Longitudinal Knowledge Assessment Offers New Approach to Board Certification

At an ACR town hall on Jan. 27, leaders of the ACR and the American Board of Internal Medicine (ABIM) described changes to the ABIM’s rheumatology maintenance of certification (MOC) assessment requirements, with a focus on the new Longitudinal Knowledge Assessment (LKA).

The LKA launched in December 2021 and offers a novel, five-year, ongoing approach to rheumatology MOC assessment.¹ Participants receive a block of assessment questions each quarter, accessible from any internet-connected device, and get instant answer feedback, as well as pass/fail results at the end of the five-year cycle. The LKA is also available for MOC in internal medicine and several other specialties.

MOC Reform

For more than 30 years, ABIM rheumatology MOC assessment has required taking a comprehensive exam at a designated testing center every 10 years. Recently, ABIM has been working on alternative MOC assessments that may better serve physicians’ needs in terms of clinical knowledge, time and convenience.

Dr. Saag

The ACR has been actively involved in rheumatology MOC assessment reform, with several members serving on the ABIM’s Rheumatology Certification Board. While presiding over the town hall, ACR President Kenneth G. Saag, MD, MSc, shared, “The ACR has been working with members since 2014 to promote meaningful change in ABIM MOC options. The ACR remains committed to making MOC a meaningful process for rheumatologists so that they may better serve their patients.”

About the LKA, he added: “We are cautiously optimistic that the LKA may address a number of the elements that our members value: a more flexible approach to continuous professional development and an alternative to the high-stakes, closed-book 10-year exam.”

The traditional, 10-year exam remains an option for MOC, but the two-year Knowledge Check-In is no longer offered.

How Does the LKA Work?

The LKA includes 600 questions offered over a five-year period. A new block of 30 questions is released every quarter. You may answer the questions at your own pace at any time during the quarter. However, once you open a question, you must answer it within four minutes to receive credit; opened but unanswered questions will be counted as incorrect.

Once you are enrolled in the LKA, questions can be accessed from any internet-connected device at your convenience. No appointments or travel are required. In addition, of the 600 questions offered, you only need to open 500 of them to fulfill participation requirements. This provides some flexibility to schedule your assessment around especially busy quarters.

Unlike the traditional 10-year exam, the LKA is an open-book assessment. You are allowed to use any resource that one would use in clinical practice, except other people. In addition, answers to questions (including clinical rationale and references from the literature) will be available instantly to provide on-the-spot teaching.

Each correctly answered LKA question will earn you 0.2 MOC points. That means you can earn up to 24 MOC points per year from the LKA if you get all 120 questions correct.

Passing the LKA

Final pass/fail results will be available at the end of the five-year LKA cycle. ABIM leaders at the town hall declined to provide an exact number of correct answers needed to pass. Instead, participants will receive an updated score report on a quarterly basis after the first year to help identify areas that need attention, “allowing physicians to demonstrate improvement as they continue to answer questions over the five-year cycle,” according to the ABIM. ²

If you pass the LKA, you have the option to enroll in the LKA again for the next five-year cycle or take the 10-year exam to push additional MOC assessments out another 10 years. Should you fail the LKA, you will need to pass the 10-year exam within the next calendar year to keep your certification.

Enrollment Information

You are eligible to enroll in the LKA for the calendar year your MOC assessment is due; physicians due for recertification in 2022 can enroll now. (Find out when your assessment is due by signing into your ABIM Physician Portal.³) Once enrolled, your certification will remain active for the next five years while you complete the LKA.

It’s best to enroll as early in the year as possible to be able to access all the questions. The first quarter ends on March 31, and unopened questions expire. If you already registered for the traditional 10-year exam but are interested in switching to the LKA, you may cancel your exam appointment and receive a credit that can be applied to the LKA.

See the ABIM presentation on the LKA or visit the ACR website for more information about CME and MOC.

Samantha C. Shapiro, MD, is an academic rheumatologist and an affiliate faculty member of the Dell Medical School at the University of Texas at Austin. She received her training in internal medicine and rheumatology at Johns Hopkins University, Baltimore. She is also a member of the ACR Insurance Subcommittee.

References

1. Longitudinal Knowledge Assessment. American Board of Internal Medicine.
2. Fall 2021 Rheumatology Board Summary. American Board of Internal Medicine. 2022 Jan 27.
3. Physician Portal. American Board of Internal Medicine.