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Certification Manual for Residents, Supervising Diplomates,
Resident Advisors, and Program Directors
Effective July 1, 2021 – June 30, 2022
The information contained in this Manual was submitted for publication on January 20, 2021 and becomes
effective on July 1, 2021. It represents the current policies, procedures and requirements for individuals
interested in certification by the American College of Veterinary Internal Medicine (ACVIM or the College).
While a concerted effort has been made to ensure accuracy, Program Directors, Supervising Diplomates,
Resident Advisors, residents, and candidates should contact the ACVIM office if questions arise. Further,
ACVIM policies and procedures are subject to periodic review and change.
If Program Directors, Supervising Diplomates, Resident Advisors, residents, or candidates have concerns
about proposed or actual changes that could impact the certification process they should contact the ACVIM
Certification and Accreditation staff at the Colorado office, preferably by email at certification@acvim.org or
by mail or phone, as referenced below.
American College of Veterinary Internal Medicine
Prentice Place Suite 300
8301 East Prentice Avenue
Greenwood Village, CO 80111
Tel: (303) 231-9933 or (800) 245-9081 (toll free in USA and Canada)
Fax: (303) 231-0880
Website: www.ACVIM.org
E-mail: Certificat[email protected]
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TABLE OF CONTENTS
1 ACVIM MISSION STATEMENT 1
2 ACVIM VISION, MISSION, AND VALUES STATEMENTS 1
3 IMPORTANT DEFINITIONS 2
3.A Active ACVIM Diplomate 2
3.B ACVIM Associate 2
3.C American Board of Veterinary Specialties 3
3.D Authorized Agent 3
3.E Board of Regents (BOR) 3
3.F Candidate 4
3.G Certification Liaison 4
3.H Certification Process 4
3.I Credentials Committee 5
3.J Diplomate 5
3.K Disabled ACVIM Diplomate 5
3.L European College of Bovine Health Management (ECBHM) 5
3.M European College of Equine Internal Medicine (ECEIM) 6
3.N European College of Veterinary Internal Medicine - Companion Animal (ECVIM-CA) 6
3.O European College of Veterinary Neurology (ECVN) 6
3.P Good Standing 6
3.Q Honorary Member 7
3.R. Inactive Candidate 7
3.S Inactive ACVIM Diplomate 7
3.T Non-Traditional Residency Training Program 8
3.U Ombudsperson 8
3.V Program Director (PD) 8
3.W Residency Training Committee (RTC) 8
3.X Residency Training/Credentials Committee 9
3.Y Residency Training Program (RTP) 9
3.Z Resident 9
3.AA Resident Advisor 9
3.BB Retired Diplomate 9
3.CC Sponsoring Institution 10
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3.DD Supervising Diplomate (Primary Specialty) 10
3.FF Veterinary Specialty Organizations Committee (VSOC) 11
Table of Essentials 12
PART ONE: APPLIES TO ALL SPECIALTIES 14
4 Requirements for All Specialties 14
4.A Achieving Board Certification (Diplomate Status) 14
4.B Summary of Procedures for all Specialties at a Glance 14
4.C Special or Additional Procedures for Each Specialty 15
4.C.1 Cardiology 15
4.C.2 LAIM 16
4.C.3 Oncology 16
4.C.4 SAIM 16
4.D Duration of RTP Training 16
4.E Time Allowed Between Successful Completion of RTP to Achieving Diplomate Status 16
4.F The Certification Process 16
4.F.1 Registration of the Resident 16
4.F.2 Registration of the Residency Training Program 18
4.F.3 Roles and Responsibilities 19
4.F.3.a. Responsibilities of the Sponsoring Institution 19
4.F.3.b Responsibilities of the Program Director 19
4.F.3.c Responsibilities of the Resident Advisor 21
4.F.3.d Responsibilities of an ACVIM Supervising Diplomate 21
4.F.3.e Responsibilities of Residents 21
4.F.4 Supervision of the Resident 22
4.F.5 Clinical Milestones 22
4.F.6 Training Site Locations 23
4.F.6.a Onsite Training 23
4.F.6.b Secondary and Offsite Training 23
4.F.7 Research Requirements 23
4.F.8 RTP Probation 23
4.F.9 RTP Termination 24
4.F.10 Journal Club 25
4.F.11 Training Weeks 25
4.F.12 Training Hours 25
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4.G General and Specialty Examinations 25
4.G.1 Examination and Credentials Expectations 25
4.G.2 Special Accommodations 26
4.G.3 Scheduling the Examinations 26
4.G.4 Fees 27
4.G.5 The ACVIM General Examination 27
4.G.6 Specialty Credentials 28
4.G.7 Specialty Examinations 28
4.G.8 Notification of Examination Results 29
4.G.9 Procedure for Reapplication Following Examination Failure 29
4.H Policy on Post-RTP Terminology and Specialty Title Usage 29
4.I Appeals 30
4.I.1 Appeals Process 30
4.J ACVIM Diplomate Certificates 31
4.J.1 Repossession of ACVIM Diplomate Certificates 31
4.J.2 Reinstatement of ACVIM Diplomate Certificates 31
4.K Maintenance of Credentials (MOC) 31
PART TWO: SPECIALTY-SPECIFIC REQUIREMENTS 32
5 Specific Requirements for the Specialty of Cardiology 32
5.A Cardiology Residency Training Programs 32
5.A.1 General Objectives of the Cardiology Residency Training Program 32
5.A.2 Specific Objectives of the Cardiology Residency Training Program 33
5.A.3 Specific Requirements to be Fulfilled During a Cardiology Residency 33
5.A.4 Definitions for Cardiology Residency Training Programs 36
5.A.4.a Cardiology Credentials Committee 36
5.A.4.b Cardiology Residency Training Committee 36
5.A.4.c Direct Supervision 36
5.A.4.d Indirect Supervision 36
5.A.4.e Non-traditional Training 36
5.A.4.f Ombudsperson 36
5.A.4.g Program Director 37
5.A.4.h Resident Advisor 37
5.A.4.i Supervising Diplomate 37
5.A.4.j Training Week 37
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5.A.5 Roles and Responsibilities 37
5.A.5.a Environment and Supervision Required at the Sponsoring Institution 37
5.A.5.b Responsibilities of the Program Director 38
5.A.5.c Responsibilities of the Resident Advisor 39
5.A.6 Required Facilities and Equipment 39
5.A.7 Didactic Learning Opportunities 39
5.A.7.a Journal Club 39
5.A.7.b Cardiology Structured Educational Experiences 40
5.A.7.c Supplemental and Suggested Cardiology Focused Educational Experiences 41
5.A.8 Research Requirement 41
5.A.9 Secondary Training Sites 42
5.A.10 Residency Training Program Registration and Evaluation 42
5.A.10.a Program Probation 43
5.B Cardiology Candidate Requirements 44
5.B.1 Distribution of Training Time 44
5.B.2 Supplemental Experiences 44
5.B.3 External (Affiliated) Rotations 44
5.B.4 Residency Training Interruption 44
5.B.5 Consultation and Supervision 45
5.B.6 Resident Evaluation 45
5.B.6.a Resident Logs 46
5.B.6.b Cardiology Residency Training Committee Log Review 46
5.B.6.c Cardiology Credentials Committee Log Review 47
5.B.7 Publication Requirement 47
5.B.8 Complaints by Residents or Candidates 47
5.B.9 Vacation and Study Time 47
5.B.10 Clinical Milestones for First Year Residents 47
5.B.11 Clinical Milestones for Second Year Residents 48
5.B.12 Credentials Items to be Submitted for the Cardiology Specialty Examination 49
5.B.12.a Procedures for Submitting Credentials 50
5.B.13 Specialty Examination Registration and Fee 51
5.B.14 Cardiology Specialty Examination Content and Format 52
5.C Maintenance of Credentials (MOC) 53
6 Specific Requirements for the Specialty of Large Animal Internal Medicine 54
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6.A Large Animal Internal Medicine Residency Training Programs 54
6.B Process for Achieving ACVIM LAIM Diplomate Status 54
6.C General Objectives of the LAIM Residency Training Program 54
6.C.1 Patient Care and Technical Skill 54
6.C.2 Knowledge of Large Animal Internal Medicine 55
6.C.3 Teaching Skills and Lifelong Learning 55
6.C.4 Interpersonal and Communication Skills 55
6.C.5 Professionalism 56
6.C.6 Scholarly Activities 56
6.D Definitions for LAIM Residency Training Programs 56
6.D.1 LAIM Residency Training and Credentials Committee 56
6.D.2 LAIM Clinical Writing Assessment Documentation Committee (CWAD) 56
6.D.3 Non-traditional Training 57
6.D.4 Ombudsperson 57
6.D.5 Training Week and Training Hour 57
6.E Roles and Responsibilities of the Sponsoring Institution 57
6.E.2 Facilities and Equipment 57
6.E.3 Didactic Learning Opportunities 58
6.E.4 Supporting Disciplines Required 59
6.E.5 Secondary and Off-Site Training Sites 59
6.F Responsibilities of the Program Director 59
6.G Responsibilities of the Supervising Diplomate 60
6.H Responsibilities of the Resident Advisor 60
6.I Responsibilities of Residents 60
6.I.1 Patient Care 60
6.I.2 Journal Club 60
6.I.3 Clinical Case Conferences (Rounds) 61
6.I.4 External (Affiliated) Rotations 61
6.I.5 Case Reports (No longer applicable) 61
6.I.6 Clinical Writing Assessment 61
6.I.7 Publication Requirement 62
6.J LAIM Residency Training Program Registration and Evaluation 64
6.J.1 Program Registration 64
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6.J.2 Program Probation 64
6.K Distribution of Time in Training 64
6.K.1 Intensive Clinical Training in LAIM 64
6.K.2 Clinical Training in Other Specialties 64
6.K.3 Additional Clinical Training in LAIM or Related Fields 65
6.K.4 Research, Scholarly Activity, and Study Time 65
6.K.5 Vacation 66
6.L Clinical Milestones 66
6.L.1 First Year Residents 66
6.L.2 Second Year Residents 67
6.L.3 Third Year Residents 67
6.M Resident Evaluation 67
6.M.1 Resident Case Logs 68
6.M.2 Resident Procedure Logs 68
6.M.3 Education Logs 68
6.N Residency Training Interruption 68
6.O ACVIM General Examination 68
6.O.1 ACVIM General Examination Registration and Fee 68
6.P Credentials Submission and LAIM Specialty Examination 69
6.P.1 Procedures for Submitting Credentials 69
6.P.2 Credentials Items to Submit 69
6.P.3 Evaluation of Credentials for LAIM Specialty Examination 70
6.P.4 LAIM Specialty Examination Registration and Fee 70
6.P.5 LAIM Specialty Examination Content and Format 70
6.Q Maintenance of Credentials (MOC) 71
6.R Online Exit Interview Survey 71
7 Specific Requirements for the Specialty of Neurology 72
7.A Process for Achieving ACVIM Neurology Diplomate Status 72
7.B Neurology Residency Training Programs 72
7.B.1 Neurology Residency Training Program Objectives 72
7.B.2 Neurosurgical Procedures and Techniques 73
7.C Definitions for Neurology Residency Training Programs 74
7.C.1 Non-traditional Neurology Residency Training Program 74
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7.C.2 Ombudsperson 74
7.C.3 Program Director 74
7.C.4 Resident Advisor 74
7.C.5 Supervising Diplomate 74
7.C.6 Traditional Neurology Residency Training Program 75
7.C.7 Training Week 75
7.C.8 Training Hour 75
7.D Roles and Responsibilities 75
7.D.1 Responsibilities of the Sponsoring Institution 75
7.D.1.a Documentation and Verification 75
7.D.1.b Facilities and Equipment 75
7.D.1.c Didactic Learning Opportunities 76
7.D.1.d Neurology Diplomates 77
7.D.1.e Supporting Disciplines Required 77
7.D.1.f Secondary Training Sites 77
7.D.2 Responsibilities of the Program Director 78
7.D.3 Responsibilities of the Resident Advisor 79
7.D.4 Responsibilities of the Supervising Diplomate 80
7.D.5 Responsibilities of Resident 80
7.D.5.a Patient Care 80
7.D.5.b Journal Club 80
7.D.5.c Clinical Case Conferences (Rounds) 81
7.E Neurology Residency Training Program Registration and Evaluation 81
7.E.1 Program Probation 81
7.E.2 Program Termination 81
7.E.3 Notifications 81
7.E.4 Acceptable Neurology RTPs 82
7.E.5 Distribution of Time in Training 82
7.F Clinical Milestones for First Year Neurology Residents 84
7.F.1 Patient Care 84
7.F.2 Medical Knowledge 84
7.F.3 Learning and Improvement 85
7.F.4 Interpersonal and Communication Skills 85
7.F.5 Professionalism 85
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7.F.6 Clinical Research 86
7. G Clinical Milestones for Second and Third Year Neurology Residents 86
7.G.1 Patient Care 86
7.G.2 Medical Knowledge 86
7.G.3 Learning and Improvement 87
7.G.4 Interpersonal and Communication Skills 87
7.G.5 Professionalism 87
7.G.6 Clinical Research and Publication 87
7.H Resident Evaluation 87
7.I Residency Training Interruption 88
7.J Neurology Credentials for the Specialty Examination 89
7.J.1 Procedures for Submitting Credentials 89
7.J.2 Credentials Items to be Submitted 90
7.J.3 Evaluation of Credentials for the Neurology Specialty Examination 90
7.J.4 Neurology Specialty Examination Registration and Fee 90
7.J.5 Neurology Specialty Examination Content and Format 91
7.K ACVIM Diplomate Certification 91
