Final decision on the creation of a new cardiovascular board expected soon

Cardiologists are currently certified through the ABIM, which has historically governed internal medicine and its subspecialties. However, increasing dissatisfaction among cardiologists has fueled the push for independence. One major concern has been the financial burden and complexity of the recertification process under the ABIM. According to Kramer, the criteria for recertification have become increasingly onerous, with mounting costs and unexpected policy changes.

For decades, cardiologists who trained before 1990 were "grandfathered in," meaning they were not required to recertify. However, a sudden policy shift by the ABIM removed these exemptions, forcing long-practicing cardiologists to undergo costly and time-consuming recertification.

"Out of nowhere, the ABIM changed those rules and removed the grandfathering clauses. So people who hadn't needed to recertify for 35 years suddenly we're asked to pay additional funds for getting a piece of paper saying you're certified and starting the testing process for recertification," he said.

Beyond financial concerns, the methodology of the ABIM’s certification exams has also been criticized. Kramer pointed out that the current system is largely punitive, pass-fail testing rather than a informative process that identifies areas for improvement.

The testing plan by the new ABCVM is the opposite, he said.  By answering questions, it will show clear areas of weakness where a physician needs to brush up on their knowledge. ABIM also plans to use other data such as patient evaluations and outcomes to determine how a cardiologist is performing.

Another major issue cardiologists face under the ABIM is the broad scope of the recertification exam. Cardiology has become increasingly specialized, with fields such as electrophysiology, interventional cardiology, congenital heart, and heart failure each requiring distinct expertise. These require separate tests that ask questions specific to those areas, not a broad set of questions that are outside the primary cardiology scope of the person being tested, and especially not being asked internal medicine questions.

"Many of us who are cardiologists don't maintain certification in internal medicine, because we don't practice internal medicine day-to-day, we practice cardiology," Kramer said, stressing cardiologists should not be tested on things that are not relevant to their practice.

"Cardiologists are so specialized now that questions that might be important for a heart failure specialist may not be important for an electrophysiologist. And so people practice their specialties and may not have necessarily kept up with the latest in structural heart disease because they don't need to, don't use that data day-to-day," he added

ABMS is now performing its final review of this proposal. A final decision is expected by the end of February.