Oh boy. This is a very complicated situation and isn't going to be easy to solve. Regardless, the first thing to do is to take a deep breath and stop thinking about suing people. That's not going to end well for you.
Let's review the full situation:
This is not a new rule. This plan was put in place 5 years ago, anyone running a residency program should know all about it. The merger between the ACGME and AOA was a shotgun marriage at best. The AOA really had no interest in this at all, and then the ABIM announced that residents in AOA accredited core residency programs would no longer be able to participate in ABIM fellowships. I have no idea why they decided to make this declaration -- I suspect it might have been the ACGME pressuring them to do so although that's a completely baseless guess on my part. In any case, this created an enormous problem for the AOA, forced them to the table, and the GME merger proceeded. The AOA and ACGME stay separate - I expect the end game is that now that all programs are under a single banner, ABOIM will be marginalized and ultimately disappear.
So, starting 5 years ago the ACGME changed the rules so that either ABIM or ABOIM faculty could be PD's under the single system. And they created a 5 year transition period where 1) any program that was ABOIM certified and switched to ABIM would have all credit count towards ABIM, and 2) Allow ABOIM PD's to certify fellows for the ABIM exam. Importantly, they also opened the door for ABOIM certified docs to become ABIM certified simply by taking the cert exam. They were very clear that this transition period would last five years, and after that all PD's would need to be ABIM certified. That 5 year transition period ended 12/2021.
This is why you're in limbo. Your program has not been paying attention. Some, if not all, of their ABOIM faculty should have been required to get ABIM certification to prevent this exact problem.
Here's how you move forward:
1. How many faculty do you have? Your post suggests there is now just one, and prior to this there were two. The ACGME requires at least four faculty, more if there are more than six fellows. If there is really only one faculty member, your program is way out of compliance with the ACGME. In general, the ACGME is not in the business of closing down programs -- if there are problems, they will give them time to fix them. But if there's only one doc for all of the fellows? They will come down with Thor's Hammer and close down the program. What is the program supposed to do when the one doc goes on vacation? Who supervises you? I am hoping I have misunderstood your post. If there is another person who is ABIM certified and meets the requirements of a PD, they should probably be put in place.
2. The current PD should apply for ABIM certification. They would be taking the exam at the same time you will, so they won't be able to certify you (until after they pass). Then, they can certify you to take it the next year. Most jobs won't care that you can't take it right away -- most require that you pass it within 5 years. So the plan would be that they pass it this year, then you take it the next year. It's a bummer (better to just get it out of the way) but not a huge problem. Of course, this person might refuse since it's a huge pain for them, and we are also assuming they will pass. And they would need to take both the Heme and Onc exams. Given what you've written here, I expect that they don't want to be PD, and will refuse.
3. They could hire a new ABIM PD. If that happens, they can certify you -- even if they are hired after you actually graduate. But they might be uncomfortable doing so, never having met you.
4. Because the ABIM has been making this clear for 5 years, I doubt they will budge. But there's some chance that a nicely worded letter to them might give you one more year of the transition rules. I would recommend asking your IM PD to step in and help, or the DIO if they are ABIM certified.
Other options get worse:
5. You could never get certified. Some jobs won't care. Some will, and it's possible that more will over time.
6. You could find another fellowship program looking for a 1 year fellow. They can then certify you.
7. You might be able to find a job at a program with a fellowship. If so, the PD of that fellowship could certify you after observing your work for some period of time. This would be highly atypical, and they would need to contact the ABIM. But it might be possible.
You do not know how much I appreciate your comment!
I'll go through the list just to clarify:
1. Currently, we have only one attending at site. We DO have more attending off site:
we go for an external rotation just for 1 month in a year where there are 5 more attendings. Our program listed them as "core faculties" so we can get the ACGME accreditation. However, these off site "core faculties" do not meet the criteria for core faculties ("Core faculty members devote at least 15 hours per week to resident, or 10 hours per week to fellow, education and administration"). Simply because we see them only one month a year and not weekly. They do not take part in research, evaluation, etc.
I was thinking about reporting this program for this (if not for other issues), but I am looking at other options first.
- Because these off site attending (majority DOs) are not willing to drive 1-2 hours to our hospital daily and they do not have capacity for more rotations at their site I highly doubt they are willing to play the role of a PD! (they are a community private group doing us a favor by having us there once a year!).
2. The PD already took the ABIM (2021) and failed! I really do not want to wait for him to take it again so he "may" pass! that is simply too risky!
I am not going into details about our conversation after he received his result! oh, man!
3. They (DIOs) said (and we think they are honest) they are looking for a new PD (ABIM certified). One person interviewed 4-5 months ago, and sign a letter of intend 1 -2 month ago. But still no contract was signed and they said "It may take months". It has been a stressful waiting time for me and other fellows.
- I am not sure if a new PD hired after my graduation can sign off on my test. I think I asked ABIM/ACGME and they said no.
4. Asking ABIM nicely! is one of my options and I talked to an attorney and he mentioned it. I think there is like 10-30% chance there!
5. I did many years of research and etc just to get into hem/onc. It will be very hard for me to end up not having the certification! but yes, you are right. This is what it is.
6. I emailed all 7-8 programs in our state about doing a 3rd year there. Only one replied "we do not have any position available".
7. That is very hard to find specially when I already contacted them for a 3rd year spot. But if I am lucky that may happen.
When I contacted ABIM-ACGME they said your program was supposed to write it in your contract that you may be ineligible for ABIM exam:
“Background and Intent: Eligibility for ABMS or AOA Board certification may not be satisfied by fellowship training. Applicants must be notified of this at the time of application, as required in II.A.4.(a).(9).”
However, our program did not do this! This can be the basis of a legal action though. In that case our program is responsible to find a "3rd year spot" in another fellowship so we can take the ABIM boards (if not other things). What is your opinion about this?
Again, I really appreciate your input and time.
