"We submitted an application to the American Board of Medical Specialties (ABMS), the governing body that certifies physicians across the country. In January of 2024, the House of Cardiology came together, saying, it's time to make a new board separate from the American Board of Internal Medicine. The new board of cardiovascular medicine cardiologists would be governed by cardiologists to assess that we are all competent clinicians taking care of patients," Kuvin explained.

Key organizations driving this initiative include the ACC, American Heart Association (AHA), Heart Rhythm Society (HRS), Heart Failure Society of America (HFSA), and the Society for Cardiovascular Angiography and Interventions (SCAI). While there has been talk about braking off from the ABIM to create a cardiology board for years, serious discussions have been ongoing since 2019. Those discussions culminated with the official ABMS submission earlier this year.

Cardiology complaints about ABIM management 

One of the biggest reasons these groups want to create an independent cardiology board is the constant complaints from cardiologists about how the ABIM manages certification and recertification. Kuvin and the societies supporting the movement for an independent board said the requirements of the ABIM do not match the needs of cardiologists, are too complex and can lead to some cardiologists being left uncertified.

Central to the proposal is the concept of tailoring certification and continuing education to the needs of cardiologists throughout their careers. Kuvin outlined a vision for a streamlined, competency-based approach that prioritizes practical application over traditional examination formats.

"This isn't just about passing tests," he remarked. "It's about ensuring that cardiologists possess the knowledge and skills essential for delivering high-quality patient care."

Kuvin said the misalignment between cardiology and ABIM policy has led to several fights over the years. A good example of this took place in August 2023, when SCAI issued a new statement urging the ABIM to rethink its maintenance of certification (MOC) policies. SCAI said some of its members have seen their privileges threatened and even revoked despite passing the necessary exams and reporting procedural volumes as required. According to the SCAI statement, ABIM has linked certification status with yearly MOC participation in a way that could potentially have a negative impact on patient care. 

The two organizations have previously worked together to ensure cardiologists have more options when working to meet MOC requirements, but SCAI said ABIM changed course by requiring interventional cardiologists to complete their assessment “through a very complex process,” achieve 100 self-assessment points every five years and perform a predetermined number of procedures every five years, all to keep ABIM certification for the full 10-year window. Failing to meet these requirements can lead to a loss of certification.

“This situation unacceptably exacerbates the interventional cardiology workforce shortage and threatens to directly impact the care of patients suffering life threatening cardiovascular emergencies,” according to an SCAI statement at the time. “It is the position of SCAI that the ABIM must immediately abandon its complex practice and stop mixing nonparticipation in MOC with ‘not certified’ status.”

SCAI said its members “must be protected” from ABIM’s pattern of making changes to the certification process. “Simple and credible rules are advisable, while a labyrinth of regulations is both unfair and unjustified,” the group concluded.

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The ACC has also had disagreements with internal medicine experts making certifications decisions for cardiologists instead of experts in cardiology.

"We felt the best way for cardiologists to be certified they are competent would be by measures that other cardiologists would ascribe to them. Essentially, we wanted to make certification qualifications relevant to the cardiology practice," explained former ACC President Hadley Wilson, MD, executive vice chair of Atrium Health Sanger Heart & Vascular Institute, in an interview with Cardiovascular Business last fall. "We believed that was no longer possible through just being grouped with internal medicine, and we felt like cardiovascular medicine is its own distinct specialty. In fact, about 50% of cardiology division programs in the country are either completely separate from internal medicine divisions or at least separate financially. And that number of independent cardiology departments that are separate, distinct entities just continues to grow."

The fact that several large cardiology groups are rallying support demonstrates the widespread endorsement for the board initiative.

"Cardiology has evolved into its own specialty. We need a board that reflects the unique training pathways, competency statements, and technological advancements inherent to cardiovascular medicine," Kuvin emphasized.

Cardiologists can support a new board in comments to the ABMS

The ABMS has opened its public comment period and will collect comments until July 24. The comment submission form can be found here.

More information about the proposed board is available here.