Practice Pathway Closing in 2025
Application Process
Primary Specialty Certification
Medical License
Acceptable Practice Activities
Counting Practice Activity Time
Practice Verifications
Practice Pathway Closing in 2025
After the 2025 application cycle concludes, will I be able to sit for the initial certification exam in Addiction Medicine through the practice pathway?
No. After the 2025 application cycle has concluded, the only way to become eligible to sit for the initial certification exam in Addiction Medicine will be via the ACGME-accredited fellowship pathway.
If I began to accumulate the required number of practice hours before the practice pathway closes, will I be allowed to complete the remainder of the required number of practice hours and apply to sit for the initial certification exam in Addiction Medicine after the practice pathway closes?
No. The time-in-practice requirements for Addiction Medicine will only be counted through June 30, 2025. Any hours accumulated after the June 30th deadline will NOT count toward time-in-practice requirements to be eligibile for the Addiction Medicine certification exam through the practice pathway.
What options do I have if my 2025 application in Addiction Medicine is denied?
If your 2025 practice pathway application is denied, you will have thirty days from the date you received your application decision to submit an appeal to the Board. Pursuant to ABPM's policies, appeal decisions are final and not subject to further consideration. If your appeal is denied in 2025, the only way to become eligible to sit for the initial certification exam in Addiction Medicine will be via the ACGME-accredited fellowship pathway. The fee to appeal an application denial is $500 and is non-refundable regardless of the outcome of the appeal.
If my 2025 application has been approved, but I either do not take or take but do not pass the initial certification exam in Addiction Medicine during my three-year exam eligibility window (i.e., 2025, 2026, 2027), what options do I have thereafter to sit for the initial certification exam?
If your 2025 application is approved, but you either do not take or take but do not pass the exam in 2025, 2026, and/or 2027, the only way thereafter to become eligible to sit for the initial certification exam in Addiction Medicine will be via the ACGME-accredited fellowship pathway.
If my application was approved in 2023, but I either do not take or take but do not pass the initial certification exam in Addiction Medicine during my three-year exam eligibility window (2023, 2024, 2025), what options do I have thereafter to sit for the initial certification exam?
If your 2023 application was approved, but you either do not take or take but do not pass the exam in 2023, 2024, and/or 2025, the only way thereafter to become eligible to sit for the initial certification exam is Addiction Medicine will be via the ACGME-accredited fellowship pathway.
If my application was approved in 2024, but I either do not take or take but do not pass the initial certification exam in Addiction Medicine during my three-year exam eligibility window (2024, 2025, 2026), what options do I have thereafter to sit for the initial certification exam?
If your 2024 application was approved but you either did not take or take but do not pass the exam in 2024, 2025, and/or 2026, the only way thereafter to become eligible to sit for the initial certification exam in Addiction Medicine will be via the ACGME-accredited fellowship pathway.
If my practice pathway application is approved in 2025, am I required to take the initial certification exam in 2025?
No, if your application is approved in 2025, you are not required to take the exam in 2025. Physicians whose Addiction Medicine applications are approved in 2025, including those who applied through the practice pathway, are granted a three-year eligibility window to take and pass the initial certification exam. If your practice pathway application is approved in 2025, you may take the exam in 2025, 2026, and/or 2027. If you do take the exam in 2025 but do not pass, you still may retake the exam in either or both 2026 and 2027. Be advised, however, that if you either do not take or take but do not pass the exam during your three-year eligibility period (2025, 2026, 2027), the only way thereafter to become eligible to sit for the initial certification exam in Addiction Medicine will be via the ACGME-accredited fellowship pathway.
Application Process
What are the steps in the Addiction Medicine practice pathway application process?
- Physicians complete the application online. In the application, they provide detailed descriptions of their practice activities, therapies, volumes of patients, and the prescriptive licenses they hold. Included with the practice description is the average number of hours the applicant is engaged in each practice activity.
- After an application is submitted, ABPM staff verify the applicant's medical degree, medical license, and primary specialty certification, and confirm receipt of all required practice verifications and letters of reference. If anything is missing or incomplete, they will contact the applicant.
- Next, the application is reviewed by a physician who is certified by ABPM in Addiction Medicine. The physician reviewer will evaluate the applicant's practice activities and hours along with the supporting verifications and letters of reference. The reviewer may render a decision or may request additional information.