7.L Maintenance of Credentials 91
7.M Online Exit Interview Survey 91
8. Requirements for the Specialty of Oncology 92
8.A Abbreviations 92
8.B List of Required Specialty of Oncology Forms 92
8.C Process for Achieving ACVIM Oncology Diplomate Status 92
8.D Annual Report during the RTP 93
8.E Registering for the ACVIM General Examination 93
8.F Procedures for Submitting Credentials for the Specialty Examination in Oncology 93
8.F.1 Credential Items to be Submitted 94
8.F.2 Evaluation of Credentials for Specialty Examination in Oncology 94
8.F.3 Registration and Fee for Taking the Specialty Examination in Oncology 94
8.F.4 The Specialty Examination in Oncology Content and Format 94
8.F.5 Publication Requirement 95
8.G The Residency Training Program 96
8.G.1 Oncology Residency Training Committee 96
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8.G.2 Acceptable Oncology RTPs 97
8.G.3 Correspondence and Inquiries 97
8.G.4 Institutional Requirements for Approved Oncology Residency Training Programs 97
8.G.5 Objectives of the Residency Training Program 97
8.G.6 Clinical Milestones for First Year Oncology Residents 98
8.G.7 Clinical Milestones for Second Year Oncology Residents 98
8.G.8 Clinical Milestones for Third Year Oncology Residents 98
8.H Distribution of Time in Training 99
8.I Training Week 99
8.J Patient Care 99
8.K Clinical Case Conferences (Rounds) 99
8.L Intensive Clinical Training in Oncology 99
8.M Clinical Training in Other Specialties 100
8.M.1 Required Affiliated Rotations 100
8.M.2 Other Rotations 101
8.N Unsupervised Time 102
8.O Research 102
8.P Journal Club 102
8.Q Seminar or Lecture Series and Formal Conferences 102
8.R Continuing Education Conferences 103
8.S Formal Examination Review Sessions 103
8.T Non-Traditional Training Programs 103
8.U Responsibilities of the Sponsoring Institution 104
8.U.1 Documentation and Verification 104
8.U.2 Facilities and Equipment 104
8.U.3 Supporting Disciplines Required 104
8.V Responsibilities of the Program Director 104
8.V.1 Oncology Residency Training Program Registration and Evaluation 104
8.V.2 Resident Evaluation 105
8.V.3 Program Probation 105
8.V.4 Program Termination 105
8.V.5 Substantive changes to an RTP 105
8.W Responsibilities of the Resident Advisor 106
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8.X Responsibilities of the Supervising Diplomate 107
8.Y Responsibilities of Residents 107
8.Y.1 Off-site Rotations 108
8.Y.2 Residency Training Interruption 108
8.Y.3 Secondary Training Site 108
8.Z Maintenance of Credentials (MOC) 109
8.AA Frequently Asked Questions for ACVIM Oncology RTPs & Board Certification 109
9 Specific Requirements for the Specialty of Small Animal Internal Medicine 111
9.A Small Animal Internal Medicine Residency Training Programs 111
9.A.1 General Objectives of the SAIM Residency Training Program 112
9.A.2 Specific Objectives of the SAIM Residency Training Program 113
9.B Definitions for SAIM Residency Training Programs 113
9.B.1 Non-Traditional Training 113
9.B.2 Ombudsperson 114
9.B.3 Program Director 114
9.B.4 Resident Advisor 115
9.B.5 Supervising Diplomate 115
9.B.6 Program Probation 115
9.B.7 Program Termination 115
9.C Roles and Responsibilities 116
9.C.1 Responsibilities of the Sponsoring Institution 116
9.C.1.a Documentation and Verification 116
9.C.1.b Facilities and Equipment 116
9.C.1.c Didactic Learning Opportunities 116
9.C.1.d Supporting Disciplines Required 117
9.C.1.e Secondary Training Sites 117
9.C.2 Responsibilities of the Program Director 118
9.C.3 Responsibilities of the Resident Advisor 118
9.C.4 Responsibilities of the Supervising Diplomate 118
9.C.5 Responsibilities of Residents 119
9.C.5.a Patient Care 119
9.C.5.b Journal Club 119
9.C.5.c Clinical Case Rounds 119
9.C.5.d Publication Requirement 119
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9.D SAIM Residency Training Program Registration and Evaluation 121
9.D.1 Resident Evaluation 121
9.D.2 Resident Case Logs 121
9.D.3 Resident Procedure Logs 121
9.D.4 Education Logs 122
9.E Residency Training Interruption 122
9.F Distribution of Time in Training 122
9.F.1 Intensive Clinical Training in SAIM 122
9.F.2 Clinical Training in Other Specialties 123
9.F.2.a Other ACVIM Specialties 123
9.F.2.b Non-ACVIM Specialties 123
9.F.3 Additional Clinical Training in SAIM or Related Fields, Research/Scholarly Activity, 123
Exam Preparation and Vacation 123
9.F.4 Research and Scholarly Activity 124
9.F.5 Protected Study Time for the General and SAIM Specialty Examinations 125
9.F.6 Vacation and Personal Time 125
9.G Clinical Milestones for First Year SAIM Residents 125
9.G.1 Expectations Regarding Patient Care 125
9.G.2 Expectation Regarding Medical Knowledge 126
9.G.3 Expectations Regarding Learning and Improvement 126
9.G.4 Expectations Regarding Interpersonal and Communication Skills 127
9.G.5 Expectations Regarding Professionalism 127
9.G.6 Expectations Regarding Clinical Research and Publication Productivity 127
9.H Clinical Milestones for Second and Third Year SAIM Residents 128
9.H.1 Expectations Regarding Patient Care 128
9.H.2 Expectations Regarding Medical Knowledge 128
9.H.3 Expectations Regarding Practice-Based Learning and Improvement 128
9.H.4 Expectations Regarding Interpersonal and Communication Skills 128
9.H.5 Expectations Regarding Professionalism 128
9.H.6 Expectations Regarding Clinical Research and Publication 129
9.I Procedures for Submitting Credentials for the SAIM Specialty Examination 129
9.J SAIM Specialty Examination 130
9.J.1 SAIM Specialty Examination Registration and Fee 130
ACVIM CERTIFICATION MANUAL
Mission Statement
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1 ACVIM MISSION STATEMENT
The mission of the American College of Veterinary Internal Medicine (ACVIM or the College) is to enhance
animal and human health by advancing veterinary internal medicine through training, education, and
discovery.
2 ACVIM VISION, MISSION, AND VALUES STATEMENTS
Our Vision: Improving lives of animals and people globally.
Our Mission: Being the trusted leader in veterinary education, discovery, and medical
excellence.
We value:
• Inclusion-creating a community of inclusiveness that respects the diverse backgrounds and
values of its members, candidates, staff and partners
• Integrity – fostering honesty and trust, and adhering to the highest standards of professionalism
• Connection – being part of a supportive network with shared experiences and priorities
• Empathy – relating to others with kindness and humanity
• Excellence – committing to continuous improvement, for ourselves and our profession
In pursuit of our mission, the ACVIM advances knowledge of animal health and diseases and fosters the
continued development of specialty veterinary care in cardiology, large animal internal medicine, neurology,
oncology, and small animal internal medicine. To achieve these purposes, the ACVIM
:
● Certifies new Diplomates by guiding training programs and ensuring fair and appropriate
credentialing and examination procedures;
● Promotes and advocates ACVIM specialization to those individuals within the veterinary profession
and to the animal-owning public, so that the value of certification is recognized;
● Promotes continuing education and the dissemination of knowledge in veterinary cardiology, large
animal internal medicine, neurology, oncology, and small animal internal medicine through the
ACVIM Forum, the Journal of Veterinary Internal Medicine, advanced continuing education (ACE)
courses, and other means;
● Promotes the generation of new knowledge relevant to ACVIM specialties for the benefit of
improved animal and human health.
ACVIM CERTIFICATION MANUAL
Important Definitions
2
3 IMPORTANT DEFINITIONS
3.A Active ACVIM Diplomate
One of four designations a Diplomate may have. An Active ACVIM Diplomate is a veterinarian who
receives approval for this designation by the Board of Regents (BOR) after having fulfilled all
prescribed credentials’ requirements, including passing the General and Specialty Examinations,
being current on annual dues and, for Diplomates certified in 2016 and later, fulfilling the requirements
for Maintenance of Credentials.
A Maintenance of Credentials (MOC) program is in effect for all ACVIM Diplomates certified after
January 1, 2016 and for any Diplomate certified before January 1, 2016 who volunteered to participate
in MOC. Every Diplomate who completed credentials and became a Diplomate on or after January 1,
2016, is awarded a Diplomate certificate that is valid for a period of 10 years. By the end of this 10-
year period, the Diplomate must have met the criteria established to maintain credentials in order to
remain a Diplomate. If the Diplomate fails to meet the criteria, the certificate becomes inactive and the
Diplomate is no longer recognized as a Diplomate by ACVIM. The general criteria for maintaining
credentials and the specialty-specific criteria for maintaining credentials can be found at
www.ACVIM.org.
3.B ACVIM Associate
An ACVIM Associate is a veterinarian certified as a specialist by a non-ACVIM specialty organization
such as the European College of Veterinary Internal Medicine-Companion Animal (ECVIM-CA) in a
specialty which has an ACVIM equivalent. ACVIM grants certain privileges to the ACVIM Associate.
However, the ACVIM Associate is subject to the following:
● Associates do not have ACVIM Diplomate status;
● In some specialties an associate may be part of a training program, e.g. as a Supervising
Diplomate, Resident Advisor, etc. See each individual specialty for rules governing that
specialty’s permissions;
● Associates do not have the right to use the name American College of Veterinary Internal
Medicine;
● Associates may not use the letters ACVIM in the individual’s title;
● Associates may, however, use the ACVIM logo in association with the individual’s work or
associated institution;
● Associates cannot hold college-wide office within ACVIM, nor may they vote in ACVIM
(college-wide or specialty) elections. In some specialties, associates may serve as members
on some specialty (not college-wide) committees;
● Associates may attend specialty business meetings, when permitted by the specialty, but may
not vote in those meetings;
● Associates are entitled to reduced rates for the ACVIM Forum.
See specialty requirements later in the Certification Manual for any further definition:
ACVIM CERTIFICATION MANUAL
Important Definitions
3
3.C American Board of Veterinary Specialties
The AVMA American Board of Veterinary Specialties (ABVS) is the umbrella organization for
accrediting veterinary specialties within the United States. An ABVS-accredited specialty organization
is identified as a Recognized Veterinary Specialty Organization (RVSO) and an accredited specialty is
identified as a Recognized Veterinary Specialty (RVS). The ACVIM is an RVSO and all ACVIM
specialties are RVSs. The ABVS is composed of:
● four voting representatives from American Veterinary Medical Association (AVMA)-
recognized veterinary specialty organizations (chosen by the Veterinary Specialty
Organizations Committee (VSOC), see 3.EE below);
● four voting representatives representing non-specialty AVMA members;
● one voting liaison from the Association of American Veterinary Medical Colleges;
● one voting liaison from the American Association of Veterinary State Boards;
● one voting psychometrician;
● one voting public member.
3.D Authorized Agent
The Authorized Agent (AA) is the individual with administrative responsibility at a Sponsoring
Institution that must verify that the named Program Director has the authority needed and will receive
the support necessary for the Residency Training Program (RTP) to succeed. The Authorized Agent
may be the department head if the RTP is in a university, or an owner or officer of the company if the
RTP is in a private practice. Each year, upon renewal of the RTP, the Authorized Agent must provide
signed support in the form of a completed Authorized Agent letter that documents the ongoing support
of each RTP.
3.E Board of Regents (BOR)
The BOR is the governing body of the ACVIM. Voting members are the BOR Chair, President,
President Elect, At-large Members, and Specialty Presidents.
