ATLANTA — Cardiology’s bid to escape what many see as burdensome requirements for board certification maintenance under the American Board of Internal Medicine (ABIM) is well underway, a panel reported at the American College of Cardiology (ACC) annual meeting.
The ACC announced in September 2023 the break with the ABIM to create an independent cardiology board. It’s joined by the American Heart Association, Heart Failure Society of America (HFSA), Heart Rhythm Society, and Society for Cardiovascular Angiography & Interventions (SCAI) for a “true house of cardiology movement,” said ACC president B. Hadley Wilson, MD.
The application to create a new Board of Cardiovascular Medicine was submitted in January through the American Board of Medical Specialties (ABMS), which oversees ABIM and 23 other specialty boards.
A 90-day public comment period is coming soon, and a decision on the application is expected within the next 6 to 8 months. If accepted, the board could be operational by early 2025, said panelist Jeffrey Kuvin, MD, of Northwell Health in Manhasset, New York.
The cardiology societies have named 10 of the anticipated 15 members of its transitional board and aim to add representation for adult congenital, imaging, and education, as well as patients.
However quickly things appear to be moving, the panel repeatedly cautioned cardiologists to continue paying their fees and completing board certification through existing ABIM pathways until everything is finalized.
Cardiology has been part of the internal medicine board since 1941, but it’s time for a change, argued Kuvin, who has been a leader in the cardiology board effort.
“Now is the time that cardiology needs to distinguish itself as a separate specialty,” he said. “Many cardiology departments are separated from internal medicine departments, building their own service lines, building their own institutes for cardiovascular centers.”
American Heart Association President Joseph C. Wu, MD, PhD, told attendees at the session that he is in the midst of preparing for his own 10-year recertification and has seen a real potential for improvement in the process.
“The way that we’ve been testing our cardiologists, including myself, is probably not the right approach,” he said. “Think about all the exams that we try to cram and memorize for. Three months later, it’s all gone. I actually think most of the information is available online these days, and we should be testing … the application of knowledge, not a brute force memorization.”
The group described an iterative rather than punitive process.
“There will be an initial certification process for fellows as they enter into the practice of cardiology,” said Kuvin. “Thereafter, it’s going to be more of continuous back and forth certification: understanding what you know in your field of practice, getting feedback, and then filling those knowledge gaps without high stakes testing, without putting you in a corner to say, ‘You didn’t pass this test, you need to step aside from what you’re doing right now.'”
“We envision this to be a much more supportive process as professionals to enhance your practice, not to limit you. So, you know, stay tuned for further details. But it’ll be less about testing, more about learning.”
For practicing cardiologists, there are other potential benefits as well, noted Wilson.
Notably, “significant cost savings for the member participants,” he told MedPage Today, pointing to projections of costs “40% to 50% less than they may be currently paying … and then also we can make the continuing competency be in a more organized fashion where it will not be as difficult for people to continue to be certified.”
It’s the first application for a new board to be submitted in the last 30 years, but Wilson noted that it may pave the way for others.
Professional organizations have increasingly expressed dissatisfaction with the ABIM’s maintenance of certification program, with calls for change or elimination from oncology and infectious diseases societies.
“I’ve been on some of these multidisciplinary, multispecialty panels, and we are the first to do this, but there has been just informally, interest from gastroenterology, oncology,” Wilson told MedPage Today.
For centers currently working on their credentialing, George D. Dangas, MD, PhD, president of SCAI, noted from his own experience that using the wording “any new equivalent board in ABMS” could prepare for future changes.
While “change is hard,” it would be largely administrative, noted HFSA President James C. Fang, MD. And, he added, “it’s hard to imagine a downside if we’re really trying to improve care for the public.”
Primary Source
ACC
Source Reference: Wu JC, et al “Charting a new frontier: Next steps in efforts to create a new CV board” ACC 2024; Session 2002.
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