- Applicants will be notified of decisions or requests for more information by email and should monitor the status of their application through the online Physician Portal.
Primary Specialty Certification
Can I be eligible for Addiction Medicine subspecialty certification if I am not currently certified through an ABMS Member Board?
Current primary specialty certification is a core requirement to be eligible for the Addiction Medicine certification exam.
Current primary specialty certification through an ABMS member board, the American Osteopathic Association (AOA), the Royal College of Physicians and Surgeons of Canada (RCPSC), or the College of Family Physicians of Canada (CFPC) will satisfy this requirement.
Will AOA or Canadian board certification fulfill the primary specialty certification requirement?
Yes; primary specialty certification through an ABMS Member Board, the American Osteopathic Association, the Royal College of Physicians and Surgeons of Canada, or the College of Family Physicians of Canada will meet the primary certification requirement.
I have not maintained my primary specialty board certification, but I have maintained my subspecialty certification. Will my current certification meet primary specialty board certification requirements to be eligible for ABPM subspecialty certification?
Some ABMS boards consider maintaining subspecialty certification as meeting the primary specialty certification requirements. In those cases, the individual is deemed certified in the primary specialty. Primary specialty certification status is determined by each individual board. For more information about qualifying primary specialty certificates, please visit the ABMS website.
Primary specialty certification is a core requirement. Physicians must possess current primary specialty certification through an ABMS Member Board, the American Osteopathic Association (AOA), the Royal College of Physicians and Surgeons of Canada (RCPSC), or the College of Family Physicians of Canada (CFPC).
Medical License
My state medical license was restricted when I entered an addiction treatment program required by my state medical board, and I have complied with all the requirements of my state medical board. Do those license restrictions for medical reasons prevent me from applying for Addiction Medicine certification?
A physician who has voluntarily entered into a rehabilitation program for chemical dependency/addiction/substance use disorder or a practice improvement plan with the approval of a state medical board shall not be considered to have a restriction on his/her license to practice medicine for the purposes of applying for Addiction Medicine certification.
Acceptable Practice Activities
What activities will count towards the requirements of the practice pathway?
To count towards practice pathway requirements, practice must consist of broad-based professional activity with significant Addiction Medicine responsibility. Broad-based Addiction Medicine involves a comprehensive approach to preventing, diagnosing, and managing patients with various substance use disorders and addictions. It emphasizes specialized addiction management as the primary focus of patient care, encompassing medication for addiction treatment, evidence-based interventions, evaluation/management of co-occurring medical and psychiatric conditions, and harm reduction efforts.
Collaboration within multidisciplinary teams is essential, and practitioners should demonstrate proficiency in managing complex cases across diverse populations. The Addiction Medicine subspecialty goes beyond just treating patients with addiction disorders, which is an element of all medicine practices. It represents a higher level of experience and expertise, requiring specialized training, continuous learning, and ongoing dedication to the growth of the field, whether in a clinical or academic setting.
Time spent working as the primary decision maker providing direct patient care in Addiction Medicine counts toward practice pathway requirements. Examples include prescribing buprenorphone in an office-based opioid treatment program; working in a methadone maintenance clinic; providing medically managed withdrawal treatment from alcohol, sedatives, opioids, or other substances; providing hospital-based addiction consultation services (consultation-liaison service); and acting as a medical director of a residential addiction treatment program.
In addition, up to 1,440 hours (i.e., 75% of the 1,920 total required hours) of Addiction Medicine research, administration, or teaching may count toward practice pathway requirements. To receive credit for such activities, you must submit independent verification or the work product (published papers, lists of lectures, etc.) with your application.
Is it possible to fulfill a portion of practice pathway requirements during my residency, through electives, research, or other means?
Addiction Medicine practice, electives, research, or other activities done while in a residency program or a non-Addiction Medicine fellowship program do not count toward Addiction Medicine practice pathway requirements.
Do CME credits count toward practice pathway requirements?
While ABPM supports lifelong learning, CME activities, even if Addiction Medicine related, do not count toward practice time requirements of the practice pathway.
The required 1,920 practice hours may only include direct patient care, research, training, and administrative activities specifically related to Addiction Medicine.
During my Critical Care Medicine fellowship, I led the implementation of an alcohol withdrawal treatment protocol in the SICU and published a paper based on my work. Can I count this activity toward Addiction Medicine practice pathway requirements?