Non-voting members include the ACVIM Chief Executive Officer (CEO), ACVIM Treasurer, ACVIM
Certification Liaison, immediate Past-Chair of the BOR, Advanced Continuing Education Committee
Chair, ACVIM Forum Program Chair and Co-Chair, ACVIM General Examination Committee Chair,
Membership and Communications Committee Chair, Education and Research Committee chair, Co-
Editors of the Journal of Veterinary Internal Medicine, and Specialty Presidents-Elect.
The exact composition of the BOR and its Executive Committee, along with the duties and
responsibilities of the BOR and ACVIM officers is spelled out in the ACVIM’s Constitution and By-laws.
ACVIM CERTIFICATION MANUAL
Important Definitions
4
3.F Candidate
A candidate is a veterinarian actively seeking board certification by the ACVIM, who has successfully
enrolled in an ACVIM-approved Residency Training Program (RTP), is registered with the ACVIM, and
is making satisfactory progress towards attaining board certification. An individual remains a candidate
until that person:
1) obtains Active Diplomate status (including time between successful completion of the residency and
achieving Active Diplomate Status), or
2) until the candidate withdraws from the RTP prior to satisfactory completion of the program, or
3) until the candidate is excused from an RTP prior to satisfactory completion of the program, or
4) until the individual fails to achieve board certification within the specified allowable candidacy period
as defined in the ACVIM Certification Manual (CM) that is applicable to that candidate.
Candidates are governed by the CM rules in effect at the start of their residency with the following
exceptions: if a rule eliminates or lessens a training requirement, that lessened requirement will
normally apply to current candidates (exceptions will be stated at the time of any rule change). If a rule
is purely procedural and does not impact residency training requirements, e.g. the date of an
examination or the format of an examination, that rule becomes effective for all candidates at the time
the rule is implemented, regardless of the start date of a candidate’s RTP.
3.G Certification Liaison
The Certification Liaison is an ACVIM Diplomate who serves as the ACVIM’s representative to the
Veterinary Specialty Organizations Committee and to the ABVS, and also oversees the activities of
the ACVIM Appeals Committee. The Certification Liaison also performs other tasks as assigned by the
Chief Executive Officer, at the request of the Executive Committee, or at the request of the Voting
BOR. The Certification Liaison is a non-voting member of both the BOR and the Executive Committee
of the BOR.
3.H Certification Process
The ACVIM certification process includes, but may not be limited to, the candidate’s registering with
the ACVIM, completing an approved RTP, successfully passing the General and Specialty
Examinations, paying all associated fees, and meeting all other credentialing requirements of a
specialty. The residency training requirements are defined in the Certification Manual and include
certain requirements for all candidates as well as requirements specific to each individual specialty. It
is incumbent on each candidate to be familiar with and complete all requirements of their specialty,
and also to be familiar with and complete all requirements in Section 4 (Requirements that apply to all
specialties) of this manual. The process of certification (policies and procedures), e.g. registration,
examination dates, deadlines, standard logs, standard forms, etc. are provided on the ACVIM’s
Candidate webpages, located on the ACVIM’s Website. It is critical that candidates (and their mentors)
monitor this site to ensure compliance with published deadlines and that they use the most current
forms.
ACVIM CERTIFICATION MANUAL
Important Definitions
5
In the context of ACVIM-related residency training, the terms “Cardiologist”, “Large Animal Internist”,
“Neurologist”, “Oncologist”, and “Small Animal Internist” applies only to an individual who is an ACVIM
Diplomate in that respective specialty or a diplomate in an equivalent EBVS recognized veterinary
specialty who is acting as an authorized SD in an ACVIM approved RTP.
Candidates (and their mentors) need to be familiar with both the training requirements (the CM) and
the certification process (Candidate Webpage information) for a candidate’s certification success.
3.I Credentials Committee
A specialty’s Credentials Committee (CC) evaluates a candidate’s progress during the training period,
including completion of any publication requirement and the candidate’s examination results. The
specialties of Cardiology, Neurology, Oncology, and Small Animal Internal Medicine each have a
separate CC that evaluates candidate- provided documentation as well as documents from or
regarding the Resident Advisor (RA) and Program Director (PD). In the specialty of Large Animal
Internal Medicine, the functions of the CC are combined with those of the Residency Training
Committee (RTC) into a single Residency Training/Credentials Committee (RTCC).
3.J Diplomate
A Diplomate is a member of one of the ACVIM specialties who has fulfilled all of the criteria to be an
active ACVIM Diplomate at some point (synonym: board-certified). Every Diplomate has one of four
designations: active, inactive, disabled, or retired.
3.K Disabled ACVIM Diplomate
An Active ACVIM Diplomate can request permanently or temporarily disabled status within ACVIM by
petitioning the ACVIM office. A permanently disabled ACVIM Diplomate is “one who certifies the existence of a
permanent disability that prevents them from engaging in veterinary activities as a full-time occupation”. A
temporarily disabled ACVIM Diplomate is one who certifies that due to a temporary medical disability that
individual cannot currently engage in veterinary activity as a full-time occupation (ACVIM Constitution Article V
Section 9). A disabled ACVIM Diplomate has the same responsibilities and benefits as an Active Diplomate,
with the exception of the following:
● The requirement to pay dues;
● The ability to vote (both College-wide or specialty);
● The ability to hold an office within ACVIM (both College-wide or specialty);
● The ability to serve as PD, RA, or Supervising Diplomate (SD) (for any specialty RTP).
After returning to full-time professional veterinary activity, temporarily disabled ACVIM Diplomates may petition
the ACVIM in order to have their Active ACVIM Diplomate status restored. ACVIM confers such Active status
to the Diplomate with BOR approval and payment of that year’s dues. If there are fewer than 9 months
remaining in the membership year, the dues will be prorated.
3.L European College of Bovine Health Management (ECBHM)
ACVIM CERTIFICATION MANUAL
Important Definitions
6
The European College of Bovine Health Management (ECBHM) advances herd- health-oriented
bovine production management in Europe and increases the competency of those who practice in this
field of veterinary medicine.
ECBHM guidelines and training standards for postgraduate education and experience establish
prerequisites for an individual to specialize in bovine health management, to take the examination
related to bovine health management, and to receive authentication as a Specialist in Bovine Health
Management. ECBHM Diplomates are eligible for Associate status within ACVIM.
3.M European College of Equine Internal Medicine (ECEIM)
The European College of Equine Internal Medicine (ECEIM) advances equine internal medicine in
Europe and increases the competency of those who practice in this field of veterinary medicine.
ECEIM Diplomates are eligible for Associate status within ACVIM.
3.N European College of Veterinary Internal Medicine - Companion Animal (ECVIM-CA)
The European College of Veterinary Internal Medicine - Companion Animal (ECVIM-CA) represents
companion animal internal medicine specialists in Europe. The organization’s mission is similar to
ACVIM. It sets standards for residency training and examines candidates. It certifies individuals post-
residency and on successful completion of all certification requirements. Specialty groups within
ECVIM-CA are Cardiology, Internal Medicine, and Oncology. ECVIM Diplomates are eligible for
Associate status within ACVIM.
3.O European College of Veterinary Neurology (ECVN)
The European College of Veterinary Neurology (ECVN) certifies veterinarians as specialists in
veterinary neurology. The organization furthers knowledge related to the pathogenesis, diagnosis,
therapy, and control of diseases affecting the nervous system of animals. The European Board of
Veterinary Specialization (EBVS) and the Royal College of Veterinary Surgeons also recognize ECVN
Diplomates as specialists. ECVN Diplomates are eligible for Associate status within ACVIM.
3.P Good Standing
Candidate: Good standing means that a candidate either must be actively enrolled in an approved
RTP or must have successfully completed an RTP. If a candidate leaves an RTP, either temporarily
(e.g. a leave-of-absence) or permanently (e.g. dismissal or permanent withdrawal) before completing
the residency, the candidate is no longer in good standing and ineligible to take any examination until
that individual resumes an approved RTP (either the original or a new program) and the appropriate
specialty’s RTC or RTCC designates the candidate’s current status as being active (good standing). If
an actively enrolled resident’s status changes such that the resident is no longer in good standing, the
PD must notify the ACVIM of that status change within 30 days of the change in status.
Program: Good standing means that an RTP has submitted all required documents (e.g. Authorized
Agent Letter, RTP renewal paperwork, etc.) to document that the RTP has the facilities and personnel
required to provide residency training, has provided satisfactory evidence of compliance with
requirements as stated in this Manual, and has its submissions reviewed and approved by the
specialty’s RTC. If deficiencies are identified in an RTP, the RTC may place the RTP on probation.
If the deficiencies are severe and/or not corrected by the RTP within the deadlines set by the RTC,
the RTC will notify the Board and will terminate the RTP rather than either placing it on probation or
ACVIM CERTIFICATION MANUAL
Important Definitions
7
continuing probation. Each RTP will be evaluated on an annual basis to determine if it remains in
good standing.
3.Q Honorary Member
This recognition is for individuals who are retired or nearing retirement. The BOR may confer honorary
membership on persons who contributed materially to the disciplines of veterinary internal medicine.
An Honorary Member has many of the rights and privileges of an active ACVIM Member, but does not
have the following responsibilities, benefits, or privileges:
● Is not required to pay dues;
● Cannot serve as PD, RA, or SD;
● Cannot vote, hold office, or attend ACVIM business meetings;
● Cannot use this recognition, nor the ACVIM name or logo, in any way that states or implies
that honorary membership is a professional qualification, e.g., no “Jane Doe, DVM, ACVIM
(hon)”.
Diplomates desiring to submit a nominee for consideration as an Honorary Member should present
their nominee’s credentials to the president of the appropriate specialty (current presidents contact
information may be found on the ACVIM website) for further consideration by the specialty’s
nominating committee. Nominations approved by the specialty nominating committee should then be
presented to that specialty for approval. If approved by the specialty, the nominations are presented to
the BOR for final approval. Honorary Member certificates are presented at the ACVIM Forum.
3.R. Inactive Candidate
If a candidate fails to achieve Active Diplomate status within the time specified by the ACVIM Specialty
under which the candidate is registered, the candidate’s status changes from active to inactive. An
inactive candidate may not resubmit credentials or participate in additional examination attempts and
is ineligible to become board-certified.
3.S Inactive ACVIM Diplomate
One of four designations a Diplomate may have. An inactive ACVIM Diplomate is a veterinarian who
does not remain current on payment of annual dues, or who is certified on or after January 1, 2016
and fails to meet MOC program criteria. An inactive ACVIM Diplomate is subject to the following:
● May not use the name American College of Veterinary Internal Medicine;
● May not use the letters ACVIM in the individual’s title;
● May not use the ACVIM logo in association with the individual’s work or associated
institution;
● Per ABVS guidelines, inactive Diplomates that lose their status due to failure of MOC may no
longer claim to be board-certified specialists.
The inactive ACVIM Diplomate immediately loses the following benefits:
● The ability to serve as PD, RA, or SD (thus, although an inactive Diplomate may assist in
training a resident, none of that training will be counted as official time served in training; nor
may that inactive Diplomate be listed/credited in the RTP submission by a program). A
Diplomate that has become inactive due to loss of their certificate (e.g. failure to meet MOC
requirements) may not participate in any residency training activities;
ACVIM CERTIFICATION MANUAL
Important Definitions
8
● The right to vote, to hold office, to serve on committees, and to attend business meetings of
ACVIM and their respective specialty or specialties;
● The ACVIM Diplomate discount on ACVIM Forum registration and all other ACVIM discounts;
● Access to the ACVIM’s website, along with access to all ACVIM updates and other member
communications;
● The listing as an ACVIM Diplomate in the ACVIM Diplomate Directory and on
VetSpecialists.com;
● Other privileges as deemed appropriate by the BOR.
Reinstatement to Active Diplomate status is contingent upon approval by the BOR, payment of all
dues in arrears (to a maximum of three years), and payment of current dues in full. Reinstatement of
an ACVIM Diplomate Certificate after failure to meet MOC criteria is possible by meeting all of the
requirements of the specialty MOC committee, in addition to the requirements stated above.
3.T Non-Traditional Residency Training Program
A non-traditional RTP is a program that is approved by a specialty’s RTC or RTCC and which is
intentionally non-continuous.
3.U Ombudsperson
An ombudsperson is an individual appointed by a specialty president. This individual, who is available
to candidates, helps to serve as a liaison during conflicts between a candidate and either an RTP or
the ACVIM. The ombudsperson provides a neutral and confidential environment in which to voice
concerns. The ombudsperson advises and offers options toward resolution of a problem as the
ombudsperson deems appropriate. The scope of the ombudsperson’s work excludes matters relating
to examinations and/or denial of credentials, which are addressed by the Appeals Committee (see
section 4.I). The ombudsperson does not engage in any arbitration process, does not offer legal
advice, and does not impose sanctions on individuals or RTPs.
