Breadcrumb trail:
Equity Pledge
In June of 2020, in the wake of the murder of George Floyd, leaders of ABIM and the ABIM Foundation issued a statement decrying systemic racism, and pledged “to do all we can to eliminate racism, its underlying roots of power and privilege, and its impact within our organizations, our communities and our country.”
As the current leaders of these organizations, aware of the ongoing presence of structural barriers (including but not limited to racism) and interpersonal bias in medicine, we now reaffirm that pledge and our commitment to the goals expressed in that statement. ABIM and the ABIM Foundation have acted to embed our commitment to health equity and diversity, equity and inclusion (DEI) into the work of both organizations.
Since 2020, our accomplishments include the following:
- We have begun developing additional health equity content that will be included in our assessments. Health equity research has generated knowledge essential for a board certified physician to have in order to deliver optimal care to all patients.
- We conducted a pilot initiative to undertake a fairness review of questions (items) on our assessments, so as not to unfairly and inaccurately penalize candidates with culturally specific or otherwise biased questions. The small number of items that were found to be possibly biased (after statistical analysis and review by a panel of physicians) were removed from ABIM’s item pool. The pilot initiative continues in four specialties (Internal Medicine, Cardiovascular Disease, Gastroenterology and Nephrology) and will be expanded to include additional specialties.
- We conducted a research project, published in The Annals of Internal Medicine1, on the relationship between internal medicine program ratings of resident knowledge and resident scores on the ABIM Initial Certification Examination. This study revealed systemic bias against nonwhite residents, and was most pronounced for those who are underrepresented in medicine.
ABIM’s mission is to enhance the quality of health care by certifying internists and subspecialists who demonstrate the knowledge essential for excellent patient care. As an organization that sets standards, we must ensure that our assessments reflect society’s and patients’ needs. Key among these needs is health equity, “a human right that allows everyone to achieve the best attainable health and outcomes, by overcoming all avoidable barriers.”2 With our mission in mind, we will continue to incorporate health equity content into our exams. We also commit to ensuring that our assessments are fair, and we will conduct ongoing analyses of our programs for biased content. We will be transparent about the results of our internal analyses, continuously hold ourselves accountable to standards of fairness, seek feedback from diverse voices and ensure that our governance reflects our diverse stakeholders, including patient voices.
Improving equity in medical care and health cannot be done alone, and we will continue to collaborate with organizations within medicine and the broader community to address health inequities and support a more diverse internist workforce.
Through the ABIM Foundation's programs, initiatives and grants, we concentrate on advancing professionalism and enhancing patient care. As part of this work, we aspire to highlight the root causes of historically merited distrust in the health care system among marginalized communities. We will work to strengthen trustworthiness by helping to support and test improvements that are designed to build trust and mitigate health inequities.
ABIM and the ABIM Foundation believe that diversity and inclusion represent a vital strategy for excellence. We therefore further commit to working to ensure that our two organizations are diverse and inclusive.
Structural and systemic racism continue to exist and to impose major adverse health impacts on our society. It is critical that ABIM and the ABIM Foundation remain focused on doing all we can to advance health equity, and ultimately improve the health of our patients.
1 Gray BM, Lipner RS, Roswell RO, Fernandez A, Vandergrift JL, Alsan M. Adoption of Internal Medicine Milestone Ratings and Changes in Bias Against Black, Latino and Asian American Internal Medicine Residents. Ann Int Med 2024 Jan;177(1):70-82. doi: 10.7326/M23-1588. Epub 2023 Dec 26.
2 Adapted from the American College of Cardiology Health Equity Task Force.