ABFM’s Approach to Health Equity and DEI in the Curation of Knowledge Assessment Questions

ABFM understands the impact that systemic and structural racism and other forms of bias have contributed to the disproportionate health disparities and poor health status among minorities and other groups of disadvantaged patients. In doing so, we acknowledge our responsibility to ensure that the questions we use in all self-assessment activities and examinations are free from bias. This includes being diligent in our attempts to ensure the use of inclusive language in our questions and eliminating words and phrases that may reflect systemic biases.

We recognize that race is a social, not a biological, construct. When race/ethnicity are used in our questions, they will be purposefully added to the critiques in order to highlight evidence of specific epidemiologic differences in patient or population outcomes, to support the need for attention to specific health disparities, to question the use of race in diagnostic or treatment algorithms, and to draw attention to the role that the trauma resulting from systemic bias and racism have had on physical and mental health.

“In our ongoing analysis, we have identified examples of historical questions in which race, used as a patient descriptor, could perpetuate stereotypes or suggest an underlying biologic explanation for the answer. We are working internally to identify these questions and have also benefitted from having Diplomates’ comment on them and bring them to our attention,” says Dr. Keith Stelter, Medical Director of Certification. “This is a process of ongoing learning and dialogue for us to continually identify ways that we can address this historic problem.”

For new question development, ABFM has recommitted to addressing cultural competency, health equity, social determinants of health, and systemic racism in relation to caring for patients and advocating for communities. Similarly, as we develop our new examination blueprint, we are committed to incorporating health equity, social drivers of health, and race-conscious care into assessment questions, as appropriate.