Key Takeaways
If you are considering the ABIM Longitudinal Knowledge Assessment, it's crucial to understand every aspect of this new exam type. While the content is the same as what you'll see on the 10-year exam, the format is new and different.
Here’s what you need to know about the ABIM quarterly Longitudinal Knowledge Assessment (LKA).
The American Board of Internal Medicine (ABIM) Longitudinal Knowledge Assessment (LKA) is a modern approach to maintaining certification for internal medicine physicians. The LKA integrates ongoing assessment with continuous learning, allowing physicians to engage with the recertification process more flexibly and conveniently.
The LKA is part of ABIM’s broader effort to respond to the evolving needs of the medical community. Physicians have expressed concerns about the high stakes and rigid structure of the traditional recertification exam, prompting ABIM to develop a more adaptive and physician-friendly option. The LKA is less disruptive to a physician's practice and offers an opportunity for ongoing professional development that aligns with the realities of modern medical practice.
The ABIM LKA is a five-year cycle exam where internal medicine physicians answer questions on a quarterly basis. It provides ongoing feedback about performance and uses the same ABIM MOC exam blueprint as the traditional exam.
The LKA represents a significant shift in how internal medicine certification is maintained. Historically, physicians had to prepare for a decennial exam that covered a broad range of topics. While effective in some respects, this approach was often seen as disconnected from daily practice and an added stressor in an already demanding profession.
The introduction of the LKA marks a move towards a more integrated assessment model. By breaking down the recertification process into smaller, more manageable segments, the LKA promotes continuous learning and retention of knowledge.
This shift reflects a broader trend in medical education towards lifelong learning and ongoing professional development.
The most significant difference between the LKA and the traditional 10-year exam is its structure. Instead of a single high-stakes exam taken every decade, the LKA spreads the assessment over five years. Physicians answer 30 questions every quarter, totaling 120 questions annually and 600 questions over the entire cycle.
Another critical difference is the LKA’s focus on feedback. After each question, physicians receive immediate feedback, including whether they answered correctly, the rationale behind the correct answer, and references for further reading. This continuous feedback loop helps identify knowledge gaps and reinforce learning.
The ABIM Longitudinal Knowledge Assessment (LKA) is structured to provide a flexible, ongoing evaluation method that fits seamlessly into a physician's professional life. Unlike the traditional 10-year Maintenance of Certification (MOC) exam, the LKA involves answering a set number of questions each quarter over a five-year period.
Specifically, participants receive 30 questions every quarter—a total of 120 questions per year and 600 questions over the full cycle. Participants have four minutes to answer each question, so you need to be efficient and focused during the assessment. Participants have a 30-minute time bank each year that can be used to extend the time for any question in 1-minute increments.
The ABIM LKA uses a unique scoring system. It's designed to reflect a physician's knowledge and performance over the entire five-year cycle. The scoring scale ranges from 100 to 150, with a mean score of 125 and a standard deviation of 8.
To pass the LKA, physicians must achieve a score that meets or exceeds the established performance standard, which is determined using the Angoff method. This method involves panels of content experts who evaluate each question and estimate the likelihood that a borderline candidate will answer it correctly. The sum of these probabilities sets the passing score, ensuring that it reflects current expectations for physician knowledge in internal medicine.
Physicians do not receive a pass/fail result until the end of the five-year cycle. However, you will receive interim formative progress reports after the first quarter of the second year, which provide an early indication of performance relative to the passing standard. This will allow you to adjust your study strategy and focus on areas you need to improve.
The ABIM's LKA Exam includes 600 questions presented to you quarterly (30 questions per quarter) over 5 years. The question content is pulled from any of the content areas on the ABIM MOC blueprint. The ABIM Longitudinal Knowledge Assessment uses the same MOC blueprint as the 10-year exam.
You can skip up to 100 questions throughout the five-year testing time.
To prepare for the ABIM LKA, understand its format and leverage the right study tools.
Since the LKA is an ongoing assessment spread over five years, it allows for a more sustained and less intensive study approach compared to the traditional 10-year exam.
Internal Medicine Qbank+: Qbanks are one of the most effective tools for preparing for the LKA. You can practice questions that mirror the format and content of the LKA, which helps you familiarize yourself with the types of questions you'll see on the exam. You can also set up Qbank+ sessions to practice answering questions within the 4-minute answering window.
Review Courses: Comprehensive review courses, whether live or online, provide an in-depth review of internal medicine topics. These courses are particularly useful for physicians who prefer structured study environments. MedStudy’s Internal Medicine Review Course, for instance, is designed to cover the breadth of the ABIM blueprint, making it a valuable resource for LKA participants. There is a Q1 course so that you can attend the full review course before your Q1 questions are due.
Video Lectures: On-demand video lectures offer flexibility and convenience, allowing you to review specific topics at your own pace. These videos can be especially helpful for visual learners or those looking to reinforce their understanding of complex subjects.
Blueprint Familiarization: Understanding the ABIM MOC blueprint is crucial for effective LKA preparation. The blueprint outlines the medical content areas and their relative weight in the assessment. Use it to prioritize what you study!
Have your open-book resource ready! The LKA is an open-book exam, so you can consult reference materials while answering questions. Most physicians use UpToDate for this, but they find the 4-minute window tough to find specific answers. You'll be at an advantage if you use an easy-to-search resource that pulls results by keyword, like MedStudy's digital Core.s:
Go in with a question-answering strategy. Effective time management is critical during the LKA. Avoid opening questions until you're ready to answer. Opened but unanswered questions count towards the limit of 100 questions that can be skipped over the five-year cycle. Using the 30-minute time bank strategically can also help manage more challenging questions.
The quarterly progress reports are a crucial component of the LKA’s continuous assessment model. These reports provide physicians with detailed insights into performance, allowing you to track your progress over time and get an idea of your pass/fail status at the end of your LKA cycle.
Video from the ABIM explaining the LKA quarterly progress report
Physicians who have finished the first quarter of their second year of taking the LKA will receive a score report. It's designed to help physicians understand how you're performing relative to the current passing standard, which areas to study more, and which areas you're performing well in.
Physicians can use these quarterly reports to adjust their study strategies. For example, if the progress report indicates a lower-than-expected score in a particular content area, focus more study time on that area before the next set of questions is released.
This targeted approach helps ensure that physicians are continually improving their knowledge and skills in areas where they may be weaker.
The ABIM Longitudinal Knowledge Assessment offers a flexible and effective way for internal medicine physicians to maintain their certification while staying current with the latest developments in their field. Its continuous assessment model, coupled with immediate feedback and ongoing professional development opportunities, makes it an attractive option for many physicians.
However, the LKA also requires a commitment to regular engagement and study. Physicians considering the LKA should weigh the benefits of its flexibility and continuous learning against the demands of ongoing participation.
The LKA fee is included in your annual ABIM MOC fee.
According to the ABIM, an internal medicine physician with one certificate will save $100 over a 10-year period when they choose to do the LKA instead of the traditional 10-year recertification exam.
You should enroll in the LKA for the year your assessment is due. To register for the LKA, you must meet these three requirements:
If you meet the above, then it's time to register!