Recent developments at the American Board of Internal Medicine (ABIM) could affect your re-certification process as a working hospitalist. In 2004 SHM petitioned the ABIM to consider a program that would recognize the specific skills and knowledge of hospitalists. Last fall, ABIM voted to begin development of a Focused Recognition of Hospital Medicine through its Maintenance of Certification (MOC) system.
This focused recognition would give hospitalists a formal credential that recognizes hospital medicine as a distinct field within internal medicine. This is the first time in its history that ABIM has offered focused recognition for any subset of internal medicine, and—if approved—the first time that the umbrella organization, the American Board of Medical Specialties (ABMS), will offer a focused recognition for a subset of any specialty.
Robert Wachter, MD, professor of medicine at the University of California, San Francisco, is chair of ABIM’s Committee on Hospital Medicine Focused Recognition (HMFR). This committee is finalizing the details of how the focused recognition will work. Issues on their agenda include:
- Demonstration of a focused practice: The committee is considering setting a minimum volume of hospitalized patients for this that can reasonably apply to academic physicians, physician-administrators, and researchers—as well as clinical hospitalists.
- Requirements for demonstrating performance in practice: For MOC requirements, ABIM is increasingly examining the use of real practice data. In other words, measuring what physicians do rather than what they know.
- Tests for MOC: The exam for MOC with Focused Recognition of Hospital Medicine could be taken from the current MOC, with the same core content on internal medicine as well as new content relevant to hospital medicine, or it could be an entirely different test, focusing on hospital medicine.
The timeframe for an MOC with a Focused Recognition of Hospital Medicine is likely to be shorter than a standard MOC. “The minimum number of years that would elapse is still being discussed, but it would be no fewer than two and no more than four or five,” says Dr. Wachter. “Now, you don’t have to do an MOC until year 10. I’m hoping that people would start working toward their MOC as soon as they end their residency, but—people being people—they may not actually start work on this until year nine.”
What the Future Holds
In June the Committee on HMFR will present its recommendations for the process to the ABIM board, including how HMFR would relate to the rest of ABIM certification and MOC in internal medicine. Once approved, the plan will be presented to ABMS. “It will have to go through a process at ABMS, which takes a year or 18 months,” warns Holly Humphrey, MD, professor of medicine and dean for Medical Education at Pritzker School of Medicine, University of Chicago.
The goal is not to limit the practice of hospital medicine to those who have been through the focused recognition certification, but rather to lend credibility to the field. “What may change is that people hiring hospitalists may value this,” speculates Dr. Wachter. “The market will dictate” how necessary the re-certification becomes. TH