All specialties have assigned an ombudsperson: Cardiology – LAIM – Neurology – Oncology - SAIM.
In the event that an ombudsperson is personally involved in a dispute with a resident, the
ombudsperson must recuse him/herself. In such a case, the associate ombudsperson or the ACVIM
Certification Liaison will serve as ombudsperson during a dispute.
3.V Program Director (PD)
The PD is the individual at a Sponsoring Institution (SI) who assumes overall responsibility for the
conduct and integrity of that institution’s RTP. The PD for any ACVIM RTP must be an active ACVIM
Diplomate, but may not necessarily be a member of the candidate’s chosen specialty when specifically
permitted by an individual specialty, e.g. Neurology. No single individual may be a PD for two separate
specialties at the same time, e.g. the same individual cannot be the PD for both the SAIM and
Neurology RTPs at a given SI. See specialty requirements later in the Certification Manual for further
definition and specifications. Cardiology – LAIM – Neurology – Oncology - SAIM
3.W Residency Training Committee (RTC)
ACVIM CERTIFICATION MANUAL
Important Definitions
9
An RTC reviews documentation for all training programs submitted by institutions or practices and
determines their acceptability. The RTC also specifies training criteria that must be met for
certification. The specialties of Cardiology, Neurology, Oncology, and Small Animal Internal Medicine
have an RTC.
3.X Residency Training/Credentials Committee
In the Specialty of Large Animal Internal Medicine, the functions of the RTC and the CC are combined
into a single Residency Training/Credentials Committee (RTCC).
3.Y Residency Training Program (RTP)
The RTP is the educational experience that is provided to a resident at a Sponsoring Institution (SI) and one in
which a resident must fully engage. An SI provides the RTP (with possible secondary experiences, off-site
experiences, or both depending on the specialty). The PD, RA, and SDs and other specialists and individuals
are involved in the training of a resident for an ACVIM specialty.
3.Z Resident
A resident is a candidate who is enrolled in an ACVIM RTP. All residents are also ACVIM candidates;
however, candidacy continues after a residency is completed. Individuals remain candidates until they
either withdraw or are dismissed from an RTP, until they exceed the total time allowed to become
Active Diplomates, until they voluntarily terminate their candidacy, or until they become Active
Diplomates.
3.AA Resident Advisor
An RA must be an active ACVIM Diplomate in the specialty in which the resident is training, unless
specified by the relevant specialty. The RA is the primary individual who monitors the resident’s
progress during clinical training. Some ACVIM specialties allow ECVIM-CA Diplomates, ECVN
Diplomates, or both to fulfill this role. See specialty requirements later in the Certification Manual for
any further definition. Cardiology – LAIM – Neurology – Oncology - SAIM
3.BB Retired Diplomate
One of four designations a Diplomate may have. An Active Diplomate petitions the ACVIM to request
Retired status within the College. The decision to grant Retired status rests with the BOR and is based
on the Diplomate meeting the following two criteria:
● The Diplomate has been an Active Diplomate of ACVIM for 25 years or more, has reached the
age of 65, or both;
● The Diplomate has retired from employment in which the individual’s ACVIM credentials are a
requirement for employment.
Income-generating professional activities that require ACVIM credentials such as part-time consulting,
teaching, writing, or continuing education are acceptable provided the total annual income from these
activities does not exceed the exempt amount for receiving full US Social Security retirement income
for those below normal retirement age (before the individual’s full retirement age as defined by US
Social Security).
The following benefits and restrictions apply to a Retired Diplomate:
● Has annual membership dues waived;
ACVIM CERTIFICATION MANUAL
Important Definitions
10
● Pays reduced (Diplomate) registration fee for the ACVIM Forum (after age 65 the fee is
reduced further – see Forum Webpage for the current discounted rate);
● Is listed in the ACVIM Diplomate Directory (members access only) but is not listed on
VetSpecialists.com; (public website)
● May not be a voting member of committees or run for office within ACVIM may not serve as
PD, RA, or SD. (Diplomates who are planning to apply for Retired Diplomate Status should
not run for office or volunteer to be on an ACVIM Committee if their retirement would occur
during the expected term of that position. If a member retires while on a committee, they may
be permitted to complete the year of their retirement as a non-voting member and then resign
from the committee, even if their term is incomplete).
3.CC Sponsoring Institution
The SI is the primary facility, practice, or institution that hosts an RTP. It is best practice for every SI to
have human resource policies that address issues of discrimination and harassment. These policies
should provide adequate pathways for a resident to resolve concerns regarding discrimination or
harassment if problems are identified.
3.DD Supervising Diplomate (Primary Specialty)
The SD actively contributes to a resident’s clinical training and will supervise that resident’s patient
management during their assigned time together on patient care rotations. Secondary-Specialty
Supervising Diplomate (SSSDs – see 3.EE below) directly supervise a resident’s training in non-
patient care disciplines, e.g. clinical pathology and in specialty areas not in the residents designated
specialty. Both an SD and an SSSD must be a Board-Certified Diplomate. Depending on the
requirements of each individual specialty, the SD may be an ACVIM Diplomate or, or in some
specialties, Diplomates of the EBVS-recognized specialties in the RTP’s specialty. An SSSD must be
either an ACVIM Diplomate, a Diplomate of an American Veterinary Medical Association (AVMA)-
recognized specialty organization, such as the American College of Veterinary Radiology or the
American College of Veterinary Pathology, or, in some specialties, Diplomates of the EBVS-
recognized specialties from the ECVIM-CA, ECVN, ECEIM, ECBHM, and the European College of
Veterinary Diagnostic Imaging (ECVDI) may serve as SSSDs.
An SD must be in good standing within that SD’s specialty organization.
An SD evaluates the resident/candidate and provides context and perspectives for those patient/client
interactions to ensure safe, timely, and appropriate medical care. See the specialty requirements later
in the Certification Manual for further definition: Cardiology – LAIM – Neurology – Oncology – SAIM.
3.EE Secondary-Specialty Supervising Diplomate
A Secondary-Specialty Supervising Diplomate (SSSD) may be any ACVIM Diplomate in a Specialty
other than the Specialty of the RTP, or may be a Diplomate of another American Veterinary Medical
Association (AVMA)-recognized specialty organization, such as the American College of Veterinary
Radiology or the American College of Veterinary Pathology, or in some specialties, Diplomates of the
EBVS-recognized specialties from the ECVIM-CA, ECVN, ECEIM, ECBHM, and the European
College of Veterinary Diagnostic Imaging (ECVDI) may serve as SSSDs. An SSSD must be in good
standing within that SSSD’s specialty organization.
ACVIM CERTIFICATION MANUAL
Important Definitions
11
An SSSD actively contributes to a resident’s clinical training and provides feedback on a resident’s
performance to the RA. The SSSD will supervise the resident’s patient management during their time
together, evaluate the resident/candidate and provide context and perspectives for those patient/client
interactions to ensure safe, timely, and appropriate medical care. An SSSD supervises the resident’s
training in specialty areas other than those areas specific to the resident’s specialty. See the specialty
requirements later in the Certification Manual for further definition: Cardiology – LAIM – Neurology –
Oncology – SAIM.
3.FF Veterinary Specialty Organizations Committee (VSOC)
The Veterinary Specialty Organizations Committee serves in an advisory role to the American Board
of Veterinary Specialties, helps to set the standards required to become an RSVO or an RVS, and
works to advance specialization in veterinary medicine. The voting membership of the Committee
consists of one (1) representative (must be an AVMA member) appointed by each AVMA-recognized
veterinary specialty organization (RVSO). Terms are three (3) years, and can be renewed
successively, as determined by each individual RVSO. Each recognized veterinary specialty (RVS)
within those RVSOs will be permitted to have 1 non-voting member who may attend or participate in,
via electronic means, all meetings.
ACVIM CERTIFICATION MANUAL
Important Definitions/Table of Essentials
12
Table of Essentials
Diplomate
Active
Diplomate
ACVIM
Associate
Inactive
Diplomate
Disabled
Diplomate
Retired
Diplomate
Honorary
Diplomate
Requirements
Is a veterinarian
√
√
√
√
√
√
+/-
Has been approved by the BOR
and has fulfilled all credentials
requirements as described in
this manual
√
√
√
√
√
Must pay annual dues and is
current on payment of such
dues
+/-
1
√
X
2
Is in compliance with
maintenance of credentials
requirements (2016 certification
and thereafter).
+/-
1
√
√
8
Privileges
May attend the business
meetings of the ACVIM and of
the respective specialty
+/-
1
√
√
3
√
May vote in ACVIM-associated
elections
+/-
1
√
May hold college-wide office
+/-
1
√
May be a voting member of
ACVIM committee
+/-
1
√
May be a Program Director,
Resident Advisor, or Supervising
Diplomate
+/-
1
√
7
√
4
Has a reduced (Diplomate) rate
when registering for the ACVIM
Forum
+/-
1
√
√
√
5
Is listed as an ACVIM Diplomate
Directory and on
VetSpecialists.com
+/-
1
√
√
May use the name American
College of Veterinary Internal
Medicine, the letters ACVIM,
and the ACVIM log in his/her
title and in association with
his/her work
√
√
√
√
√
6
Legend: √, applies to the category; +/- may or may not apply to the category; X does not apply to the
category
1
Only applies if the Diplomate has Active Diplomate Status
2
Retired Diplomates no longer need to pay annual dues when retired, but need to have been current with
dues payments up to the time of retirement
3
May attend Specialty business meetings, when permitted by the specialty, but may not vote in those
meetings
ACVIM CERTIFICATION MANUAL
Important Definitions/Table of Essentials
13
4
In certain Specialties, check the Specialty section of the CM to be certain
5
Rate is reduced below diplomate rate after age 65
6
Restrictions apply regarding scope of work consistent with Retired Diplomate Status (see ACVIM website for
details)
7
Each Specialty may have specific requirements for years of experience for eligibility to serve in each role.
8
Where applicable for their RVSO
ACVIM CERTIFICATION MANUAL
Requirements for All Specialties
14
PART ONE: APPLIES TO ALL SPECIALTIES
4 Requirements for All Specialties
The Certification Manual informs residents, candidates, SDs, SSSDs, RAs, and PDs of the ACVIM’s
residency training requirements and of the certification steps for each ACVIM specialty. Information
regarding dates of deadlines, examination content, registration procedures, fees, current forms, etc. is
maintained on the ACVIM website rather than in the Certification Manual. Candidates should regularly
check candidate webpages for any updates and/or changes in deadlines, requirements, or other matters
that may affect their completion of their credentialing process. The ACVIM office does not send out
notices to candidates or mentors regarding deadlines, as that information is maintained and kept current
on the ACVIM’s website.
An ACVIM Diplomate is a highly educated veterinary professional who has completed rigorous
residency training and is certified by the ACVIM as a specialist. Residency training is an indispensable
component of the transformation of a veterinarian into a specialist. Residency training is physically,
emotionally, and intellectually demanding, and requires focused and committed effort on the resident’s
part to master their chosen discipline. The education of veterinary specialists is largely experiential and
necessarily occurs within the context of an SI, with mentorship provided by the RA, SDs, and other
specialists. Developing the skills, knowledge, and attitudes leading to proficiency at the level of specialty
care requires the resident to assume personal responsibility for the care of individual patients/clients
and to routinely seek guidance from the RA, the SDs, and any consulting specialists.
4.A Achieving Board Certification (Diplomate Status)
The process for board certification to become a Diplomate of ACVIM involves the following steps.
An individual must:
● Be a graduate of a college or school of veterinary medicine that is accredited by the AVMA,
or be legally qualified to practice veterinary medicine;
● Demonstrate professional behavior;
● Satisfactorily complete a one-year rotating internship in medicine and surgery, or an
equivalent broad-based clinical experience;
● Satisfactorily complete an ACVIM registered RTP in the specialty for which the candidate
seeks certification;
● Pass the ACVIM General Examination;
● Fulfill all credentialing requirements of the specialty for which the candidate seeks
certification;
● Pass the ACVIM Specialty Examination in the specialty for which the candidate seeks
certification.
4.B Summary of Procedures for all Specialties at a Glance
Registration of a resident as a candidate with ACVIM is submitted online to the ACVIM Office:
When: Within ninety (90) days of beginning the RTP
What: Online registration form and registration fee
Reviewed by: ACVIM Office
Response time: Eight (8) weeks
ACVIM CERTIFICATION MANUAL
Requirements for All Specialties
15
Application to take the ACVIM General Examination is submitted online to the ACVIM Office:
When: All components due by the date specified on the ACVIM website. The deadline date
will be in the year preceding the examination.
