance on in-training examinations administered during residency
is strongly predictive of their performance on the American Board of Internal Medicine
- Residents who performed well in the In-training Examination will appear more knowledgeable
and well-rounded than their peers and provide better patient care during residency.
- Poor attending evaluations and low USMLE scores can jeopardize residency contract
Factors that negatively impact ABIM Board performance
- Low scores on initial certification exam.
- Physicians who are in solo practice rather than group practice.
- Lower pass rate of foreign medical graduates often due to limited US clinical experience.
- Older physicians who have not taken a certification examination in a number of years.
1. Dale, David C. "Recertification
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2. Choudry, N.K.,
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Experience and Quality of Health Care." Annals of Internal Medicine, 2005. 142(4):
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L, Duffy DF. "Improving the quality of care via maintenance of certification and
the Web: an early status report." Perspectives in biology and medicine, 2008. 51(1):71-83
4. Reid RO. "Associations
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5. Norcini JJ, Kimball
HR, and Lipner RS. "Certification and specialization: do they matter in the outcome
of acute myocardial infarction?" Acad Med. 2000;75(12):1193-98.
6. Turchin A, Shubina
M, Chodos AH, Einbinder JS, Pendergrass ML. "Effect of board certification on antihypertensive
treatment intensification in patients with diabetes mellitus." Circulation 117(5):623-8.
(Feb 5, 2008)
7. Pham HH, Schrag
D, Hargraves JL, Bach PB. "Delivery of preventative services to older adults by
primary care physicians." JAMA. 2005;294(4):473-81.
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S; Bylsma Wayne H; Arnold Gerald K; Fortna Gregory S; Tooker John; Cassel Christine
K. "Who is maintaining certification in internal medicine--and why? A national survey
10 years after initial certification." Annals of Internal Medicine, 2006. 144(1):29-36.
9. Freed GL, Dunham
KM, Clark SJ, Davis MM. "Perspectives and preferences among the general public regarding
physician selection and board certification." J Pediatr. 2010; 156(5):841-5.
10. Grossman RS, Fincher
RM, Layne RD, Seelig CB, Berkowitz LR, and Levine MA. "Validity of the in-training
examination for predicting American Board of Internal Medicine certifying examination
scores." Journal of General Internal Medicine, 1992. 7(1):63-7.
11. Rollins LK, Martindale
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of Internal Medicine Certifying Examination." Journal of General Internal Medicine,
12. Lipner Rebecca,
Song Hao, Biester Thomas, Rhodes Robert. "Factors that influence general internists'
and surgeons' performance on maintenance of certification exams." Academic Medicine
: Journal of the Association of American Medical Colleges, 2011. 86(1):53-8.
13. Brennan TA, Horwitz
RI, Duffy FD, Cassek CK, Goode LD, Lipner RS. "The role of physician specialty board
certification status in the quality movement." JAMA. 2004; 292(9):1038-43.