The Development of ABEM Continuing Certification: A Reason for Applause?

Oct 28, 2020
Message from the President
Mary Nan S. Mallory, M.D., M.B.A.



  • a specified state of growth or advancement
  • an event constituting a new stage in a changing situation

The one constant to ABEM’s continuing certification process is that there have always been requirements to recertify. Initially, physicians could opt to take a high-stakes, written recertification exam or an oral exam to recertify. In 2004, the ConCert Exam and LLSA requirements were instituted, and in 2011, attestation to a Patient Care Practice Improvement (PI) activity and a Communication / Professionalism (CP) activity were required.

As can be expected with any change, these modifications were not met with overwhelming applause. The institution of the LLSA requirement was initially seen as just “one more thing” that busy emergency physicians had to do. There were “too many articles and too many questions.” There was confusion about seemingly “burdensome” PI and CP attestations, with some thinking patient data needed to be submitted. And the high-stakes, high-stress ConCert Exam came with travel and preparation time and costs for the physician.

ABEM listened and physicians’ comments prompted review and some adjustments. The number of LLSA articles and questions were reduced, and the activity eventually became one applauded by physicians. The CP attestation was dropped as not being relevant to practice in the emergency department. More recently, a summit of representatives of all Emergency Medicine (EM) organizations was convened to discuss the ConCert Exam, followed by focus groups and surveys of all ABEM-certified physicians. That exploration ultimately led to the development of MyEMCert. Each change made by the Board has been made through the lens of whether it would improve the continuing certification process while still maintaining a high standard for certification. The recent changes to the process reflect that philosophy.

MyEMCert is designed with the uniqueness of Emergency Medicine in mind and was informed by the preferences of ABEM-certified physicians. It removes the high-stakes, high-stress ConCert Exam as a requirement and replaces it with an open-book, online, personal for learning assessment that can be taken anytime, anywhere. Topic-specific modules are based on subjects that are clinically relevant to the practice of EM. Key advances facilitate learning and amplify medical discoveries so you can assess and use them to improve patient care. These are characteristics that incorporate physician needs, improvements to the process, and high standards.

The establishment of a 5-year certification period has been made using the same criteria. During the exploration of the ConCert Exam, physicians mentioned that ten years between exams was probably too long. Emergency Medicine practice evolves at such a fast pace that such a space of time was too long to ensure physicians were keeping up to date with current changes. A 5-year certification cycle encourages ongoing engagement to stay current with key advances in the specialty and demonstrates to the public that we are all committed to doing so.

Practically speaking, the 5-year cycle won’t have much effect on most physicians’ certification activities. Over 80 percent of ABEM-certified physicians already complete the activities every five years that are required to be designated as “participating in continuing certification;” that is, 4 LLSAs and 1 IMP attestation, with the additional every-ten-year ConCert Exam requirement. In the new 5-year certification period, physicians will complete 4 MyEMCert modules and one IMP attestation every five years, with no ConCert requirement. The timing of the change was made to minimize the number of adjustments physicians would have to make over time, and to allow those with certifications that expire as early as 2021 the ability to recertify using MyEMCert instead of ConCert.

Just as the practice of Emergency Medicine develops and evolves, ABEM’s certification processes have and will continue to develop and evolve over time. You may not applaud each change, at least not initially, but we hope you continue to make suggestions for how the Board might improve the continuing certification process while maintaining both fairness for all ABEM certified physicians and the highest standards for our specialty.

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