ABNM Policy on Licensure Standards for Certification and Maintenance of Certification

Approved February 16,2015

1.  Licensure policy.

(a) To be eligible for ABNM certification or maintenance of certification, a physician must maintain a current, full, and unrestricted license to practice medicine in at least one (1) jurisdiction in the United States, its territories, or Canada. The physician also must have a current, full, and unrestricted license to practice medicine in all jurisdictions where the physician is licensed, and, except as provided in Section 2, must never have had a license that was restricted or limited, revoked or suspended, or voluntarily surrendered or allowed to expire to avoid action(s).

(b) The ABNM will investigate and, if appropriate, take action regarding certification or maintenance of certification in the event it becomes aware that a physician’s medical license in the United States, its territories, or Canada, has become subject to a disciplinary action, probation, conditions or requirements (whether imposed by a licensing authority, or as the result of an agreement and/or stipulation between the physician and a licensing authority) or has been restricted or limited, revoked or suspended, voluntarily surrendered, or allowed to expire to avoid action(s). Actions taken by the ABNM may include disciplinary sanctions, such as: denial of initial certification; suspension of certification (where the physician’s certification is suspended for a specified time or pending further investigation and/or action); probation (where the physician continues to be certified during a specified period with stipulated conditions, such as periodic contacts and meeting the requirements of maintenance of certification); and revocation of certification (where the physician ceases to be certified). The ABNM reserves the right to determine the appropriate action based on the seriousness of the infraction that resulted in a medical licensure board taking an action against a physician’s license. The physician will be notified, in writing, of any action proposed to be taken by the ABNM. Such notification will:

  1. advise the physician that the ABNM Credentials Committee (CC) will determine on behalf of ABNM, no fewer than sixty (60) days after the date of the notice, whether to recommend any disciplinary action;
  2. summarize the relevant evidence in ABNM’s possession;
  3. include copies of any relevant documentary evidence in ABNM’s possession;
  4. provide the physician an opportunity to make a written submission to the CC;
  5. disclose the policy (ies) and/or procedure(s) pursuant to which ABNM may recommend an action, and the possible action(s);
  6. advise the physician that the failure to respond within sixty (60) days to the notice may be considered unprofessional and weighed against the physician by the CC; and
  7. advise the physician that if the CC recommends an action, the physician will have the right to make a written appeal to a panel designated by ABNM’s Board of Directors.

All submissions to ABNM by or on behalf of the physician shall be in writing.

In the event the CC makes a determination that it intends to recommend an action, it shall so notify the physician in writing. Such notification will:

  1. set forth the factual bases for such determination;
  2. summarize the reasons for such determination;
  3. advise the physician of his or her right to request an appeal of the CC’s determination;
  4. advise the physician that any request for an appeal of the determination must be submitted to ABNM, in writing, within thirty (30) days of the date of the notice of the CC’s determination;
  5. provide procedural information about the appeals process; and
  6. advise the physician that while a recommended action is not final and does not affect a physician’s Board Certification status, a physician who is subject to a recommended action is not eligible to participate in the Certification process.

If a physician does not submit an appeal of a recommended action within thirty (30) days of the date of the notice, the recommended action determined by the CC shall become the final decision of ABNM. All submissions to ABNM by or on behalf of the physician shall be in writing.

An appeal of a recommended action by the CC shall be determined by an Appeals Panel consisting of three (3) directors of the ABNM who do not serve on the CC. The Appeals Panel shall have the discretion to affirm, rescind, or modify a recommended action, or impose an alternative action. The CC shall provide each member of the Appeals Panel and the physician-appellant with copies of the documentary record for the recommended action and appeals proceeding. In its consideration of an appeal of a recommended action, the Appeals Panel shall not be bound by any technical rules of evidence, and shall consider any information timely submitted by or on behalf of the physician at any stage of the proceeding along with any information provided by ABNM. After reaching a decision, the Appeals Panel shall notify the physician of its decision in writing. Such written decision shall include the factual basis of the decision and a summary of the reasons for the decision. The decision of the majority of the Appeals Panel shall be the final decision of ABNM.

