Frequently Asked Questions (FAQ): Clinical Informatics Subspecialty

Background: In March 2007, with financial support from the Robert Wood Johnson Foundation, AMIA launched an 18 month process to define the core content of the subspecialty of clinical informatics and the training requirements for proposed clinical informatics fellowships. Upon approval of these documents by the AMIA Board in November 2008, AMIA contacted several medical specialty boards to assess their interest in, and willingness to sponsor, an application to the American Board of Medical Specialty (ABMS) to create an approved certification process for the clinical informatics subspecialty. In July 2009, the American Board of Preventive Medicine (ABPM) agreed to sponsor the application for a new subspecialty examination, and, in March 2010, ABPM submitted a formal application to ABMS to create the subspecialty certification. After an extensive review by the ABMS specialty boards and the ABMS Committee on Certification (COCERT), the proposal was approved by the ABMS Board in a vote on September 21, 2011.

Question: Where can I learn more information about the requirements for physicians becoming certified in the clinical informatics medical subspecialty?

Answer: The American Board of Preventive Medicine (ABPM), a Member Board of the American Board of Medical Specialties (ABMS), was the first sponsor of the application for subspecialty certification in Clinical Informatics and should be contacted for all questions about the examination. Visit: www.theabpm.org/

Question: Where can I find more information about developing a fellowship program for the purpose of training physicians for the subspecialty of clinical informatics?

Answer: The Accreditation Council for Graduate Medical Education (ACGME) will eventually accredit training programs in clinical informatics but at this point in time the ACGME has not released specific accreditation criteria nor has it defined the logistical processes that will be involved in the program reviews. However, the AMIA Academic Forum has established a Clinical Informatics Specialty Program Accreditation Task Force to pursue and provide up-to-date information to training programs as it becomes available through the establishment of a regular communications between ACGME and AMIA. To receive updates from the AMIA Academic Forum, consider becoming a member program: www.amia.org/programs/academic-forum.

Question: How do I prepare for the clinical informatics subspecialty when the ABPM begins taking applications to sit for the examination?

Answer: AMIA developed a Clinical Informatics Board Review Course that is offered both live and online for those who are interested in sitting for the CI board exam offered by the American Board of Preventative Medicine, www.theabpm.org website should be consulted for current information on the board exam.

The AMIA course director is William (Bill) Hersh, MD, FACP, FACMI, who works with AMIA staff, course faculty and our e-learning provider to develop content for the course. In addition to the live and online courses a practice exam is offered. AMIA practice exam will include sample questions in clinical informatics content areas likely to be covered on the examination. The live courses are offered in April, June, August and September.

Sign up to receive information on the AMIA Clinical Informatics Board Review Course receive registration information when it becomes available at: www.amia.org/clinical-informatics-board-review-course/request-preparatory-coursework.

Question: What options exist for certification of professionals who are not eligible for the clinical informatics medical subspecialty (non-physicians, or physicians who do not practice, have not been certified by one of the member boards of the ABMS, or have not maintained their certification)?

Answer: At its June 2011 meeting, the AMIA Academic Forum decided to create an Advanced Interprofessional Informatics Certification (AIIC) Task Force whose charge is to explore the issue of an alternate pathway for certification of clinical and public health informatics professionals in parallel with the subspecialty certification of physicians. The AIIC Task Force has delivered a recommendation to the AMIA Board of Directors to pursue the establishment of an Advanced Interprofessional Informatics Certification and there is a now a Roles and Functions Task Force working on a white paper that will present a structure, building upon prevailing definitions, for describing and categorizing the varying roles, functions and related certification needs among those working in the discipline of biomedical informatics or closely related fields.  The work of both task forces will be presented to the AMIA Board for a decision about how to proceed in September 2012.

Question: I have specialty boards from ABMS in a field other than preventive medicine. Am I still eligible to take the CI subspecialty examination and from whom will I receive the certification?

Answer: All ABMS member boards have agreed to allow their diplomates to take the clinical informatics subspecialty examination if they are otherwise eligible. Most people will apply to the ABPM and receive their certification from that Board. Other member boards may participate as cosponsors, in which case those other boards may handle the application and certification process for their own diplomates, even though all candidates will take the same examination. The American Board of Pathology is currently the only formally approved cosponsoring board for the CI subspecialty certification process.

Question: What will be the Maintenance of Certification (MOC) requirements for individuals who are successfully certified in the CI subspecialty?

Answer: As with essentially all other ABMS certifications, the credential will be time limited and there will be a formal process that certified physicians will need to follow in order to maintain their certification. Details of MOC will be made available on the ABPM web site referenced previously.  AMIA is working with board to develop an AMIA-managed MOC process for those who get certified. Note, in addition, that the ABMS has required that maintenance of certification in the CI subspecialty will also require ongoing certification in the individual’s primary specialty (i.e., MOC in the primary specialty unless the individual has been certified for life, as was the case before formal MOC was introduced). Reciprocal arrangements among boards, to facilitate maintenance of dual certifications, are likely and will be described on the ABPM web site as the details become available.

Question: If I am already working as a clinical informatician and want to take the board examination in order to be formally certified, do I need to take a formal fellowship?

Answer: For the first five years, it will be possible to be accepted as board eligible based on practice rather than a formal fellowship. The details regarding the criteria for board eligibility based on practice (sometimes referred to as “grandfathering”) will be made available on the ABPM web site at the time that the Board is prepared to accept initial applications from those who seek to be certified. AMIA is not determining those criteria. After the first five years, it will be necessary to have completed an ACGME-accredited fellowship program in clinical informatics in order to be eligible to sit for the CI subspecialty boards. The ABPM will make it clear when that 5-year period of “practice eligibility” has come to an end.

Question: If I am already working as a clinical informatician (and am potentially eligible for the subspecialty examination based on my current work) but I never had formal training in informatics, are there more extensive options available for me to pursue for a broad exposure to the topic, even before I take an AMIA board review course?

Answer:  Most people in this situation will not be interested in returning to graduate school for a full time degree program, so they typically pursue a series of courses, often online, which may lead to a formal certificate.  AMIA's 10X10 courses are one useful option, as are the various community college and university-based training programs that were created under the auspices of the Office of the National Coordinator for Health Information Technology (ONC).  Self-study with online courses and key textbooks are additional options.  AMIA has also worked with the American College of Physician Executives to produce an excellent overview of HIT and informatics through a series of online video lectures and supporting materials. See the ACPE web site for details and also AMIA's listing of programs and courses at www.amia.org/education/programs-and-courses.

Question: What is the relationship between AMIA, ABPM, and ACGME?

Answer: The CI subspecialty certification process is the sole responsibility of the ABPM and cosponsoring boards. AMIA has offered assistance and expertise but has no direct responsibility for the exam or for defining the certification criteria. AMIA will generally refer all questions regarding the exam and eligibility to the ABPM. Similarly, the ACGME is a separate corporate entity from ABPM and its sole responsibility is the accreditation of training programs. The evaluation of training programs will be guided by the competencies evaluated in the ABPM’s CI board examination, but there is no formal link. Generally, however, the ABMS expects that applicants for subspecialty certification will have completed a fellowship program that has been evaluated and certified by the ACGME.