ABIM Certification & Re-certification

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.^[1]

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.^[2] 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.^[3]

Physicians certified by the ABIM, on average, deliver a higher quality of health care.^[4]

Certified physicians had a lower mortality rate for patients with acute myocardial infarction than non-certified physicians.^[5]
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.^[6]
Preventative care services were provided to Medicare patients by certified physicians more often than non-certified.^[7]

Employers and health plans require it, and patients prefer it.

One-half of physicians report that their employer requires maintenance of certification.^[8]
- 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.^[8]
- 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.^[8]

Residency In-training Examination as a Predictor of Performance on the ABIM Certification Exam

A resident's performance on in-training examinations administered during residency is strongly predictive of their performance on the American Board of Internal Medicine Certification exam.^[10,11]
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 renewal.

Factors that negatively impact ABIM Board performance^[12]

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.