The American Board of Cardiovascular Medicine (ABCVM) was founded with a bold vision: to recognize cardiovascular medicine as a distinct specialty and create a modern, holistic certification process that reflects the realities of clinical practice. Our goal has been to move beyond high-stakes, punitive exams toward a supportive, technology-driven approach that identifies knowledge gaps, integrates non-clinical competencies, and credits continuous improvement activities cardiologists already perform – all for the ultimate benefit of patients and the profession.

Despite strong support from the cardiology community and leading societies – including the American College of Cardiology, the American Heart Association, Heart Failure Society of America, Heart Rhythm Society, and the Society for Cardiovascular Angiography and Interventions – the American Board of Medical Specialties (ABMS) declined our application last February to establish an independent cardiovascular board. This decision raises critical questions about the future of certification. While ABMS allows for reapplication after two years, their failure to recognize cardiovascular medicine as a distinct specialty and reluctance to embrace modern competency models makes a clear path forward uncertain.

Where We Stand Today

Currently, the American Board of Internal Medicine (ABIM) remains the sole recognized certifying body for cardiovascular medicine. ABIM offers initial certification and maintenance pathways, such as the Collaborative Maintenance Pathway (CMP), 10-Year Examination and Longitudinal Knowledge Assessment (LKA). While these options represent incremental progress, they continue to rely on static, pass/fail knowledge tests that overlook practice-specific skills, non-clinical competencies and quality improvement efforts. Although ABIM has expressed interest in modernization, collaboration with ABCVM has not materialized.

Exploring Alternatives

The ABCVM Board of Directors* continues to evaluate partnerships with organizations, such as the National Board of Physician and Surgeons, the American Board of Physician Specialties, and the American Osteopathic Association, to accelerate innovation. However, differences in scale, resources, recognition and philosophy limited these options. We remain committed to identifying viable pathways that align with our mission: creating a competency model that is formative, personalized, and integrated into daily practice.

The Future of Competency Assessment

Clinical competency demands continuous, adaptive assessment tailored to specialty, practice focus, and patient outcomes. Leveraging AI, data analytics, and real-time feedback can transform certification from episodic testing to ongoing professional development. This evolution requires collaboration among societies, certifying bodies, payers, regulators and clinicians, along with a shared commitment to measuring impact on patient care and physician experience. A "lifelong learning portfolio" of competency would provide an opportunity for each cardiologist, from training to retirement, to identify and fill knowledge gaps and catalog multi-source data specific to their practice setting. We owe this to our patients and to the profession.

Our Commitment

Through our due diligence, we have exposed and highlighted many challenges and road blocks to innovation while learning a lot along the way: we have united the leading cardiology societies and the entire profession around a noble cause; we have clearly articulated what is broken or mis-aligned and presented a sound approach for improvement; we have moved forward the evolution of cardiovascular medicine, independent from internal medicine; we have continued to fight for what is right and evidence-based; and we now better understand the obstacles in our way. The ABCVM will continue to advocate for a fresh approach that welcomes alternative assessments of clinical competency. We are living in uncertain times, yet our mission remains clear: to provide the best patient care possible with physicians who demonstrate continued competence in clinical cardiology.

Thank you for your unwavering support as we navigate these challenges. Together, we will shape a certification model that reflects the excellence and complexity of cardiovascular medicine.

Jeffrey Kuvin, MD, FACC, ABCVM President
Christopher M. Kramer, MD, FACC, ACC President

*American Board of Cardiovascular Medicine Board of Directors: Jeffrey Kuvin (President), Mark Drazner (Treasurer), Jodie Hurwitz (Secretary), Katie Berlacher, Renee Bullock-Palmer, Peter Duffy, David Faxon, Edward Fry, Judith Hochman, Esther Kim, Michelle Kittleson, Daniel Kolansky, Gregory Michaud, William Roach, Karen Stout.

Keywords: Education, Continuing, Clinical Competence, Certification