What: Online registration form, RA progress letter, two multiple-choice questions, progress
record reflecting activities to that point, and examination fee payment.
Reviewed by: ACVIM Office
Response time: Thirty (30) days
Credentials for all specialties for the Specialty Examination are submitted online to the ACVIM
Office:
When: All components due by the date specified on the ACVIM website. The deadline date
will be in the year preceding the examination.
What: All components of the credentials packet and credentials fee
Reviewed by: Specialty CC or RTCC
Response time: Sixty (60) days
Registration and Fee for the Specialty Examination for all specialties are submitted online to the
ACVIM Office:
When: By the date specified on the ACVIM website. For most examinations, the date will
be the year of the examination. For the LAIM Specialty Examination, the date will
typically be the year before the examination.
What: Examination fee and previously approved credentials
Reviewed by: ACVIM Office
Response Time: Thirty (30) days
Appeals for rejection of credentials and/or examination failure are submitted online to the ACVIM
Office:
When: Within thirty (30) days of results notification to the candidate
What: Brief letter summarizing the basis for the appeal
Reviewed by: ACVIM Appeals Committee
Response by: ACVIM Certification Liaison
Response time: Within thirty (30) days of receipt of appeal
4.C Special or Additional Procedures for Each Specialty
4.C.1 Cardiology
Resident Logs are submitted online to the ACVIM Office:
When: By the date specified on the ACVIM website. Updated logs are due each year
following the start of the residency through the end of the residency.
What: Echocardiography Log, Procedures Log, and Structured Educational Experience
Log
Reviewed by: Cardiology Residency Training Committee (CRTC)
Response Time: Eight (8) weeks
ACVIM CERTIFICATION MANUAL
Requirements for All Specialties
16
4.C.2 LAIM
● Clinical Writing Assessments (CWA) may be submitted on a rolling submission basis.
Check the ACVIM website for specific details. See 6.I.6 for more details regarding the
CWA.
● Publication guidelines are on the ACVIM website. Proof of publication may be submitted at
any time.
4.C.3 Oncology
● Publication guidelines are on the ACVIM website. Proof of publication may be submitted at
any time.
4.C.4 SAIM
● Unannounced audits of a resident’s Journal Club log are possible.
● Publication guidelines are on the ACVIM website. Proof of publication may be submitted at
any time.
4.D Duration of RTP Training
Most RTPs are a minimum of three (3) years of continuous training; however, the specialties of
LAIM and Neurology allow approval of residencies that can be completed in two (2) years of
continuous training. All specialties allow non-traditional (intentionally non-continuous) RTPs that
may be a maximum of 5 years in duration. All specialties stipulate that in a non-traditional
residency, all of the requirements of a traditional residency must be met in full and that all training
must take place within clearly defined, continuous blocks of training time. Cardiology – LAIM –
Neurology – Oncology - SAIM
4.E Time Allowed Between Successful Completion of RTP to Achieving Diplomate Status
In all cases, the maximum time allowed for completion of the board certification process is 5 years
after the successful completion date of the RTP (the date on the candidate’s Residency
Certificate). For those programs that do not provide Residency Certificates, they must provide the
candidate and the ACVIM a letter stating that the candidate has successfully completed their
residency and the date of that completion.
4.F The Certification Process
4.F.1 Registration of the Resident
A resident must register as a candidate with ACVIM using the online registration form and
must also pay a one-time registration fee within 90 days of beginning the RTP (e.g., by
October 12 for programs that began on July 15). Registration information is posted on the
ACVIM website. Registration is necessary to ensure that a resident embarks on a training
program that conforms to the requirements of the specialty in which the individual wishes to
become certified. Responsibility for registering is solely incumbent on the resident, with
supportive information provided by the SI.
NOTE. Failure of a candidate to register, or registering after the 90-day deadline, may
jeopardize the resident's certification process. Time served in the RTP before the candidate’s
registration may not be recognized or accepted. Time served in a program before the
ACVIM CERTIFICATION MANUAL
Requirements for All Specialties
17
program’s registration (see section 4.F.2 below) will not count towards completion of the
candidate’s RTP.
The ACVIM office and the relevant RTC or RTCC evaluate the candidate’s application. The
candidate receives notification of status within eight (8) weeks of registration. When approved,
the candidate receives a unique identifying number that the individual uses throughout the
candidate’s certification process to access information, including examination results.
The Certification Manual’s rules and regulations regarding residency training requirements
that are in effect at the time the candidate registers apply for the duration of the candidate’s
certification process, unless an exception applies (see section 3F). If a candidate registers for
certification in an additional specialty, the rules in effect for that specialty’s residency training
requirements apply for the duration of the candidate’s certification process for that specialty.
Policies and procedures that do not affect training requirements, e.g. registration deadlines,
fees, submission forms, etc. may become effective for ALL candidates at the time the change
is made and published on the ACVIM website.
The candidate must complete the registration process as a candidate before the certification
process can begin. This is different from the RTP registration process, which is the registration
and approval of the training program. Only the PD may complete and submit the paperwork
for approval of an RTP. Before starting an RTP, the resident should verify with their RA that
the PD registered the program and that the ACVIM and the appropriate specialty RTC/RTCC
approved that RTP. If the RTP has not been approved at the time the candidate attempts to
register, the candidate’s registration will either be delayed or denied pending submission of
paperwork by the RTP’s PD.
If a candidate wishes to change training emphasis and become certified in a specialty other
than the one for which the individual registered, the candidate must be accepted into a new
training program. The candidate then notifies the ACVIM office to register in the new specialty.
The appropriate RTC/RTCC rules on the acceptability of the candidate's credentials, including
the relevance of any training that the candidate already completed.
If a candidate wishes to become certified in more than one specialty, the candidate must
indicate that multiple registration forms are being submitted and must satisfy the requirements
of each specialty. Each training program component is counted toward the requirements of
one specialty only. ACVIM requires a separate registration fee for each specialty.
If a candidate wishes to change training programs but wishes to continue in the same
specialty, the candidate must be accepted into a new training program. In this case, the new
training program must apply for approval as a non-traditional training program for that specific
candidate, even if that SI already has an approved RTP in that specialty. This is because the
candidate will be participating in a unique experience in that SI, rather than the previously
approved RTP. Both the appropriate RTC/RTCC and CC will rule on the acceptability of the
candidate's credentials to that point, including the relevance of any training that the candidate
already completed, as well as approving the newly created non-traditional program for that
specific candidate.
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4.F.2 Registration of the Residency Training Program
The ACVIM office maintains a registry of ACVIM-approved RTPs. Each year, a specialty’s
RTC or RTCC reviews its associated RTPs to ensure that the programs remain in good
standing (see 3.O).
Registration materials for programs are specialty-specific and details regarding required
information/online forms can be found on the ACVIM website. Program Directors for all
existing RTPs must submit current year renewal information each year no later than the date
specified on the ACVIM website. Program Directors must always submit registration
information for existing and new programs at least 90 days before the scheduled residency
start dates. Each calendar year, (current year) online forms are updated and made available
to all PDs no later than the date specified on the ACVIM website. Program Directors submit
completed online forms via the ACVIM website. The ACVIM office forwards the submitted
information to the appropriate specialty RTC/RTCC for review and approval or denial. The
RTC/RTCC responds within 45 days of the submission deadline or date of submission for new
programs. If that review results in a program being placed on probation, the program will have
30 days to respond to the specialty RTC/RTCC with a remediation plan for correcting the
deficiencies identified on review. Failure to provide such a plan is grounds for termination of
an RTP. If there are severe deficiencies in an RTP which would result in a program being
unable to provide the required training, an RTC may terminate a program immediately, without
a probationary period.
Each RTP must register with the ACVIM before any resident begins that training program.
Program registration is different from Candidate registration, which is covered in section 4.F.1,
above. If a candidate starts an RTP before the program is registered, the time spent in the
RTP before that RTP is registered does not count towards completion of credentialing
requirements. Neither the candidate nor the PD may accelerate the completion date of a
program once that program has been approved by the RTC/RTCC.
The requirements specified in the RTP description become the official requirements for
completion, even if those requirements exceed the minimum requirements stipulated in this
Certification Manual. Neither a candidate nor a PD may retroactively petition for successful
completion of a residency, even if the resident has met the minimum requirements of this
Certification Manual, if the candidate left the program before completing all requirements of
the program as previously approved.
If the candidate completes any clinical portion of the RTP at a location separate from the
primary residency site, the candidate must obtain the written approval of the SD for each
secondary and off-site rotation.
Documentation of this approval must be forwarded to and approved by the specialty
RTC/RTCC before the start of experience at each separate location.
All programs must be completed within the timelines specified in 4.D and 4.E above.
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4.F.3 Roles and Responsibilities
4.F.3.a. Responsibilities of the Sponsoring Institution
The SI and the PD must ensure the availability of all necessary professional, technical, and
clerical personnel to best support the RTP. These resources include, but are not limited to the
following:
● All ACVIM RTPs offered by the SI must be registered and approved by ACVIM;
● Residents must have ready access to specialty-specific and other appropriate
reference material in print or electronic format;
● Electronic medical literature databases with search capabilities should be available.
This must include access, either direct or remotely, to a veterinary or human medical
library containing the textbooks and current journals the RTC/RTCC specifies;
● The SI must provide access to all required textbooks either as hard copies or as
digital copies;
● The SI must ensure access to clinical pathology services that include hematologic,
clinical chemistry, microbiologic, and cytologic diagnostic abilities. All clinical
pathology reports must be archived and retrievable;
● The SI must ensure access to anatomic pathology services;
● All anatomic pathology reports must be archived and retrievable;
● A medical records system must be in place that allows the resident to maintain a
medical record for each patient under the resident’s care;
● The medical records must be retrievable within a searchable database;
● All necessary equipment for specialty-appropriate comprehensive imaging studies
must be available (this includes access to standard radiographic equipment,
ultrasonography, computed tomography, and magnetic resonance imaging as
appropriate for the specialty);
● When required by a specialty, an intensive care facility must be present on the
premises with qualified staffing that provides 24-hour care;
● An intensive care facility is a designated area of a hospital facility that is dedicated to
the care of patients who are seriously ill or in need of continuous monitoring. The
intensive care facility must be staffed by qualified veterinary technicians with direct
oversight by a licensed veterinarian;
● There must be regularly-scheduled and performed didactic teaching sessions,
Journal Clubs, and scientific seminars. The RA or PD must be able to provide
documentation of these teaching events upon request of the RTC and/or CC;
● The PD and the RA must complete and approve semiannual written reviews of a
resident’s progress. Evaluated competencies should include clinical and technical
skills and knowledge base. The resident must sign- off on these evaluations as
documentation that the resident received the review. The resident must be provided
a copy of the review for their records.
4.F.3.b Responsibilities of the Program Director
The PDs responsibilities are as follows:
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● Each year, the PD certifies to the appropriate RTC or RTCC and to the ACVIM, in
writing, that the PD has read the ACVIM Certification Manual and understands the
PDs role in residency training;
● The PD ensures that all reports from the SI to the ACVIM are accurate, timely, and
complete;
● The PD ensures substantive changes within the RTP affecting compliance with a
specialty’s or ACVIM’s requirements are reported to the ACVIM and the chair of the
appropriate specialty RTC/RTCC within fourteen (14) days of the implementation.
This includes, but is not limited to, ensuring that the minimum number of SDs defined
by each specialty is present within the RTP structure;
● Each year, the PD updates and re-registers each RTP with the ACVIM by the date
specified on the ACVIM website to ensure that the RTP is in good standing and
remains approved to train residents;
● The PD is responsible for notifying the ACVIM of any change in a resident’s status
within fourteen (14) days of such a status change. If the resident is placed on
probation, the required information must include the reason for probation and the
date of the next scheduled resident review. If the resident is dismissed the
information provided must include the effective date of dismissal. If a resident on
probation is reinstated to good standing, the PD will also notify the ACVIM of that
change in status within fourteen (14) days;
● Failure to submit the appropriate information by deadlines published in this
Certification Manual may result in an RTP being placed on probation. If the PD
(whether the RTP is in good standing or on probation) does not respond to an
RTC’s/RTCC’s request for documentation regarding the RTP within 30 days of the
request, that RTP may be placed on probation, the current probation may be
extended, or may be terminated. If an RTP is placed on probation or is terminated,
the ACVIM notifies the PD and all residents currently in the RTP of the action against
the RTP. If an RTP is terminated, it may not be renewed. A previously terminated
RTP may reapply as a new RTP; however, any time served by a resident after the
RTP’s termination does not count towards completion of that individual’s residency.
