Application for an Independent Medical Board for Cardiologists Is Imminent

The effort to form a new, independent board for the certification and recertification of physicians in cardiovascular medicine by the “House of Cardiology” continues, with an application to the American Board of Medical Specialties (ABMS) expected to be submitted within the next few weeks.

The application is ready, and the formal submission awaits the release of new guidelines for submission from the ABMS, which could come in days, according to Jeffrey Kuvin, MD (Northwell Health, Manhasset, NY), a member of the American College of Cardiology (ACC)’s board of trustees and chair of the workgroup focused on forming the board. The new entity will be called the American Board of Cardiovascular Medicine (ABCVM).

The ABMS has not admitted a new board in decades, with the last being the American Board of Medical Genetics and Genomics in 1991, according to Susan Morris, associate vice president of communications for the ABMS, who added that the organization “is working diligently to finalize the submission process and is continuing to maintain an open dialogue with the applicants until that is completed.”

Once the application is submitted, it “will take some time” for the ABMS to review it, with Kuvin estimating that it could be close to a year before any final decision is made. Morris said the timeline is difficult to determine right now because it will depend on both the complexity of the application and the number of public comments that are received.

The ACC announced the move to create a board separate from the American Board of Internal Medicine (ABIM), which currently remains the certifying body for cardiovascular physicians, back in September, partnering with the Heart Failure Society of America (HFSA), the Heart Rhythm Society (HRS), and the Society for Cardiovascular Angiography & Interventions (SCAI). The American Heart Association (AHA) has since joined the others, making five societies that will go on the formal application to ABMS.

Discontent with the process for maintenance of certification through the ABIM has existed within the cardiology community for years, prompting this latest effort for cardiologists to create their own independent board, albeit one that would remain under the larger umbrella of the ABMS, which represents 24 certifying boards.

Since the effort was announced, there’s been a lot of discussion on social media and in board rooms about what the ABCVM is going to look like, how it will be governed and funded, and other issues, Kuvin said. The collaboration has used webinars and a dedicated website with answers to frequently asked questions to keep cardiologists apprised of how the process is going.

And while awaiting the time to formally send the application to the ABMS, the societies have been working to move the creation of the new board along, Kuvin said. There’s a need to set up a transitional board of governors to think about what the bylaws of the board will look like, what committees are needed, what competencies are needed to be on the board of directors or to serve as a staff member, and other issues that pertain to getting the ABCVM up and running. The idea is to be able to have the new board ready to go when the ABMS gives the thumbs up, Kuvin said.

The application, he noted, is built around the latest standards on initial and continuous certification released by the ABMS.

“We think it's important to align with the ABMS. The ABMS is really the only recognized, universal certifier for cardiovascular professionals in the United States, so we want this to be an easy transition from the ABIM to the new board of cardiovascular medicine—easy for our diplomates, easy for our payers, our practices, our health systems,” Kuvin said. “That’s why the ABMS is an important partner in this.”

While initial certification will look similar to what it is now under the new board, there will be significant changes in the continuous certification pathway, with that process playing out “in a much more supportive and much less punitive environment,” Kuvin said. “We feel that that’s been the crux of the issues regarding maintenance of certification. It’s not that cardiologists or any practitioner doesn’t believe in maintaining competence in one’s area of practice, but it has to be relevant, it has to be appropriate.” And, he added, the process has to be focused on identifying and addressing knowledge gaps and not on testing irrelevant medical topics.

That’s really important—that everybody feel represented by this board. Jeffrey Kuvin

Asked why the ABMS would entertain the addition of a new board focused on cardiovascular medicine and removal of those responsibilities from the ABIM, Kuvin said that it’s because over the past decades, cardiology has established itself as a specialty distinct from internal medicine, noting that that separation is already evident in health systems, academic programs, and clinical practices.

“It does not mean that as cardiologists we don’t benefit from training in internal medicine, but the world of cardiology has evolved so much and so broadly over the last 30 years in terms of technology, in terms of pathways, in terms of specialty training, in terms of guidelines and competencies, that we have identified ourselves as clearly separate,” he said. “And now is the time to address this independence, if you will, and what better way to do it that than to form a new board. And I believe the American Board of Medical Specialties understands this.”

The ABMS, Kuvin added, “has been a great partner up to this point, and I’m really hopeful and optimistic that we’re going to see this [through] to becoming a new board.”

Asked how receptive the ABMS is to a new board, Morris said it “is open to approving new boards and accepts applications from any medical specialty board eligible for membership under its policies and procedures.”

To physicians who might be concerned that the processes under the ABCVM will not be substantially different than those under the ABIM, Kuvin stressed that the new board will be an independent one governed by the House of Cardiology.

“Cardiologists will have a vested interest in making sure that this is fulfilling the needs of its diplomates and its constituents,” he said. “As we’ve gone through this process, we have had our ears open, we have listened to a lot of different individuals in many different practice environments to make sure that we are hearing what the cardiologists really need and want and expect. But I think we all need to recognize that maintaining competence in our area of practice is important for our patients and our profession, and we intend to make this efficient, easier, and consistent with what is necessary for the practicing cardiologist.”

The founding societies of the ABCVM continue to have discussions internally with the aim of ensuring that each subspecialty organization feels like its members are getting what they need from the new board, Kuvin said. “That’s really important—that everybody feel represented by this board.”