American Board of Medical Specialties (ABMS) Member Boards are enhancing their assessment of professionalism in both their initial certification and continuing certification programs.
For board certification, Member Boards are assessing professionalism through Objective Structured Clinical Examinations (OSCEs) and Peer Review Programs, among other activities.
The American Board of Anesthesiology’s (ABA) OSCE includes seven stations where candidates interact with standardized patient actors. Five stations focus on communication and professionalism while two focus on technical skills. ABA is currently developing scenarios to capture team-based skills and patient communication, aiming to pilot these new scenarios in 2027 and launch them as early as 2028.
While the American Board of Urology (ABU) recently started using OSCEs to simulate real-world scenarios for candidates to demonstrate their professional skills, the American Board of Otolaryngology – Head and Neck Surgery will begin using a new case-based oral exam which will include ethics and professionalism as one of the scoring domains covered by the exam. The first exam with the new format will be administered this September. The American Board of Emergency Medicine (ABEM) will begin using standardized cases to assess patient-centered communication in its new certifying exam that will launch in 2026.
Starting this July, every resident who wants to sit for the American Board of Orthopaedic Surgery (ABOS) Part I Examination after graduation must participate in the ABOS Knowledge, Skills, and Behavior (ABOS KSB) Program. The ABOS KSB Program measures professional behavior using the ABOS Behavior Tool to assess five domains (i.e., ethics, communication, interaction, reliability, and self-assessment) through an end-of-rotation review after each surgical rotation and an annual 360o evaluation. As part of the latter, faculty, fellow residents, and other health care providers (e.g., nurses) assess residents’ professional behavior. When a candidate applies for the ABOS Part II Oral Examination or for recertification, ABOS sends an email request to dozens of the candidate’s colleagues to complete a peer review survey. Similar requests are sent to local ABOS board certified orthopaedic surgeons who were not listed on the application.
Similarly, the American Board of Thoracic Surgery (ABTS) recently implemented 360o reviews focusing on professionalism and communications skills for trainees who want to apply for certification in the specialty. Residents scheduled to complete their training between June and August 2026 are now required to receive feedback from a formal 360o review. The first feedback survey was sent in March, and a follow-up survey is scheduled to be sent this fall. The American Board of Plastic Surgery also requires peer evaluations that address professionalism during both the initial and continuing certification process.
The American Board of Surgery (ABS) has incorporated ethical considerations into its blueprints for qualifying exams across the subspecialties. For example, the Complex General Surgical Oncology exam addresses ethical issues in clinical trials; the Surgical Critical Care exam highlights ethical issues for advanced care directives, palliative care, and organ donation; and the Pediatric Surgery exam raises ethical considerations for surgical indications for pediatric patients.
The American Board of Pediatrics (ABP) requires program directors to attest to the professionalism of each trainee annually. To help them identify professional behavior, ABP created a primer entitled Teaching, Promoting, and Assessing Professionalism Across the Continuum: A Medical Educator’s Guide. ABP staff recently began working on the third edition of the primer. In addition, ABP is in the early stages of using competency-based medical education to assess professionalism in residents. The board is piloting the use of a smartphone-based app to record faculty assessments of pediatric residents based on the entrustable professional activity (EPA) framework. In addition to EPA-based questions, there are currently four assessment forms designed to capture narrative feedback about important elements of professionalism (i.e., patient-family centered care, equity, knowing limits and help seeking behavior, etc.) The professionalism assessments center around the needs of patients and the data are designed to be used for formative development, focusing on positive professionalism and learner growth rather than exclusively focusing on identification of outliers and/or residents with challenges.
For continuing certification, Member Boards are using a mix of professionalism-related journal articles and modules, among other activities. ABU uses log reviews, peer reviews, Professionalism and Ethics Modules, Patient Safety Modules, and patient safety videos. The American Board of Obstetrics and Gynecology offers AMA Ed Hub modules, many of which are professionalism focused, to meet continuing certification requirements. The American Board of Genetics and Genomics requires participating geneticists to complete a patient safety module and plans to incorporate professionalism topics into its longitudinal assessment program next year.
Other Member Boards are also planning to enhance their professionalism offerings to meet continuing certification requirements. The American Board of Pathology is adding Certlink® items on professionalism in July, instructing item writers to include professionalism topics in upcoming exams, and considering an in-training assessment for residents. ABEM is also looking to highlight professionalism topics in future continuing certification activities.
While professionalism is not a new competency, ABMS Member Boards are taking a fresh look at it to ensure that their programs help board certified physicians meet the challenge of professionalism as it applies to the practice of medicine in the 21st century.
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