Therefore, if an RTP is placed on probation prior to a new resident’s start date (prior
to the resident registering as a candidate), the RTP is responsible for notifying the
resident of the change in the RTP’s status prior to the resident beginning the
residency;
● Before each new resident starts the RTP, the PD must inform the resident of the
resident’s obligation to read Part 1 (section 4) of this Certification Manual, which
applies to all specialties, and the section in Part 2 of this Certification Manual that
applies to the specialty in which the resident is to be registered;
● The PD ensures that the RTP maintains the correct ratio of Diplomates to residents
as specified by a specialty;
● The PD monitors resident supervision provided by others to ensure adequacy;
● The PD monitors and ensures the quality of training activities that do not involve
direct patient care such as Journal Club, didactic education, and research
requirements of the specialty;
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● The PD provides verification to the CC/RTCC that a candidate has completed all
residency training requirements.
4.F.3.c Responsibilities of the Resident Advisor
The RA responsibilities are as follows:
● Each year, the RA certifies to the appropriate RTC/ RTCC and the ACVIM, in writing,
that the RA has read the ACVIM Certification Manual and understands the RAs role
in residency training;
● The RA signs all documentation verifying completion of a resident’s program and
provides this documentation to the PD;
● The RA contributes to a fair, respectful, and courteous atmosphere within the RTP;
● The RA is available for career counseling and clinical mentoring of the resident;
● The RA provides meaningful and direct assessments of strengths and weaknesses
to the resident, in writing, at least semi-annually (Clinical Milestones: Cardiology –
LAIM – Neurology – Oncology – SAIM). The resident is to sign the SIs copy of the
evaluation to document that the resident has received the assessment;
● The RA supports and encourages the resident to participate in scholarly activities
and guides the resident and ensures that case reports, publications, and research
projects as required by the specialty are completed;
● The RA ensures that the successful resident gains competency and can perform all
diagnostic and therapeutic procedures essential to the specialty;
● The RA supports and attends resident Journal Club on a regular basis.
4.F.3.d Responsibilities of an ACVIM Supervising Diplomate
SDs responsibilities include the following:
● An SD in the primary specialty ensures that the resident provides appropriate and
compassionate clinical patient care;
● An SD in the primary specialty ensures that the resident gains a growing knowledge
of established and evolving medical literature that is essential to the specialty;
● An SD in the primary specialty participates in clinical rounds or discussion of topical
issues germane to the resident’s specialty;
● An SD in the primary specialty supports and attends resident Journal Club meetings;
● An SD, in supporting disciplines that are required by a specialty, provides
appropriate mentoring in that supporting discipline as required by a specialty.
● An SD contributes to a fair, respectful, and courteous atmosphere within the RTP
4.F.3.e Responsibilities of Residents
During the certification process, residents are required to:
● Register with the ACVIM within 90 days of starting their RTP to become candidates;
● Conduct themselves in a professional and ethical manner.
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● Residents that fail to maintain ethical standards of conduct will be subject to
disciplinary actions as described in section 4.G.1 below and may also be found in
the “Academic Misconduct Statement” which is located on the candidate webpages
of the ACVIM’s website;
● Provide competent and compassionate medical care;
● Communicate effectively and honestly with the owners of their patients, with all
members of the supporting medical staff, and with referring veterinarians;
● Maintain timely and accurate medical records;
● Be responsive to patient needs;
● Respect the privacy interests of the owners of their patients;
● Progress satisfactorily in their training as defined by their individual programs;
● Comply with the clinic schedule provided them by their RA, including emergency
duties, research time off, etc.;
● Participate in scholarly activities such as seminars, didactic education, and Journal
Club.
4.F.4 Supervision of the Resident
The SI must ensure that each RTP provides an appropriate level of supervision for all
residents/candidates based on specialty requirements. Supervision may be direct, indirect, or
remote.
Direct supervision is defined as having the SD and candidate on clinical duty together with
hands-on management of cases interactively and concurrently. The SD is expected to be
available for face-to-face consultation with the resident throughout the day. See specialty
requirements later in this Certification Manual for any further definition: Cardiology – LAIM –
Neurology – Oncology – SAIM
Indirect supervision refers to the SD being immediately available (telephone, text, email, etc.)
for consultation and direct supervision when needed by the candidate. Remote supervision is
the use of technology such as video conferencing (e.g. Zoom or MS Teams) to permit
modified Direct Supervision. This was put in place as a variance for Covid-19 restrictions and
is being continued as it has proved to be a viable method for resident supervision. Such
availability may be further defined by each specialty: Cardiology – LAIM – Neurology –
Oncology – SAIM
4.F.5 Clinical Milestones
Clinical milestones are not requirements of ACVIM, rather they are recommendations of a
specialty (Cardiology – LAIM – Neurology – Oncology – SAIM), which provide guidelines
for both candidates and mentors. An RTP, RA, and a resident should use these clinical
milestones as guides to gauge clinical competencies and resident progress through the arc of
the training program. The RTP can use each specialty’s clinical milestones to identify a
resident’s strengths and weaknesses, and areas where the resident can improve.
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The RTP can also use them to decide whether to give a resident earlier leadership
opportunities or privileges, whether it is appropriate to provide remediation to the resident, or
whether it is necessary to dismiss the resident.
4.F.6 Training Site Locations
Training experiences may take place onsite, at a secondary site, or at an offsite location with
limits dictated by some specialties. Supervision at any of these locations may be direct or
indirect based on the requirements of each specialty.
4.F.6.a Onsite Training
Onsite training occurs at the SI. It can include a primary site (the site where the resident
spends the greatest portion of training time), secondary site, or remotely when necessary.
During remote training, the resident is at an authorized (Primary or Secondary) location and
the mentor is monitoring their progress from a remote location. In these cases, there is still
direct supervision by an approved diplomate, however, a specialty may permit that diplomate
to be board certified in a different specialty and, in some cases, by a different RVSO, e.g.
ACVECC.
For experiences that require direct supervision, the SD and the resident must work at the
same physical location (e.g. practice, teaching hospital, research laboratory) during the time of
supervision. As explained above, for remote training there must still be an onsite and
approved diplomate in the same physical location as the resident. Onsite experiences may fall
in either direct, indirect, or remote supervision categories.
4.F.6.b Secondary and Offsite Training
A secondary training site is a satellite clinic or educational facility at a separate location that is
directly associated with the primary hospital or SI, or an independent facility for which a
current and continuous relationship exists with the RTP. Offsite training occurs at a facility that
is independent from the SI. Approval of training at secondary and offsite training locations
must be approved by the appropriate specialty’s RTC prior to training taking place.
4.F.7 Research Requirements
Scientific discovery is a critical mission of ACVIM Diplomates. In recognition of this, all RTPs
must include an assessable period of instruction or participation in creative scholarship that
fosters appreciation of, competency in, and contribution to the knowledge base of the
candidate’s respective specialty. This creative scholarship also supports development of
candidates as clinician scientists. Research is an essential credentialing requirement that the
candidate must complete before board certification is granted. See individual specialties for
elaboration on this requirement: Cardiology – LAIM – Neurology – Oncology – SAIM
4.F.8 RTP Probation
The RTC/RTCC of a specialty may place an RTP on probation. The RTP may continue to train
residents during probation; however, it is subject to additional scrutiny by the specialty
RTC/RTCC. While on probation, an RTP may not accept new residents into the RTP (unless
the RTP can document that the resident was offered and had accepted the residency prior to
the RTP having been placed on probation).
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If an RTP is placed on probation after a resident has been offered and accepted a position,
but prior to the resident’s start date, the RTP must notify the resident of the change in the
RTP’s status prior to the resident’s start date. In such a case, the ACVIM will still allow the
candidate to register, in the expectation that the RTP will mitigate the deficiencies and return
to good standing.
However, acceptance of candidate registration in this circumstance is neither an assurance
that the RTP will return to good standing nor an assurance that the time in training will count
towards the residency requirements. Thus, it is imperative that the candidate be fully informed
by the RTP of the RTP’s communications with the RTC.
If, within the time specified by the specialty RTC/RTCC, the RTP does not mitigate the
reasons for imposing probationary status on a training program, ACVIM will terminate the
program. Triggers that may result in probationary status include but are not limited to:
Failure of an RTP to comply with all requirements by ACVIM and the individual specialties for resident
training.
Failure to submit the appropriate information by the deadlines published on the ACVIM website (on the
candidate’s webpage) or within the deadlines set by the RTC/RTCC if additional information is
requested.
Failure of the PD to fill out all forms, accurately and completely, and submit them to the ACVIM office
as required.
Failure to have an acceptable pass rate, as defined by each specialty, of residents taking the ACVIM
General Examination, the Specialty Examination, or both over an extended period of time.
Failure to notify the ACVIM, the specialty RTC/RTCC, or both within fourteen (14) days of substantive
changes to an RTP that could lead to noncompliance with the requirements of the specialty or ACVIM.
Placing a resident on probation or terminating a resident will count as such a substantive change.
4.F.9 RTP Termination
The Board of Regents (BOR) may terminate any RTP after a recommendation by a specialty
RTC/RTCC. Upon termination, an RTP is immediately ineligible to train residents or
candidates. Termination normally, but not always, follows a probationary period during which
the RTP failed to satisfactorily resolve deficiencies that triggered probation. Immediate
termination of the RTP by the ACVIM, without prior consideration or probation, may result
when the PD, RA, or any supervising individual dishonestly or inaccurately reports the RTP’s
training resources/capabilities, or if it is learned that an RTP fails to meet any of the
requirements of a specialty.
If at a later date, the terminated RTP wishes to be reinstated, the RTP may submit an RTP
application to be approved as a new RTP. The new RTP submission must provide clear
documentation of what steps it implemented to correct the prior issues and how it plans to
keep the corrections ongoing. The ACVIM archives all relevant documents and notes of the
RTC/RTCC pertaining to termination of an RTP. The documents are available to future
RTCs/RTCCs upon request.
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4.F.10 Journal Club
An organized, routinely scheduled, and documented Journal Club of at least 80 total contact
hours over the course of the residency must be an integral part of all RTPs; teleconferencing
and programs having a joint Journal Club is acceptable when necessary. Documentation will
include dates of meetings, names of participants, and articles reviewed at each meeting. The
RTC or RTCC may request the documentation from the program if there are questions during
a program’s review. Residents and at least one board-certified individual from any ACVIM
specialty or from other specialties recognized by the American Board of Veterinary Specialties
(ABVS) and/or the European Board of Veterinary Specialization (EBVS) as permitted by a
specialty in this Certification Manual must attend Journal Club. Through the Journal Club, a
resident sharpens critical thinking skills and increases understanding of statistical analysis of
scientific data and clinical material: Cardiology – LAIM – Neurology – Oncology – SAIM
4.F.11 Training Weeks
For all ACVIM specialties, with some specific exceptions as defined by individual specialties,
one week’s experience is defined as a minimum of 40 hours over a contiguous seven-day
period. Normally a resident may not claim more than one week of training in any seven-day
calendar week. However, half week divisions and two half weeks in the same calendar week
are acceptable when necessary. See specialty requirements later in this Certification Manual
for further definition of the 40-hour week and an explanation of any exceptions to the
contiguous day requirement: Cardiology – LAIM – Neurology – Oncology – SAIM
4.F.12 Training Hours
In certain specialties, training experience for certain defined activities may be defined as
Training Hours rather than a Training Week. A Training Hour is defined as one continuous
hour of direct or remote (e.g. video conference) contact time with a supervising specialist in
the specified training activity, e.g. clinical pathology. See specialty requirements later in this
Certification Manual for further definitions of the application of Training Hours.
4.G General and Specialty Examinations
4.G.1 Examination and Credentials Expectations
All submitted credentials must accurately represent the candidate’s own work. Additionally,
candidates take all examinations on the honor system. Please refer to the Academic
Misconduct Statement on the Candidate pages of the ACVIM website. Therefore, the following
infractions by a candidate may result in disciplinary action:
● Misrepresenting any portion of their credentials;
● Receiving outside assistance on an examination (including advance notice of
questions on the examination);
● Cheating on an examination;
● Misrepresenting work on an examination;
● Violating the confidentiality of an examination;
● Having behaved unethically in any other way during the credentialing or
examination process
.
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The following disciplinary action may be taken regarding the candidate:
● Rejecting credentials;
● Receiving a failing grade on the examination in question;
● Forfeiting fees;
● Being subject to any other disciplinary action deemed appropriate by the BOR.
The disciplinary actions may include denial of permission to retake the examination in future
years, loss of the ability to attain ACVIM certification, or both.
4.G.2 Special Accommodations
The ACVIM complies with the Americans with Disabilities Act of 1990, as amended by the
Americans with Disabilities Act Amendment Act of 2008 (the “ADA”). Any candidate’s
disability/impairment which may require special accommodation(s) in order to take an
examination must complete the application form found on the ACVIM website and return it
with the examination registration form by the registration deadline.