2.  Exceptions to policy.

The ABNM may, in its discretion, allow a physician to be certified or maintain certification even though the physician’s license to practice medicine in one or more jurisdictions has been restricted or limited, suspended or revoked, voluntarily surrendered, or allowed to expire to avoid action(s), so long as the physician is able to practice at the standard of a certified physician within the restrictions or limitations established by the relevant licensure board and at least one (1) of the following exceptions applies:

(a) The physician has an unrestricted license in all jurisdictions where the physician currently practices medicine;

(b) The physician has a restricted or limited license and the restriction or limitation has been put in place because of a disability; or

(c) The physician does not have an unrestricted license in any jurisdiction in the United States, its territories, or Canada, but there are additional circumstances supporting the goal of physician rehabilitation that justify allowing the physician to be certified or maintain certification.

3. Institutional licensure.

The ABNM may, in its discretion, allow a physician to become certified while practicing under an institutional license while the physician is in specialty or subspecialty training provided all of the following requirements are met. The physician must:

(a) Provide the ABNM with a written statement from the physician’s training program stating the anticipated completion date of the training;

(b) Notify the ABNM, in writing, within thirty (30) days of discontinuation or completion of the training, and

(c) Provide the ABNM with satisfactory, written proof that the physician (1) has obtained full and unrestricted licensure within sixty (60) days following the last day of the physician’s full participation in the training program or (2) is still in an approved training program and is covered by an institutional license of that program.

If any of these requirements is not met within sixty (60) days of the last day of the physician’s full participation in the training program, the physician’s certification will be suspended. Certification will be revoked for failure to obtain licensure within an additional sixty (60) days.

4.  Foreign Licensure.

The ABNM may, in its discretion, allow a physician practicing medicine exclusively outside the United States, its territories, and Canada, to be certified or maintain certification, without a full and unrestricted license in at least one (1) jurisdiction in the United States, its territories, or Canada, provided that all of the following requirements are met:

(a) The physician has complied with all legal and regulatory requirements governing the practice of medicine in the country where the physician is practicing, and has an unrestricted license to practice medicine in that country; and

(b) Any prior license to practice medicine in the United States, its territories, or Canada, has not been revoked or suspended, voluntarily surrendered, or allowed to expire to avoid action(s).

 5.  Breach of professionalism or medical ethics.

(a) In the event the ABNM becomes aware of a breach of professionalism or medical ethics, as defined by the American Medical Association or the American Board of Medical Specialties, it may, in its discretion, take action regarding certification or maintenance of certification, and/or notify a physician’s medical licensing board(s), other ABMS Member Boards, law enforcement agencies, and local credentialing bodies, of such breach and/or action. Breaches of professionalism and medical ethics include, but are not limited to, the following:

  1. cheating on certification or other examinations;
  2. copying or sharing questions and answers (for example, “recall questions”) from examinations;
  3. providing false information to current or potential employers, state medical licensing board, medical organizations, the ABNM, or other professional groups;
  4. research fraud;
  5. billing fraud;
  6. violation of a patient’s legal rights; and
  7. serious or repeated acts of negligence or malpractice causing or likely to cause patient harm and indicating the physician is not practicing at the standard of a certified physician.

(b) The ABNM will inform a physician, in writing, of its intention to take action regarding his or her certification, or maintenance of certification, according to the procedure described in Section 1 (b) of this policy.

5. References.

  1. AMA’s Code of Medical Ethics. Available at: http://www.ama-assn.org/ama/pub/physician-resources/medical-ethics/code-medical-ethics.page.
  2. Wynia MK, Papadakis MA, Sullivan WM, Hafferty FW: More Than a list of Values and Desired Behaviors:  A Foundational Understanding of Medical Professionalism. Acad Med 2014; 89(5):712-714.