ABIM and ABAI: The Comparison BEFORE you respond to the survey, please review this information carefully.

Take time to understand the differences between the MOC programs and reflect on how moving initial certification to a new board might impact the field of rheumatology and the patients we serve.

Initial Subspecialty ABIM ABAI Certification To become certified in the subspecialty To become certified in the subspecialty of of rheumatology, physicians must: allergy and immunology, physicians must: n Be previously certified in internal medicine n Be previously certified in internal medicine by ABIM; by ABIM and/or ABP; n Satisfactorily complete the requisite n Satisfactorily complete the requisite grad- graduate medical education fellowship uate medical education fellowship training; training; n Demonstrate clincial competence, proce- n Demonstrate clinical competence, dural skills, and moral and ethical behavior procedural skills, and moral and ethical in the clinical setting; behavior in the clinical setting; n Hold a valid medical license; n Hold a valid medical license; n Pass the Allergy & Immunology n Pass the Rheumatology Certification Certification Examination. Examination. Note: if adult rheumatology moves to ABAI, certification would still be in the subspecialty of rheumatology (not allergy/immunology).

Maintenance ABIM and ABAI diplomates must complete all four parts of the MOC process of Certification in order to successfully maintain their certification. The charts below summarize (MOC) the features of each program.

ABIM ABAI PART 1: Licensure Hold a valid, unrestricted medical license in US, its territories or Canada

ABIM ABAI

Attest to completing 25 CME hours PART 2: Earn 100 MOC points every 5 years Lifelong each year Learning Every 2 years complete at least Every 10 years complete 1 patient safety 1 MOC activity module and 1 communication module

PART 3: ABIM ABIM ABAI Assessment 2-Year Knowledge Continuous Assessment 10-Year Exam Check-in (KCI) Pilot (CAP) Program Every 2 years Frequency Every 10 years Starting in 2019 rheumatologists Every 6 months will have the option of the 10-year exam or the KCI CAP consists of two 5-year Pass the 10-year exam within 10 years of when you cycles, for a total of 10 years. Cycle last passed OR take a KCI every 2 years and remain Each year has two 6-month on a succcessful path blocks PART 3: ABIM ABIM ABAI 2-Year Knowledge Continuous Assessment Assessment 10-Year Exam Check-in (KCI) Pilot (CAP) Program continued continued continued continued

Personal computer or test Personal compute Test Center Testing Location center (desktop only) (desktop or mobile)

Recorded via webcam Secure login and Security Recorded with in-person and spot-checked attestation proctoring (no live proctoring) (no webcam or proctoring)

Physician selects 10 articles 240 multiple-choice 90 case-based multiple- from the 12-15 posted for each questions including brief choice questions including 6-month cycle and answers Structure/Format statement, case history, brief statement, case history, 30 article-based questions graph or picture graph or picture (3 per article) + 10 core questions Physician has the option of 4 dates per year. KCIs will be Physician has 6 months to Testing Windows Physician has the option offered every other year. e.g., review articles and answer of 4 dates per year Rheumatology KCI will be questions at the time of offered in 2019 and 2021 their choosing 10 minutes per question. Testing Average 2 minutes per Average 2 min per time is based on individual text Time question; 10 hours total question; approximately questions. Questions may (8 hours of testing); 3 hours total (with breaks); be answered in batches complete in a single setting complete in a single sitting or individually Access to any online or printed resource is Open Book Access to certain up-to-date resources provided permitted. Group study of articles encouraged

Breadth of Full breadth: The 10-year exam and the 2-year KCI MD selects 10 articles from will use the ABIM MOC exam blueprint that contains the 12-15 posted for each Discipline questions that cover the breadth of the discipline 6-month cycle

Questions are tested by How are Questions are tested live during the exam, meaning the ABAI question writing Questions each exam includes questions that do not count towards committee prior to Pre-tested? the physician’s score inclusion in the assessment. Questions are not tested live Immediate pass/fail notification Results and feedback Immediate pass/fail after each answer submitted; reported within 3 months notification at the completion question-specific feedback Results/Feedback after the exam date; of the assessment; provided immediately with not question specific feedback report will follow; educational links and/or not question specific answer rationale

Retake assessment in 2 years; if unsuccessful on two Physician will be permitted Remediation Retake exam in the next consecutive attempts, to drop the 2 lowest 6-month testing window physician must pass cycle scores during each the 10-year exam 5-year period

The passing standard for an exam is based on a Required to meet a minimal specified level of mastery of content in the specialty pass rate, e.g. 75-80% (after Passing Score area; no pre-determined percentage of examinees lowest two cycles dropped); will pass or fail the exam pass rate set in advance PART 4: ABIM ABAI Practice Assessment/ Recognizes MOC points for Part 4, Activity must be completed once every Quality but requirement currently suspended; five years (range of options commonly Improvement future unknown done in practice)

Other ABIM ABAI Considerations Fees: Initial Subspecialty $2,255 Current A&I Fee: $2,350 Certification Similar to ABIM $275 The ABAI fee for rheumatology would not be known Fees: until final calculations are prepared. The goal would Annual MOC Based on payment received in year due be to keep the costs comparable to ABIM fees. The ABAI fee for A&I MOC is $400.

n ABIM has a well-established pathway n Within ABAI, a new pathway for initial rheumatol- for initial certification ogy certification would need to be established Initial n Test questions are written by n Test questions would still be written Certification rheumatologists by rheumatologists n Certification is in the subspecialty of n Certification would still be in the subspecialty rheumatology of rheumatology (not allergy/immunology)

n Were rheumatology to join, diplomates would n Rheumatology diplomates represent represent 50% 3% of ABIM’s diplomates n Size of ABAI provides ability for rapid response Organizational n ABIM currently oversees internal to diplomate concern and changes within the Size and Scope medicine + 20 subspecialties practice of medicine n Size of ABIM represents a significant n Were rheumatology to join, diplomates would voice in ABMS represent 50% n Opens avenues for scientific collaborations

n There are already a number of academic divisions/departments that include allergy, immunology and rheumatology n Maintains rheumatology within the Academic n Opportunity to establish greater positioning core of internal medicine Position for rheumatology as the experts in the care of immunologic disease and musculoskeletal medicine n Opens avenues for scientific collaborations

UNKNOWNS TO CONSIDER The ABIM provides internal medicine initial certification and MOC. For rheumatologists who choose to maintain their internal medicine certification, the methods for this process would be Internal Medicine determined in the event of moving rheumatology certification to ABAI. Currently, ABIM works Certification closely with other certifying ABMS Boards to streamline the MOC process for Board Certified and MOC physicians and offers reciprocal credit. It may be possible for your internal medicine ABIM MOC point requirement to be waived if you are currently certified by and meeting the MOC requirements of another board. Impact on the Would changes in MOC brought about by a move from ABIM to ABAI encourage rheumatologists Workforce considering retirement to remain in practice? Could changes in the certifying board between ABIM or ABAI positively or negatively impact Training rheumatology training? We anticipate both programs will continue to evolve; however, we do not know the details of Future Changes the evolution or what actual timelines for change would be.

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