The ACVIM cannot guarantee the availability of accommodation onsite if a candidate who
requires special accommodation does not request accommodation by the registration
deadline. If a disability/impairment is identified after the registration deadline, the candidate
must notify the ACVIM within 30 days of the diagnosis/recognition of the disability/impairment.
Accommodation cannot be granted retroactively. Therefore, if a candidate informs the ACVIM
of impairment or disability after an examination has been completed, no changes can be
made in that candidate’s examination results or how that candidate’s examination is graded in
comparison to other candidates.
4.G.3 Scheduling the Examinations
A candidate may elect to take the General and Specialty Examinations in the same year, or
may take the General and Specialty Examinations in separate years provided the following
criteria are met: A candidate must be in good standing to take either the General or the
Specialty Examination. See section 3.P.
If a candidate leaves a program, either temporarily (e.g. a leave-of-absence) or permanently
(e.g. dismissal) before completing the residency, the candidate is ineligible to take any
examination until that individual resumes the training program and the appropriate specialty’s
RTC or RTCC approves the candidate’s current status as being active.
Dates for each examination, registration deadlines, and steps required to submit credentials
are maintained in the Candidates’ Webpages on the ACVIM website.
● A candidate may take their ACVIM General Examination for the first time provided
that they will have completed at least eighteen (18) months of an approved RTP
before the examination date and have met all other requirements specified by their
specialty.
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● A candidate wishing to take the Specialty Examination must satisfy the specialty’s
examination prerequisites first: Cardiology – LAIM – Neurology – Oncology – SAIM
● A candidate may elect to take the General and Specialty examinations at the same
time. In order to do so, the candidate generally must have completed at least twenty
seven (27) months of an approved RTP before the examination date. Specialty
requirements on credentialing vary but eligibility to take the ACVIM General
Examination is the same for all specialties: Cardiology – LAIM – Neurology –
Oncology – SAIM
4.G.4 Fees
Fees are associated with candidate registration, the ACVIM General Examination, specialty
credentials submission, and Specialty Examinations (Cardiology – LAIM – Neurology –
Oncology – SAIM). Candidates whose credentials were not previously approved and who are
resubmitting credentials do not pay an additional credentials fee. Candidates whose
credentials have been approved, but who are repeating all or a portion of an examination,
whether the General Examination or a Specialty Examination, must pay a retake examination
fee.
The BOR determines the fee amounts annually. Fees must be paid online or by other means
set forth by ACVIM. The ACVIM website contains details regarding payment of the various
fees, including deadlines, under individual sections dealing with each specific portion of the
certification process: Cardiology – LAIM – Neurology – Oncology – SAIM
4.G.5 The ACVIM General Examination
An ACVIM committee appointed by the BOR develops the ACVIM General Examination
content. Appointed members of the ACVIM General Examination Review/Examination
Committee come from all specialties within the ACVIM. In addition, under the guidance of a
psychometrician, all new examination content is reviewed for clarity and appropriateness in
reflecting the knowledge a candidate should have and rated for suitability before inclusion as
an item in the examination bank.
The ACVIM General Examination questions are in a multiple choice format. The examination
consists of two parts: a general section for all candidates, and a large animal section or small
animal section that candidates select according to their RTP, e.g. SAIM candidates will select
Small Animal, LAIM candidates will select Large Animal. Cardiology, Neurology, and
Oncology candidates may choose either the Small or Large Animal section. The ACVIM
General Examination covers all aspects of veterinary internal medicine and must be taken and
passed by all candidates seeking certification by any specialty within the ACVIM. A candidate
who fails the ACVIM General Examination may retake the examination where and when it is
next offered.
Each part of the ACVIM General Examination is considered separately, so a candidate that
passes one part but not the second is only required to retake the part that was failed.
To take the ACVIM General Examination, candidates must have completed at least 18 months
of an ACVIM RTP by the time the ACVIM General Examination is taken.
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Detailed information regarding requirements to take the General Examination, criteria for
developing and submitting the required original multiple choice examination questions, and
the steps needed to apply for the examination may be found on the Candidate’s Information
section of the ACVIM website.
Candidates can use these links for additional information regarding the ACVIM General
Examination: Cardiology – LAIM – Neurology – Oncology – SAIM
4.G.6 Specialty Credentials
Candidates must submit documentation of their credentials to ACVIM before they are eligible
to take their respective Specialty Examination. The specialty CC or RTCC of the relevant
specialty reviews, and accepts or rejects, the candidate’s documentation.
Each specialty has established credentials requirements, some or all of which must be
satisfied before the candidate may take the Specialty Examination: Cardiology – LAIM –
Neurology – Oncology – SAIM. There is a Specialty Examination Review/Examination
Committee for each specialty which develops, administers, and grades its respective Specialty
Examination. Each specialty’s examination content (both new and current) is also reviewed
under the guidance of a psychometrician to be certain that the questions are appropriate for
inclusion on that specialty’s examination.
The candidate accesses application/credentials requirements from the ACVIM website:
(Cardiology – LAIM – Neurology – Oncology – SAIM) It is the candidate’s responsibility to
review and comply with these requirements.
Deadline dates for credentials documents and the credentials fee vary between the
Specialties. Appropriate dates may be found at the ACVIM website and within the application
materials submitted online. (Cardiology – LAIM – Neurology – Oncology – SAIM)
4.G.7 Specialty Examinations
A candidate intending to take a Specialty Examination must submit their credentials by the
credentials submission deadline established by each specialty. Each candidate receives
notification no later than 60 days after the submission deadline as to the acceptability of the
submitted credentials and their eligibility to register and take their Specialty Examination.
(Cardiology – LAIM – Neurology – Oncology – SAIM) Candidates retaking a Specialty
Examination are not required to resubmit credentials, but are charged a fee for each
reexamination.
THERE ARE NO EXCEPTIONS TO THE DEADLINE – CREDENTIALS PACKETS MUST BE
SUBMITTED BY THE DUE DATE TO ALLOW ADEQUATE TIME FOR REVIEW BY THE
RTCC OR CC.
Failure to register by the appropriate deadline makes the candidate ineligible to take the
Specialty Examination at its next offering. A candidate not on the list of registered candidates
is not admitted to the examination.
Specific and current information about the composition and grading of each specialty’s
examination may be found on the candidates’ pages of the ACVIM website.
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4.G.8 Notification of Examination Results
Candidates in all specialties of the ACVIM are identified only by the unique identification
numbers assigned to them by the ACVIM office at the time they register. The BOR approves
individual candidate scores displayed only by their unique identification numbers. The
notification process is the same for the ACVIM General Examination and all of the Specialty
Examinations. The ACVIM General Examination Committee Chair and the respective
Specialty Examination Committee Chairs notify Specialty Presidents of examination results for
each specialty. Results are subsequently presented by the Examination Committee Chairs to
the BOR for approval. Examination results are provided in letters that are uploaded to the
candidates’ website. Once the BOR has approved the results, a message is posted on the
ACVIM website providing instructions to candidates on how they may obtain their individual
results. Candidates receive this written notification of their examination results within 45 days
from the date of the examination.
4.G.9 Procedure for Reapplication Following Examination Failure
In order for a candidate to retake any previously failed examination (whether the ACVIM
General Examination, the Specialty Examination, or both), the candidate must register online
and pay the appropriate fees at the dates specified on the ACVIM website. (Cardiology –
LAIM – Neurology – Oncology – SAIM)
4.H Policy on Post-RTP Terminology and Specialty Title Usage
A candidate who has not completed the credentialing process and who is not an Active ACVIM
Diplomate cannot use partial completion of the credentialing process as a qualification for self-
promotion nor can they use the name ACVIM, the letters ACVIM, the ACVIM logo, or any other
implication of achievement of some degree of specialization. Such usage is unethical and
forbidden.
The ACVIM’s Code of Conduct, the AVMA’s Principles of Veterinary Ethics and the American
Board of Veterinary Specialties’ Policy Manual are quite clear that “it is unethical for veterinarians
to identify themselves as members of an AVMA- recognized specialty organization if such
certification has not been awarded. Only those who are board-certified may claim that status. Only
those veterinarians who have been certified by an AVMA-recognized specialty organization should
refer to themselves as specialists.”
In the opinion of the ACVIM and the ABVS both the terms “board eligible” and “board qualified” are
old and inappropriate terms regarding the certification process that are misleading and neither
should be used by any veterinarian. One is either board-certified, having met all of the criteria of a
particular specialty college or board, or one has no board credentials. Candidates that have
successfully completed a residency training program and have received a residency certificate may
identify themselves in one of two ways.
They may identify themselves as “Practice Limited to” the specialty in which they were trained, e.g.
Practice Limited to Oncology. They may also identify themselves as “Residency Trained in” the
specialty in which they were trained, e.g. Residency Trained in Cardiology.
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Requirements for All Specialties
30
4.I Appeals
The Chair of the BOR appoints one ACVIM Diplomate from each specialty to serve as a voting
member on the Appeals Committee. The ACVIM Certification Liaison serves as ex-officio member
of this committee. When a candidate or a PD files an appeal, the Certification Liaison organizes a
telephone conference call for the committee membership, led by the Committee Chair, to review
the appeal and to render a decision. The committee is charged solely with determining whether the
various specialty training, credentials, and examination committees followed proper administrative
procedure in the decisions made. The Appeals Committee decides whether the committee(s) acted
erroneously by:
● Disregarding established criteria for certification or approval;
● Failing to follow stated procedure;
● Failing to consider relevant evidence and documentation presented by the candidate.
4.I.1 Appeals Process
Either a candidate or a PD who has received a negative decision and who believes that a
specialty's residency training, credentials, or examination committee failed to follow proper
procedures may appeal the decision. For MOC there is a stand-alone appeals process and
committee that is specific to the MOC. The process of filing an appeal for MOC is, however,
the same as for a general appeal.
Appeals must be submitted to the ACVIM office in writing or by email within 30 calendar days
of receipt of the decision being appealed.
● Appeals should consist of a brief letter summarizing the reason for the appeal, along
with any supporting documents;
● When an appeal is received, the ACVIM’s Certification Liaison notifies the Chair of
the BOR, the appropriate Specialty President, the Chair of the appropriate Specialty
Examination Committee and the appropriate CC, MOC or RTCC, and the members
of the Appeals Committee (or the MOC Appeals Committee) that an appeal has been
submitted, maintaining the anonymity of the appellant(s);
● The Chair of the appropriate RTC, CC, MOC, RTCC, or Examination Committee
submits all data relevant to the appeal and a letter summarizing the reasons for the
committee’s decision to the Appeals Committee as soon as practical, so that the
Appeals Committee (or the MOC Appeals Committee) can meet within its deadline;
● The Chair of the appropriate Appeals Committee calls a meeting, organized by the
Certification Liaison, within 30 calendar days of the receipt of the appeal to review an
appeal;
● The Certification Liaison notifies the Chair of the BOR, the Specialty President, and
the appropriate committee chair(s) of the results of that review within 7 calendar days
of the decision, maintaining anonymity of the appellant(s);
● The ACVIM Certification Liaison notifies the PD or candidate of the Appeals
Committee’s decision within 7 calendar days of the decision.
● Both the ACVIM Appeals Committee’s and the ACVIM MOC Appeals Committee’s
decisions are final and cannot be appealed within the ACVIM
.
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Requirements for All Specialties
31
4.J ACVIM Diplomate Certificates
A candidate becomes an active ACVIM Diplomate immediately after completion and acceptance by
the ACVIM of all requirements established in this Certification Manual. The ACVIM office notifies
the candidate of the decision. The candidate is awarded an official ACVIM Diplomate Certificate at
the next ACVIM Forum. The ACVIM office prepares these certificates and publishes lists of new
ACVIM Diplomates.
4.J.1 Repossession of ACVIM Diplomate Certificates
ACVIM Diplomate Certificates always remain the property of the ACVIM and will be
repossessed when one or more of the following occurs:
● The issuance of such an ACVIM Diplomate Certificate or its receipt by an ACVIM
Diplomate is contrary to or in violation of any provisions of the ACVIM's Constitution
and Bylaws;
● An ACVIM Diplomate fails to maintain an acceptable degree of competence in the
practice of veterinary internal medicine, one of its specialties, or both;
● An ACVIM Diplomate that earned a certificate during or after 2016 fails to maintain
credentials.
4.J.2 Reinstatement of ACVIM Diplomate Certificates
Reinstatement of an ACVIM Diplomate Certificate is possible with the individual meeting all of
the requirements of a specialty MOC committee. Reinstatement is contingent upon the
approval of the BOR, payment of all dues in arrears (to a maximum of three years), and
payment of current dues in full.
