ABIM Designates Critical Care Medicine
as a Subspecialty of Internal Medicine

The American Board of Internal Medicine (ABIM) has designated critical care medicine as a subspecialty of internal medicine, representing a significant recognition for critical care within ABIM and a success for the Society of Critical Care Medicine (SCCM), which took an active role in supporting this development. ABIM made this change in conjunction with designating all of its subdisciplines as subspecialties rather than areas of added qualification.

ABIM’s designation of critical care as a subspecialty translates into several benefits for ABIM diplomates, namely that they now can complete the maintenance of certification program and renew their critical care medicine subspecialty certificate independently of maintaining their underlying certification in internal medicine or in another subspecialty. This "unlinking" of critical care medicine from an underlying certification now also applies to geriatric medicine. However, ABIM encourages physicians to maintain their internal medicine and other subspecialty certificates.

The ABIM Critical Care Medicine Test Writing Committee also will continue to have representation on the ABIM Board of Directors. Since 2003, Society member Robert Danner, MD, chair of the test writing committee, has been serving on the ABIM Board of Directors to help ensure proper communication as talks about designating critical care medicine as a subspecialty became more focused. The change from added qualification to subspecialty will ensure that critical care always will have a strong voice within ABIM. The subspecialty of critical care now is one of the largest subspecialty groups within ABIM.

This development is the culmination of many years of hard work and dedication by several healthcare organizations, leaders within ABIM and others in the critical care community. The Society has long supported efforts to designate critical care as a subspecialty of internal medicine. In March 2006, Society representatives joined several other groups at the Critical Care Medicine Stakeholder’s Meeting to discuss the future of a critical care subspecialty. The ABIM convened the meeting to explore how critical care and pulmonary disease communities could make the designation a positive development for both professions. Society members Frederick Ognibene, MD, FCCM, Derek Angus, MD, MPH, FCCM, and Mark Astiz, MD, FCCM, met with representatives from the American Thoracic Society and the American College of Chest Physicians and with leaders from ABIM. Members of the ABIM Critical Care Medicine Test Writing Committee and the ABIM Subspecialty Board on Pulmonary Disease also attended. Attendees from a variety of backgrounds discussed the benefits and possible drawbacks of critical care as a subspecialty and reached a consensus that efforts should continue to move critical care medicine to subspecialty status, setting the stage for this decision only months later.

“All those discussions were very patient-orientated,” Dr. Danner said. “No matter what was on the table, it always led back to what was best for patient care.”

This accomplishment does not mark the end of the Society’s efforts related to the subspecialty of critical care medicine within ABIM. In Fall 2006, the Society plans to attend a second stakeholder’s meeting to discuss future considerations for this new subspecialty, to reanalyze the benefits, and to pinpoint remaining concerns.

Maintenance of certification requirements for critical care medicine diplomates remain the same with the new subspecialty designation. In addition to being licensed in good standing and passing the secure examination, they are required to earn 100 points of self-evaluation, with 20 points in medical knowledge, 20 points in practice performance and 60 additional points from either medical knowledge, practice performance or both. The 100 points may be applied to all the certificates the physician intends to renew.

For more information, visit ABIM’s Web site at www.abim.org