Perceptions of the certification standards of the American Board of Internal Medicine

Perceptions of the certification standards of the American Board of Internal Medicine (ABIM) and the qualities of care provided by certified and non-certified practicing internists are reported from surveys of ABIM Board members, internal medicine program directors, and samples of third-year residents, practicing internists, nurses, and hospital administrators. ABIM pass rates were estimated accurately and viewed as appropriate. Physicians perceived the deficiencies of non-certifiable residents to be in clinical judgment and factual knowledge; non-physicians indicated deficiencies in humanistic qualities. The groups estimated that approximately 70% of all practicing internists and 37% of the non-certified internists they know provide excellent care while 15% of the certified internists give inappropriate care. Perceived deficiencies of internists giving low-quality care were nearly identical to those of non-certifiable residents. The results support ABIM's initial certification process and suggest that a written examination with well chosen standards would be useful for experienced internists.