Policies and Procedures for Certification - College of Medicine

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REQUIREMENTS FOR CERTIFICATION ININTERNAL MEDICINETo become certified in internal medicine, a physician mustcomplete the requisite predoctoral medical education, meet thegraduate medical education training requirements, demonstrateclinical competence in the care of patients, meet the licensure andprocedural requirements, and pass the Certification Examination inInternal Medicine.Predoctoral Medical EducationCandidates who graduated from medical schools in the UnitedStates or Canada must have attended a school that was accredited atthe date of graduation by the Liaison Committee on MedicalEducation (LCME), the Committee for Accreditation of CanadianMedical Schools, or the American Osteopathic Association.Graduates of international medical schools must have one of thefollowing: (1) a standard certificate from the EducationalCommission for Foreign Medical Graduates without expired examinationdates; (2) comparable credentials from the Medical Councilof Canada; or (3) documentation of training for those candidateswho entered graduate medical education training in the UnitedStates via the Fifth Pathway, as proposed by the American MedicalAssociation.Content of TrainingThe 36 calendar months of full-time internal medicine residencyeducation:(1) Must include at least 30 months of training in generalinternal medicine, subspecialty internal medicine andemergency medicine. Up to four months of the 30 monthsmay include training in areas related to primary care, such asneurology, dermatology, office gynecology, or officeorthopedics.(2) May include up to three months of other electives approvedby the internal medicine program director.(3) Includes up to three months for vacation time.See “Leave of Absence and Vacation” policy on page 11.In addition, the following requirements for direct patientresponsibility must be met:(1) At least 24 months of the 36 months of residency educationmust occur in settings where the resident personally provides,or supervises less experienced residents who provide directcare to patients in inpatient or ambulatory settings.Graduate Medical EducationTo be admitted to the Certification Examination in InternalMedicine, physicians must have satisfactorily completed, byAugust 31 of the year of examination, 36 calendar months,including vacation time, of graduate medical education accreditedby the Accreditation Council for Graduate Medical Education(ACGME), the Royal College of Physicians and Surgeons ofCanada, or the Professional Corporation of Physicians of Quebec.Residency or research experience occurring before completion ofthe requirements for the MD or DO degree cannot be creditedtoward the requirements for certification.(2) At least six months of the direct patient responsibility oninternal medicine rotations must occur during the R-1 year.Clinical Competence RequirementsABIM requires documentation that candidates for certification ininternal medicine are competent in: (1) patient care (medicalinterviewing, physical examination, and procedural skills); (2)medical knowledge; (3) practice-based learning and improvement;(4) interpersonal and communication skills; (5) professionalism;and (6) systems-based practice.The 36 months of residency training must include 12 months ofaccredited internal medicine training at each of three levels: R-1,R-2, and R-3. No credit is granted for training repeated at the samelevel or for administrative work as a chief medical resident. Inaddition, training as a subspecialty fellow cannot be credited towardfulfilling the internal medicine training requirements.Through its tracking process, FasTrack, ABIM requires programdirectors to complete clinical competence evaluations each year forinternal medicine residents. A candidate may be excluded from anABIM examination if the required components of clinical competenceare not satisfactorily documented by the training program.2
PROGRAM DIRECTOR RATINGS OF CLINICAL COMPETENCECOMPONENTS and RATINGSR-1 and R-2 R-3 Fellows (any year)Overall Clinical CompetenceSatisfactory or SuperiorFull creditFull creditFull creditMarginalFull credit for one marginal yearRepeat one year if both R-1and R-2 are marginalNot ApplicableNot ApplicableUnsatisfactoryNo credit, must repeat yearNo credit, must repeat yearNo credit, must repeat yearMoral and Ethical BehaviorSatisfactoryFull credit Full credit Full creditUnsatisfactoryNo credit, must repeat year or, at the request of theprogram director and at ABIM’s discretion, a successfulperiod of observation can be arranged in lieu ofrepeating the year to be granted creditNo credit, must repeat year or, at the request of theprogram director and at ABIM’s discretion, a successfulperiod of observation can be arranged in lieu ofrepeating the year to be granted creditNo credit, must repeat year or, at the request of theprogram director and at ABIM’s discretion, a successfulperiod of observation can be arranged in lieu ofrepeating the year to be granted creditEvaluation of Individual General Competencies*Satisfactory or SuperiorFull credit Full credit Full creditUnsatisfactoryFull creditNo credit, must repeat yearMust repeat year if during finalyear of required training* The six required competencies are: (1) patient care (which includes medical interviewing, physical examination, and procedural skills); (2) medical knowledge;(3) practice-based learning and improvement; (4) interpersonal and communication skills; (5) professionalism, and (6) systems-based practice.As outlined in the table above, all residents must receive satisfactoryratings in overall clinical competence and moral and ethicalbehavior in each year of training. In addition, residents mustreceive satisfactory ratings in each of the components of clinicalcompetence during the final year of required training. It is theresident's responsibility to arrange for any additional trainingneeded to achieve a satisfactory rating in each component of clinicalcompetence.Procedures Required for Internal MedicineSafety is the highest priority when performing any procedure on apatient. ABIM recognizes that there is variability in the types andnumbers of procedures performed by internists in practice.Internists who perform any procedure must obtain the appropriatetraining to safely and competently perform that procedure. It is alsoexpected that the internist be thoroughly evaluated and credentialedas competent in performing a procedure before he or she canperform it unsupervised. For certification in internal medicine,ABIM has identified a limited set of procedures in which it expectsall candidates to be competent with regard to their knowledge andunderstanding. This includes: (1) demonstration of competence inmedical knowledge relevant to procedures through their ability toexplain indications, contraindications, patient preparation methods,sterile techniques, pain management, proper techniques forhandling specimens and fluids obtained, and test results; (2) abilityto recognize and manage complications; and (3) ability to clearlyexplain to a patient all facets of the procedure necessary to obtaininformed consent.For a subset of procedures, ABIM requires all candidates todemonstrate competence and safe performance by means ofevaluations performed during residency training. The set ofprocedures and associated competencies required for each arepresented in the table on page 4.3
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Policies and Procedures for Certification - College of Medicine

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