Pilot Model Pathway to Board Eligibility for Exceptionally Qualified International Medical Graduates
Please note: This pilot is not yet active; it is in the input stage. This FAQ section is intended to provide additional background and context information for diplomates interested in the effects of the proposed pilot program. To share your comments on the proposal with ABIM, please visit the survey open now through October 1, 2024.
The ABIM Council has proposed a pilot model for exceptionally qualified international medical graduates (IMGs) pursuing accredited subspecialty fellowship in the US or Canada to become eligible for ABIM Board Certification. These physicians currently do not have a pathway to Board Eligibility.
The proposed pilot model would be in addition to four existing special consideration pathways that enable American Osteopathic Association (AOA)-accredited or internationally trained physicians to obtain ABIM certification. The new pilot program focuses on physicians who have met the following criteria:
- Successful completion of internal medicine training in another country (or successful completion of a residency accredited by ACGME International).
- Fulfillment of the ACGME criteria to be considered an “exceptionally qualified candidate” (see ACGME Common Program Requirements (Fellowship), III.A.1.c) for subspecialty fellowship training.
- Successful completion of accredited fellowship training in the U.S. or Canada.
The pilot program would allow participating physicians to apply for the Internal Medicine Initial Certification Examination once successful completion of accredited fellowship training is verified. If a physician in this pathway is admitted to and passes the Internal Medicine Exam, they would then be eligible to take the Subspecialty Certification Examination in the area in which they completed accredited training.
Like other ABIM diplomates, physicians in the proposed pilot would need to pass the ABIM Internal Medicine Certification Examination and successfully complete their accredited fellowship training to be eligible for subspecialty certification.
Pilot Eligibility
Can I apply for/participate in the pilot program now?
The pilot program isn’t currently active – there are several levels of approval needed by ABIM and the American Board of Medical Specialties before the pilot program can be implemented. ABIM will be communicating with eligible applicants and the graduate medical education community where possible to make sure potential candidates are aware of the opportunity should it become available.
Who is eligible to be a pilot participant?
Pilot participants are physicians who trained in internal medicine residency internationally (or trained in an ACGME-I accredited residency) and have successfully completed an accredited fellowship in the U.S. or Canada, and who meet the qualifications to be considered an “exceptionally qualified candidate” per ACGME criteria. Pilot participants may apply for the ABIM Internal Medicine Initial Certification Examination only once fellowship is successfully completed and competency in all domains is documented by the accredited training program in FasTrack.
What does “exceptionally qualified” mean?
ABIM will be using the longstanding ACGME definition of “exceptionally qualified” (see ACGME Common Program Requirements (Fellowship), III.A.1.c). ABIM’s pilot may be able to shed light on whether there is a shared perspective on what characterizes an exceptionally qualified candidate.
Additionally, the ACGME criteria to be considered “exceptionally qualified” call for a competency-based performance evaluation at 12 weeks of fellowship training.
Will pilot eligibility be retroactive, i.e., can a physician who meets the pilot eligibility criteria and who has successfully completed accredited fellowship training apply for admission to the Internal Medicine Initial Certification Exam?
Yes, candidates who have successfully completed ACGME-accredited fellowship within the prior seven years will be considered eligible, consistent with ABIM’s Board Eligibility policy.
Does it matter how long the fellowship is (one year versus multiple years)?
This pilot program will be available in all ABIM subspecialty disciplines where accredited training is required, regardless of training length. Pilot participants will be subject to all other initial certification eligibility requirements, e.g., licensure requirements and ABIM Board Certification in Internal Medicine prior to application for to the ABIM Subspecialty Certification Examination.
Would fellows from ACGME-I residencies be able to participate in this pilot?
Yes.
Can the pilot participants use the NRMP match process?
The ABIM pilot does not affect match rules. Eligibility for the match is determined by the National Residency Matching Program (NRMP). Many pilot participants may have entered ACGME-accredited fellowships through the NRMP.
Pilot Requirements
Will the fellowship program be responsible for certifying the fellow's competence in general internal medicine?
Not specifically. Program directors would evaluate the fellow’s competence and their Board Eligibility in the discipline they are training in. The six general core competencies for internal medicine and subspecialties are the same at the competency level and similar at the milestone level. If competency isn’t achieved in residency training, it should become apparent in fellowship. ACGME criteria to be considered “exceptionally qualified” also call for a competency-based performance evaluation at 12 weeks of fellowship training. The Internal Medicine Certification Exam serves as an assessment of medical knowledge and judgement in internal medicine.
Can pilot participants sit for the Internal Medicine Certification Exam before they apply for fellowship?
No. There is a requirement that Board Eligibility is tied to competency demonstrated by the successful completion of accredited training in the U.S. or Canada. Pilot participants will not be eligible to apply for the Internal Medicine Certification Exam until they document competency through successful completion of their accredited fellowship training program.
Could the Internal Medicine and Subspecialty Certification Exams be completed in the same calendar year?
No. Physicians must be certified in Internal Medicine at the time they apply for subspecialty certification. Since the Internal Medicine Exam is administered in the summer, it would not be possible to meet this requirement for fall Subspecialty Certification Exams.
Pilot Outcomes
Will successful pilot participants receive the same certificate as other initial certification candidates?
Yes, if they pass the Internal Medicine and Subspecialty Exams. Pilot participants will be held to the same fellowship training standards as other fellows, they will take the same certification examinations as other initial certification candidates (both in Internal Medicine and their subspecialty) and, if successful, will earn the same certificates as other diplomates (both in Internal Medicine and their subspecialty). They will be held to the same requirements and standards as other diplomates in the Maintenance of Certification (MOC) program.
What questions will the pilot answer?
There are many potential inquiries that this pilot will address. Some of the primary questions ABIM will seek to answer include, but are not limited to:
- Do these physicians pursue Board Certification?
- How do they perform on ABIM assessments?
- What is their practice setting post-training?
- Do they remain in the U.S.?
- Does the pilot affect in any way the number of U.S. medical graduates matching into accredited fellowship programs?
How will ABIM know the pilot is a success?
ABIM is hopeful that through the information we learn, we can decide whether the pilot is viable (Is it possible for physicians to do it?), feasible (Is it easily integrated into the training process? What are the outcomes for pilot participants?) and scalable (Can it be applied across fellowships in different states and different disciplines? Does it show evidence of a standardized concept for an “exceptionally qualified candidate”?)
After extensive data collection and careful analyses, the ABIM Council will decide whether or not to apply to the American Board of Medical Specialties to make the pilot program an official, standard pathway to ABIM Board Eligibility.