Eligibility for Certification and Board Policies
The information provided on ABIM's website and in ABIM's print publication, Policies and Procedures for Certification, November 2024 (pdf), governs ABIM's decision about eligibility for certification. The November 2024 edition supersedes all previous publications. ABIM reserves the right to make changes in fees, examinations, policies and procedures at any time without advance notice. Admission to ABIM's certification process is determined by policies in force at the time of application. ABIM is a member of the American Board of Medical Specialties (ABMS).
General Requirements
To become certified in the subspecialty of nephrology, physicians must:
- At the time of application, be previously certified in internal medicine by ABIM;
- Satisfactorily complete the requisite graduate medical education fellowship training;
- Demonstrate clinical competence, procedural skills, and moral and ethical behavior in the clinical setting;
- Hold a valid, unrestricted and unchallenged license to practice medicine; and
- Pass the Nephrology Certification Examination.
Nephrology fellowship training must be accredited by the Accreditation Council for Graduate Medical Education (ACGME), the Royal College of Physicians and Surgeons of Canada or the Collège des médecins du Québec.
No credit will be granted toward certification in a subspecialty for training completed outside of an accredited U.S. or Canadian program.
Fellowship training taken before completing the requirements for the MD or DO degree, training as a chief medical resident, practice experience, and attendance at postgraduate courses may not be credited toward the requirements for subspecialty certification.
To be admitted to an examination, candidates must have completed the required training in the subspecialty, including vacation time, by October 31 of the year of examination.
Candidates for certification in the subspecialties must meet ABIM's requirements for duration of training as well as minimum duration of full-time clinical training. Clinical training requirements may be met by aggregating full-time clinical training that occurs throughout the entire fellowship training period; clinical training need not be completed in successive months. Time spent in continuity outpatient clinic, during non-clinical training, is in addition to the requirement for full-time clinical training. Educational rotations completed during training may not be double-counted to satisfy both internal medicine and subspecialty training requirements. Likewise, training which qualifies a diplomate for admission to one subspecialty exam cannot be double-counted toward certification in another subspecialty, with the exception of formally approved pathways for dual certification.
Training and Procedure Requirements
Training and Procedures Requirements Before Academic Year 2024-25
The procedures required for fellows beginning their nephrology fellowship before Academic Year 2024-25 are outlined below.
| Minimum Months of Training |
Clinical Months Required |
Procedures |
|---|---|---|
|
* For deficits of 35 days or less in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf. |
||
| 24* | 12 |
|
The ABIM Nephrology Specialty Board has approved for ABIM certification in Nephrology. A summary of the intended competencies and the rationale for inclusion can be found here. The requisite procedures for fellows beginning their fellowship in or after Academic Year 2024-25 are outlined below:
| Minimum Months of Training |
Clinical Months Required |
Procedures |
|---|---|---|
|
* For deficits of 35 days or less in required training time, ABIM will defer to the judgment of the program director and promotions or competency committee in determining the need for additional training. With program director attestation to ABIM that the trainee has achieved required competence, additional training time will not be required. Trainees cannot make a request to ABIM on their own behalf. ** An opportunity to train standard consists of both a knowledge requirement of training all fellows in the indications, contraindications, risks and benefits of the procedure and a requirement to provide the opportunity to train in the procedure to the level of competent and independent performance for those fellows who request the training. This opportunity to train must be arranged and sponsored by the fellowship program, but the training can be provided outside of the program. All fellows are not required to perform the procedure to competence to be eligible for ABIM certification, but program directors will need to attest that all fellows fulfilled the knowledge requirement and fellows requesting the training to procedural competency were provided the opportunity to train. |
||
| 24* | 12 |
The following procedures are required to be performed competently:
The following procedural experiences must be provided at an “opportunity to train” standard**:
|
Clinical Competence Requirements
ABIM requires documentation that candidates for certification are competent in: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice.
Through its tracking process, FasTrack®, ABIM requires verification of fellows' clinical competence from a program director certified by ABIM in the discipline for which they are program director (other ABMS Board and Canadian certification is acceptable, if applicable).
As outlined in the Program Director Ratings of Clinical Competence table below, all fellows must receive satisfactory ratings of overall clinical competence. In addition, fellows must receive satisfactory ratings in each of the six ACGME/ABMS Competencies and the requisite procedures during the final year of required training. It is the fellow's responsibility to arrange for any additional training needed to achieve a satisfactory rating in each of the six ACGME/ABMS Competencies and overall clinical competence.
Program Director Ratings of Clinical Competence
Six ACGME/ABMS Competencies:
The resident/fellow is demonstrating satisfactory development of the knowledge, skill and attitudes/behaviors needed to advance in training. S/he is demonstrating a learning trajectory that anticipates the achievement of competency for unsupervised practice that includes the delivery of safe, effective, patient-centered, timely, efficient and equitable care.
| Components and Ratings | Residents/Fellows: Not Final Year of Training |
Residents/Fellows: Final Year of Training |
|---|---|---|
|
* The six required competencies are: (1) patient care and procedural skills, (2) medical knowledge, (3) practice-based learning and improvement, (4) interpersonal and communication skills, (5) professionalism and (6) systems-based practice. † At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six ACGME/ABMS competencies. |
||
| Yes | Full credit | Full credit |
| Conditional on Improvement | Full credit | No credit; must achieve satisfactory rating before receiving credit † |
| No | Full credit | No credit; must repeat year |
Overall Clinical Competence
This rating represents the assessment of the resident/fellow's development of overall clinical competence during this year of training:
| Components and Ratings | Residents/Fellows: Not Final Year of Training |
Residents/Fellows: Final Year of Training |
|---|---|---|
| * At the discretion of the program director, training in the final year may be extended as necessary to achieve satisfactory ratings in overall clinical competence and/or the six general competencies. | ||
| Satisfactory or Superior | Full credit | Full credit |
| Conditional on Improvement | Full credit | No credit; must achieve satisfactory rating before receiving credit* |
| Unsatisfactory | No credit; must repeat year | No credit; must repeat year |
Candidates for Special Consideration
ABIM diplomates in internal medicine may be proposed for special consideration for admission to a subspecialty examination by the program director of an accredited fellowship program.
Guidelines for proposals are available in Proposing Candidates for Special Consideration.
Certification Using the Research Pathway
The ABIM Research Pathway is designed to integrate training in research and clinical internal medicine for those physicians who are seriously pursuing careers in basic science or clinical research. The value of the ABIM Research Pathway is that while it requires core clinical training, it concentrates on fostering a research experience that is comprehensive in terms of time, formal curriculum, and structured evaluation and feedback. These components are essential for professional growth and development and to promote continuous quality improvement.
Guidelines for certification using the research pathway are available in Research Pathway.