Any time spent in non-Addiction Medicine fellowships cannot be counted toward Addiction Medicine practice pathway requirements. Elective rotations during residency also do not count toward Addiction Medicine practice pathway requirements.
I shadowed (observed) an Addiction Medicine physician in a residential Addiction Medicine physician in a residential addiction treatment program. Can I count this towards the practice requirements of the practice pathway?
No, observation or shadowing without hands-on patient care for which you are the primary provider, even in Addiction Medicine, will not count towards the practice requirements of the practice pathway. The required 1,920 practice hours may only include direct patient care, research, training, and administrative activities specifically related to Addiction Medicine.
Can volunteer work count toward practice pathway requirements?
Non-compensated or volunteer work may count towards practice requirements, provided you are a primary decision maker and are providing direct patient care. Non-compensated and volunteer work must be verified and supported with appropriate documentation and letters of reference.
Time spend observing or shadowing without primary decision-making responsibility for patient care does not count toward practice requirements.
I completed Addiction Medicine volunteer work while in an ACGME-accredited training program; however, this work was completed outside of the ACGME-accredited training program. Can this volunteer time be used toward the eligible requirements for the Addiction Medicine practice pathway?
No. Even though this volunteer time in Addiction Medicine occurred outside of an ACGME-accredited training program, to count toward time-in-practice requirements of the practice pathway, you must be the primary decision-making physician and not a trainee. Further, such volunteer time cannot be concurrent with time as a trainee within an ACGME-accredited training program.
Counting Practice Activity Time
I worked 100% full time in Addiction Medicine for one month. How many hours can I count towards the practice requirements of the practice pathway?
In your practice pathway application, you should report the number of hours you spent in direct patient care, research, training, and/or administrative activities up to 40 hours per week.
ABPM defines "full time" as 40 hours per week; no more than 40 hours per week can be counted towards practice time requirements for any individual full-time position listed in your application.
If I have met the 1,920 hours of required practice time, but the practice time spans less than the required 24 months, do I qualify to sit for the initial certification exam in Addiction Medicine through the practice pathway?
No. Among other things, to qualify to sit for the initial certification exam in Addiction Medicine via the practice pathway, you must meet both the time AND duration components, meaning the minimum of 1,920 hours of time in practice must have taken place over a minimum of twenty-four months.
In addition to direct patient care, how many hours of Addiction Medicine research can count toward practice pathway requirements?
Up to 1,440 hours (i.e., 75% of the 1,920 total required hours) of Addiction Medicine research, administration, or teaching may count toward practice pathway requirements. To receive credit for such activities, you must submit independent verification or the work product (published papers, lists of lectures, etc.) with your application.
To be eligible for the Addiction Medicine certification exam through the practice pathway, you must also demonstrate a minimum of 480 hours of direct patient care in Addiction Medicine.
In addition to direct patient care, how many hours managing a medication-assisted treatment program (e.g., reviewing outcomes, implementing quality measures) can count toward practice pathway requirements?
Up to 1,440 hours (i.e., 75% of the 1,920 total required hours) of Addiction Medicine administration, research, or teaching may count toward practice pathway requirements. To receive credit for such activities, you must submit independent verification or the work product (published papers, lists of lectures, etc.) with your application.
To be eligible for the Addiction Medicine certification exam through the practice pathway, you must also demonstrate a minimum of 480 hours of direct patient care in Addiction Medicine.
I work in a private outpatient general practice and provide rotating coverage on an inpatient hospital unit. Approximately one third of the patients I see between these two practices have problems due to addiction. Can I claim one third of my practice time in both settings towards practice requirements?
No; only up to 25% of your time in general practice (i.e., practice not specific to Addiction Medicine, including psychiatry, internal medicine, family medicine, pediatrics, etc.) may be counted towards the required 1,920 practice hours.
Practice Verifications
Can my practice partner write a practice verification letter in support of my application?
No, the letter verifying your Addiction Medicine practice time and activities in support of your practice pathway application may not be written by your practice partner, even if they are certified by ABPM in Addiction Medicine. The verification letter must be written by an independent supervising physician, such as a chief of staff, department chair, or fellowship director. If you do not have an independent supervising physician, please provide the credentials of the physician who will complete the verification; ABPM will determine the suitability of the verifier's credentials.