Building a workforce of engaged physician citizens has been top of mind for me throughout my career as an infectious diseases physician and clinician educator, whether directing Johns Hopkins Bayview Medical Center’s internal medicine residency program, serving as a Medical Corps officer in the United States Army or in my current role leading academic and medical affairs at the American Board of Internal Medicine. In the years I spent training early-career physicians, I saw many pathways to pursuing medical careers and how much commitment, drive and resilience it takes to succeed in medicine.
I have worked with many international medical graduates who particularly embody this commitment to service. IMGs and other internationally trained physicians make up nearly a quarter of the U.S. physician workforce, often working in rural and medically underserved areas.
For physicians who complete an internal medicine residency abroad and have been accepted into an ACGME-accredited fellowship in the United States, there hasn’t been a clear path to becoming a board-certified internist before. I have seen well-trained physicians, including fellow ID physicians, serve the public as excellent clinicians, researchers and educators, who are unable to pursue board certification due to completing their internal medicine training abroad. This can limit access to specialized care for patients who rely on their expertise.
ABIM has identified at least 4,000 physicians across internal medicine subspecialties who may be in this situation. Now more than ever, qualified ID physicians are needed to address workforce gaps and meet the growing threats to public and global health.
A new pilot from ABIM aims to close these gaps. ABIM’s competency-based medical education special consideration pathway for IMGs is designed to help qualified physicians move forward. The pilot allows eligible physicians who trained in internal medicine outside of the United States or Canada and have completed accredited fellowship training in the United States to pursue board eligibility in internal medicine if they meet specific criteria.
If they are approved and successfully pass the Internal Medicine Certification Exam, these physicians may then apply to take the certification exam in their subspecialty. The standards they must achieve are the same as for any other physician applying for and taking the initial certification exam. Outcomes for participants will continue to be evaluated throughout the pilot period.
We thank the physicians and societies — including IDSA — who helped shape the pilot and specifically the ID fellowship directors who asked the question that led to the idea for such an approach. While the pilot is not a solution to the workforce issues in health care, it is a meaningful step toward removing a barrier for talented and well-trained physicians.
More than 150 physicians participating in the pilot pathway — about 15% of whom are ID doctors — are eligible to take the Internal Medicine Certification Exam in August and their subspeciality exam as early as 2027. We look forward to reviewing and approving many more qualified applicants and ultimately assessing the pilot outcomes.
If the CBME pilot pathway appeals to you, please consider applying and sharing news of the pilot with others who may be interested. For more information about the pilot, visit ABIM’s website.
