Thank you, Mark, and I think thank you to the organizers for having me to do this and thank you to the ABIM for putting me up as their sacrificial lamb, but also to David Buckman who's in the audience who helped create the slides. And so I'm new to the ABIM GI subspecialty boards, and I think it's probably a much better time to be a member now than it was perhaps a couple of years ago. So this is just my disclosure. I am on the American Board of Internal Medicine GI subspecialty, and basically I can't really talk about the exam. I can't talk about a lot of things, and so don't ask me. Again, one of the things at our first board meeting, we talked about a couple things. One was the longitudinal assessment, which I was very pleased that they were willing to listen to us because I'm still an active gastroenterologist and hepatologist, so I'm right with you and share all the concerns that Mark had. I've been through recertification for GI now several times and had to sit through the transplant hepatology recertification a couple of years ago. So it was nice to see that they're working with all the GI societies, and I can tell you that all of the GI societies have representative members on the subspecialty board. The other thing that we did that you all know about already is the new combined GI and transplant hepatology training pathway, sort of what I call the short track, which has now been approved by the ABIM and hopefully will soon be approved by the ACGME. We had our pilot steering committee meeting earlier at this meeting, and I can tell you if you have any questions, there's this blog.abim.org to view all the summary supports if you have any questions. All right. So this is what that longitudinal assessment, and I think this is probably one of the main things that I hope to help get through during my tenure on the board. And so in August, ABIM announced it was commitment to evolve its MOC program to provide this longitudinal assessment option. But for now, as of November 2019, the current MOC program requirements remain in place. And the details of these are being worked on. I didn't realize how challenging and how many details there were, but there's a lot of things. And what we do for GI also applies to many other specialties, and they have their own societies. And so it becomes very complex. But as Mark had said, the long, what they call the long-form point-in-time assessment, whether you do the two-year knowledge check-in or you decide to keep doing the 10-year exam, that will always be an option for you if that's how you choose to remain certified. So this new longitudinal assessment, what is it going to look like? I think Mark hit, if you look at those check marks that he had, I think this hits every one of those check marks, which is what the ABIM heard from its diplomats. So it's supposed to be a more continuous, self-paced process. And like Mark said, you'll be able to, you'll receive, at least my understanding is, is that every week or every couple of weeks you'll receive a message that there'll be a limited number of questions. It might only be three questions a week. And each, it should take you five minutes to answer them, and you get the immediate feedback to know what you're doing, as well as the rationale behind the correct answers. Certainly there will be a passing. It's not a rate who pass, it's a passing score. So hopefully over time you will be able to achieve whatever that passing score is that's determined. You have a lot of flexibility. Again, you can answer them on your phone, your tablet, your laptop, and you can do it really any time of the day. And it's not proctored like with the camera. So there is going to be, I assume, an attestation statement saying that you're not getting any help and you're doing this on your own. And I think the other advantage is that it's the ability to use educational resources while you're trying to answer these questions. So it's open book, whether you use up-to-date or whatever resource that you choose to use. But I think the AAM definitely needs your help to know what that's going to look like. They certainly don't work in a vacuum, and it's nice to see that they're very responsive. So what other ideas should the AAM consider during this early phase? Now is the time that we need input to know how this is going to roll out, because we certainly don't want to repeat any mistakes that may have been made in the past. What are the benefits? What are the challenges? And if you are everyone in this room would be willing to go to this comment form at this website, bit.ly forward slash longitudinal feedback, go in and answer these. It's more information that we can then use to help decide what this is really going to look like. So again, I think the AAM definitely believes working with the GI societies is a good thing. We definitely want input. It should be a cordial and collaborative cooperation to try to keep and address any GI diplomat concerns. I think whatever ends up happening for the GI boards will most likely translate into things going for transplant hepatology. And certainly we want to continue that. I think that I have to keep up both my GI and my transplant boards. And so for this longitudinal pathway for me, if I want to do both GI and liver, I may have to answer a few more questions each week. Maybe instead of answering two or three, I might have to answer three or four, but then I'll be able to maintain both. And if you decide to do internal medicine and GI and transplant hepatology, then you may have to answer yet some additional questions. But there, you're actually maintaining three boards at the same time. And I'm hoping, again, that with Mark, my personal view is that the questions be more tailored to what we do. So for me, if I had to answer four questions, three of them might be in liver disease, maybe two of them might be in advanced hepatology, and one might be in a more general GI topic. And that would still enable me as a diplomat to continue to maintain all the boards that I want to be active. So I just, to finish up here, again, the GI transplant hepatology, what I call the short track or the pilot program, will no longer be a pilot soon. It's been approved by the ABIM, and I served on that steering committee since its inception. We had our meeting. We found out from Oren Fix yesterday, I guess, that even though we thought everything was on track to start in July of 2020, the ACGME still has to approve it. There's a process for them to do that, which requires a period of public comment. Those of us on the committee were vigorously working to make sure that the ACGME, what you call it, Mark, the requirements, whatever, what's the thing that we worked on this last weekend? The EPAs? No. The program requirements for both transplant hepatology and GI. They had to be revised, and a lot of us spent time working this last weekend so Oren could get it in to the ACGME. So again, just to keep in mind right now that it's currently as it stands. It hasn't changed yet, but it will change, and again, this is really the option that's ideal for the candidates who are interested in a clinical hepatology career. And just to remind everybody, those current requirements include 24 months of GI, of which 18 are full-time clinical. They could have six months of research in there, and 12 months needs to be in clinical transplant hepatology if you want to go through that pathway. Right now, as it currently stands, that's done in the third year. So I think that's really all I had to say. I have 30 more seconds. Are we going to take questions at the end? Or... Yeah. At the end. All right, and I have, again, people from ABIM are here to help answer questions that I can't. Thank you.

gratitude

ABIM GI subspecialty boards

longitudinal assessment

training pathways

collaboration