1. Subspecialty Recognition in Medicine The Process The Process Step 1 Approval by the American Board of Medical Specialties (ABMS) Requires sponsorship by one ABMS primary board Formal approval by ABMS member boards Handover to ACGME

2. Step 2 Approval of Training Requirements by the Accreditation Council for Graduate Medical Education (ACGME) Normally taken from the draft requirements of the specialty Subspecialty Recognition in Medicine The Process The Process

3. The ABMS Process for Approval of a New Subspecialty New Subspecialty Obtaining an ABMS Primary Board Sponsor Constructing the Foundational Documents Core Content Draft Training Requirements

4. Demonstration of an Adequate # of Training Programs Formal Approval by ABMS Member Boards Examination offered to eligible candidates Practice track Fellowship completion The ABMS Process (cont)

5. The ACGME Accreditation Process Distribution of Program Information Forms (PIFs) Program Applications The New ACGME Accreditation Process Direct line to Duty Hours Issue

6. Focus on Patient Outcomes (safety, cost and quality) Shift from Program to Institutional Responsibility Requires Primary Specialty Department Sponsorship Milestones Have Become the Evaluation Standard The ACGME Process (cont)

7. Fellowship Funding Reduced Federal Funding More Reliance on Creative Local Funding Importance of the Addiction Medicine Foundation Program