Okay, thank you and thank you for the invitation. So the first part of the talk I'm going to start with what the ASL has been doing on our behalf and then the second part Dr. Sterling will come up and discuss the ABIM perspective. So the key thing is this has really been an evolution with the gastroenterology board. So I know we're, you know, most of us are transplant hepatologists but this is focusing on the gastroenterology boards for now and this is regarding recertification not initial certification which the current system for the time being will stay in place and to let you know this has been really a very collaborative effort between the three or really the four GI liver societies and the American Board of Internal Medicine. So this is sort of the current landscape right now is that we have a traditional 10-year mock recertification exam and then we developed the knowledge check-in which is a two-year assessment that you can take either in your office or at a testing center. But the American Board of Medical Specialties published a final report of the future vision of how recertification should look and you can see here that the key term is a longitudinal assessment. So the general concept which I'll continue to discuss over the course of my talk will be moving from a point-in-time test high-stakes exam to something that's more of like a longitudinal assessment. And I'll give you an example of something like that in a minute. But this came actually as one of the recommendations from the American Board of Medical Specialties of which the American Board of Internal Medicine is a member. So this, we've been involved with the four societies, the AGA, CG, ASG, American Board of Internal Medicine, and all the medical specialties like hemat, endocrinology, etc. having face-to-face meetings and discussions. But we have conference calls, for example, with just the four societies. The face-to-face meetings are broader and invite all the medical specialties to the face-to-face meetings in Philadelphia. The recertification content we feel should be more relevant to clinical practice. What we actually see day-to-day rather than the zebras. It should be less burdensome and time-consuming and less high-stakes with the longitudinal versus a point-in-time-based assessment. And as a disclosure, I'm recertifying for the GI boards in not too long. So I understand all of the pressures that go into sitting for a few hours taking a test, getting recertified, of which my livelihood partly depends on that so I can continue to be credentialed. And the ideas to that will also have value and transparency in the cost of recertification. And just, this is my opinion, I feel that with the talks with the IBM, and it's actually been very collaborative and instructive, you have to hear, there's sort of two sides. We know the saying, there's two sides to every story. So hearing what their concerns are, what their issues are, listening to what they have to say and trying to develop something mutually that we feel can be beneficial to our members but yet seems to be appropriate. So this evolved among the four societies to suggest something called the Gastroenterology Ongoing Assessment and Learning Program. And the point here is not to tell you this is what it's going to be. But just that philosophically, these are general concepts that we hope over time will evolve into a new recertification process. So in general, we feel mock needs to be simpler and less intrusive and less expensive. There needs to be an alternative to a 10-year exam like I just discussed with the longitudinal assessment and should not support a single source or time-limited assessment. Mock should not include high-stakes assessments in areas that diplomats may not practice. And as we know, as a specialty in hepatology, to take a GI exam, many of those things we don't see. And we should support lifelong learning. The profession is changing, so there needs to be some mechanism to support lifelong learning so we keep up with new concepts. So we've had face-to-face meetings and summits in Philadelphia with the ABIM, all medical specialty boards that included the four societies. We've had regularly scheduled conference calls with the four societies and ABIM. We've had communications. I hope you received the emails, both from ASLD and the ABIM, via either the website, emails, or newsletters. And then the proposal of something like the Goal Program for Longitudinal Assessment or something that would incorporate some of the core values I just mentioned on the prior slide. And these are sort of the things that we're looking at in general to incorporate into a new longitudinal assessment, that you can do it at home or work, it could be available on a mobile device, that you do get feedback real-time and not have to wait too long so you can learn rapidly from what you don't know. That it could be open book, like it is in practice, that we have things that are available to us open book, self-paced, that you can perhaps choose modules that you practice in and feel you need to know about. If you practice in IBD, maybe you want to have the questions enriched in IBD, and if you don't see any motility, perhaps have very little in motility. And then you get explanations and feedback right away so you can learn from your errors. So this is a hypothetical longitudinal assessment. You might have your phone with an app. Questions are delivered to your phone. You have to answer questions within a defined period of time. It will be a finite number of questions, obviously. And then you get feedback with incorrect responses that are delivered to your phone that will say this is the correct answer and these are the reasons the following answers are incorrect. And that there would be a minimum passing score. So this is a process in evolution. So the ABIM has sent some communication, and you can see on this slide that the gastroenterology board voiced support for the ABIM's mission to create a meaningful credential for summative standards and the general concepts that I just outlined on the prior slide, including moving in the direction of a longitudinal assessment. And members in general characterize this as a positive movement forward. And this is just... I think this email was sent out October 29th. I just sort of put on the right side what I thought were some of the key things that were communicated in this most recent email. So I don't anticipate you'll be able to read this because it's spelled out here. But there will be continued discussions with the ABIM and the four societies to develop a longitudinal assessment as an alternative to a secure exam. So the secure exam will still be available for those that want to do something every 10 years or every two years. But you can continue to take the 10-year exam if preferred. And the idea would be consider something modular type. And there are some other specialties that do this like oncology and cardiology that have modular types of selections. So I'm going to end there. And I'm going to invite Richard up to continue with the ABIM update.

gastroenterology board

recertification process

longitudinal assessment

Gastroenterology Ongoing Assessment and Learning Program

lifelong learning