4.K Maintenance of Credentials (MOC)
Each specialty has an MOC committee that evaluates and scores activities submitted by Active
Diplomates towards meeting the MOC requirements of their specialty. Committee activities and
requirements for each specialty’s MOC may be found at this link.
Failure to maintain credentials will result in loss of a Diplomate’s certification as a board-certified
specialist.
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Specific Requirements for the Specialty of Cardiology
32
PART TWO: SPECIALTY-SPECIFIC REQUIREMENTS
5 Specific Requirements for the Specialty of Cardiology
The American College of Veterinary Internal Medicine (ACVIM) certifies specialists in Cardiology.
Cardiologists focus on diagnosing and treating diseases of the cardiovascular system. This section of
Part Two explains the requirements for Cardiology Residency Training Programs (RTP), and the
requirements for candidates working toward certification in this Specialty that are in addition to the
requirements specified in Part 4, which are required of candidates in all specialties.
5.A Cardiology Residency Training Programs
The standards contained in this section of this Certification Manual are the minimum requirements
for the Specialty of Cardiology. Any approved Cardiology RTP may include additional requirements
above the minimum required by the CM. Those additional requirements then become part of that
specific RTP. A resident in such an RTP must fulfill all the additional requirements of that RTP
along with the minimum requirements in this Certification Manual prior to becoming an ACVIM
Diplomate in the Specialty of Cardiology, as those additional requirements are necessary for that
resident to obtain a Residency Certificate.
5.A.1 General Objectives of the Cardiology Residency Training Program
A Cardiology RTP will provide intensive training in clinical cardiology, including major
responsibility for the care of patients with cardiovascular disease. An RTP will place lesser
emphasis on training in internal medicine, which may be completed by having residents
participate in primary patient care, attend internal medicine rounds, and/or attend medical
conferences in internal medicine.
Residents will acquire a broad working knowledge of anatomy, physiology, and pathology of
all body systems, and in-depth knowledge of the cardiovascular system in health and disease.
Although clinical training in most programs is likely to emphasize small animal practice,
knowledge of comparative cardiology across species is an expected outcome of every
Cardiology RTP.
During a Cardiology RTP, residents will obtain knowledge and understanding of the following
areas:
● General internal medicine;
● Physical and laboratory diagnosis, management, and prognosis of cardiovascular
disease of all domestic animals;
● Basic sciences of the cardiovascular system that relate to clinical cardiology including
macroscopic and microscopic anatomy, macroscopic and microscopic pathology,
biochemistry, genetics/molecular biology, physiology/pathophysiology, and
pharmacology/drug therapy;
● Recording and interpreting specialized cardiac diagnostic studies used in
cardiovascular disease evaluation, including:
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Specific Requirements for the Specialty of Cardiology
33
o Electrophysiological studies – interpretation of electrocardiograms (including
loop recordings, Holter monitoring, and intracardiac recordings), and cardiac
pacing (including pacemaker interrogation and programming);
o Cardiovascular sounds – auscultation and phonocardiography;
o Hemodynamics – cardiac catheterization techniques, interpretation of
pressure tracings, indicator dilution studies, blood gases and oximetry, and
calculation of shunt volumes/ratios based on these data;
o Cardiovascular radiography, computed tomography and cardiac magnetic
resonance imaging, including angiographic and other contrast studies;
o Echocardiography - all modalities;
o Nuclear cardiology – understanding the principles of radioisotope studies of
perfusion, cardiac dynamics, and shunts;
● Interventional procedures – knowledge of the anatomy, techniques, indications, and
risks of interventional procedures.
5.A.2 Specific Objectives of the Cardiology Residency Training Program
A Cardiology RTP will provide residents with adequate practical experience in both invasive
and noninvasive cardiac diagnostic and therapeutic techniques, along with suitable clinical
case experience to ensure clinical proficiency as a cardiologist. Residents will document this
experience, including salient information about patients and procedures, by maintaining a log
of cardiovascular procedures and a log of echocardiograms they have performed using the
currently-approved forms. Residents will submit the logs to the Cardiology CC annually. The
log forms can be obtained from the ACVIM website or by requesting them in writing from the
ACVIM office. Residents must use the most appropriate version of the log for each year’s
submission. Ideally, residents would use the most current format for submitting logs. They
may also use the template in use at the beginning of their program. However, they may NOT
use outdated templates, i.e. templates that were replaced prior to the start of their RTP. Use
of outdated log forms may result in rejection of the log by the Cardiology Residency Training
Committee or Cardiology Credentials Committee.
The ACVIM Cardiology Diplomate or a Diplomate of the European College of Veterinary
Internal Medicine - Companion Animal (ECVIM-CA) in Cardiology directly supervising a
cardiovascular procedure, as defined below (5.A.3) will provide signed documentation of each
procedure’s supervision. A summary form must be included in the resident’s annual
submission indicating the total number of echocardiograms, as well as the type and number of
all cardiovascular procedures performed. The summary form is supplemental to the
echocardiography log and the cardiac procedures logs and must be submitted annually, in
addition to those two logs. The summary form can be obtained from the ACVIM website or by
requesting it in writing from the ACVIM office.
5.A.3 Specific Requirements to be Fulfilled During a Cardiology Residency
Cardiovascular Procedures
Performance of at least fifteen (15) supervised cardiovascular procedures is required during
the RTP.
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Specific Requirements for the Specialty of Cardiology
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For the purpose of these guidelines, such procedures are defined as diagnostic cardiac
catheterization and selective angiocardiography, balloon valvuloplasty, intravascular stenting,
endomyocardial biopsy, permanent transvenous cardiac pacing, placement of Swan-Ganz
catheters with subsequent hemodynamic monitoring, placement of intravascular/intracardiac
occlusion devices, heartworm or intravascular foreign body extraction, transvenous electrical
cardioversion of atrial fibrillation, invasive electrophysiological studies, and radiofrequency
ablation.
Other cardiovascular procedures may be acceptable for meeting this requirement, but those
procedures must be approved in writing by the CRTC prior to being performed. The request
for approval must be submitted to the CRTC at least 10 business days before the procedure is
scheduled to be performed. The resident must perform at least 12 procedures at the SI
(3.CC). All 15 procedures that a resident performs must occur under the direct supervision of
an SD.
“Performance” of the required procedure is defined as the trainee’s active participation in the
procedure. Observation of the required procedures is NOT adequate to fulfill the
cardiovascular procedures requirements. The resident performing the procedure will also have
primary case responsibility (“primary operator”) under the direct supervision of the Supervising
Diplomate (SD) responsible for the procedure.
A secondary operator is a resident who actively participates in the procedure but does not
meet the criteria listed above. An SD is expected to be physically present in the
catheterization lab (may or may not be scrubbed in) for ever procedure recorded in a
resident’s log. The primary operator must be actively involved, with the SD’s guidance, in all of
the following steps: pre-procedural case management, procedural planning, performance of
technical manipulations during the procedure, and post-procedural case management. Both
the primary and secondary operator may enter the procedure into their logs. When 2 residents
(a primary and a secondary operator) perform 2 or more procedures, such as a coronary
angiogram followed by a balloon valvuloplasty, in the same patient during the same session,
each resident may enter a maximum of one procedure in their individual logs for that patient
session.
No one procedure type can account for more than six (6) of the fifteen (15) total procedures to
fulfill this requirement. For example, a candidate may implant more than six (6) transvenous
pacemakers during the residency, but only six (6) would count toward this requirement and
additional procedures of other types would also be needed. Procedures that involve multiple
techniques such as diagnostic catheterization, selective angiography, and an intervention (e.g.
balloon valvuloplasty or coil embolization) could be counted in any one (but not more than
one) category. In other words, a candidate who performed eight (8) balloon valvuloplasties
could count six (6) of them as balloon valvuloplasty, and two (2) of them as diagnostic
catheterizations (which would represent the eight procedures performed, six counted in one
category and two in the second).
This is the minimum number of acceptable procedures and true proficiency is likely to require
more than this minimum standard.
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Specific Requirements for the Specialty of Cardiology
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Echocardiograms
Recording and interpretation of at least five hundred (500) echocardiograms (including M-
mode, 2D, and Doppler studies).
Conferences
Conferences and seminars are considered part of the structured educational experience of an
RTP. These can include formal case conferences, internal medicine conferences or grand
rounds, and conferences at medical schools and pediatric hospitals. The availability of
structured educational experiences, including conferences, will be considered by the CRTC
during review of the program application. Structured educational experiences that include
remote presentations or shared conferences between two or more institutions may be counted
in meeting this requirement.
Special Procedures
Theoretical training in the principles and application of radionuclide angiography, computed
tomography angiography, magnetic resonance imaging, digital subtraction angiography, and
invasive electrophysiological testing can be beneficial. Theoretical training may include
remotely presented didactic teaching. Practical training in these areas is desirable if facilities
and equipment, and qualified personnel are available.
Case Management
Given a clinical case with cardiovascular disease, the candidate should be able to evaluate
the patient in a logical and skillful manner. The candidate should be able to:
● Obtain and interpret the patient's history and conduct a complete physical and
cardiovascular examination;
● Develop a differential diagnosis, including both etiologic and pathologic (anatomical
and physiological) diagnoses;
● Suggest appropriate laboratory studies to confirm or rule out each possible diagnosis;
● Perform and interpret diagnostic studies;
● Make a presumptive or definitive diagnosis based on accumulated data;
● Outline and explain the rationale for appropriate treatment, including options and
alternatives for therapy, and render a prognosis;
● Understand the principles of cardiovascular surgery and interventional cardiac
catheterization (e.g. balloon valvuloplasty). Basic knowledge of how to perform
surgical and interventional procedures is considered essential; the ability to perform
some but not all basic interventional procedures is also essential as per
cardiovascular procedure guidelines (5.A.3), but true proficiency is not considered
attainable in all programs unless additional training is undertaken. Understanding the
indication for these procedures, how to monitor progression of the disease if
intervention is not yet indicated, when and where these procedures may be
performed, and follow-up after completion of these procedures is essential even if
proficiency is not attained in the performance of the particular procedure;
● Communicate clearly to the client the diagnosis, prognosis and recommended
management of the patient's problem.
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Specific Requirements for the Specialty of Cardiology
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5.A.4 Definitions for Cardiology Residency Training Programs
5.A.4.a Cardiology Credentials Committee
The Cardiology Credentials Committee (CCC) reviews and grades all credentials submitted by
candidates. The CCC also certifies that each candidate has met all the requirements for the
resident’s RTP and all the requirements for becoming an ACVIM Cardiology Diplomate.
5.A.4.b Cardiology Residency Training Committee
The Cardiology Residency Training Committee (CRTC) reviews and approves all new RTPs.
The CRTC reviews and approves for renewal each registered RTP annually. The CRTC also
reviews any significant changes in an RTP (e.g., change in PD or Resident Advisor (RA), a
resident/candidate’s early termination or failure to complete an RTP, alterations in program
duration or content, and locations of secondary training sites), and notifies the CCC of the
approved changes. These reviews are normally based on documents submitted by the PD;
however, if questions arise the CRTC may solicit supplemental documentation from other
individuals that have knowledge of a particular RTC. The CRTC also handles questions from
the residents/candidates or PDs regarding interpretation of the program guidelines.
5.A.4.c Direct Supervision
The SD and resident are participating in a clinical practice in which both the Diplomate and the
resident are on the clinic floor interactively, and concurrently managing cases. The Diplomate
need not personally examine each patient seen by the resident but must remain physically
available on- site and review the case with the resident. Remote supervision is permitted on a
limited basis in order to meet public health needs and still permit approved training.
5.A.4.d Indirect Supervision
The SD and resident although participating in a clinical practice together, are not on the clinic
floor simultaneously and so are not concurrently managing cases. To qualify as indirect
supervision, the SD is required to be on-site and have face to face contact with the resident at
least one hour per day for the entire week. Remote supervision is also permitted on a limited
basis for Indirect Supervision in order to meet public health needs and still permit approved
training.
5.A.4.e Non-traditional Training
Defined in Part One. For the Cardiology Specialty, all RTPs must meet the guidelines set forth
in this document. The CRTC must approve the program before a resident/candidate begins
the program.
5.A.4.f Ombudsperson
Defined in Part One. Residents and candidates may contact the Cardiology ombudsperson at
CardiologyOmbuds@ACVIM.org.
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37
The role of the ombudsperson is to advise and offer options toward resolution of a problem as
deemed appropriate, should any arise, between residents in training and either their
institutional training programs officers, supervisors, or directors or with ACVIM as an
organization. All communications are held in strict confidence.
5.A.4.g Program Director
Defined in Part One. For the Cardiology Specialty, the Program Director (PD) must be an
ACVIM Cardiology Diplomate or an ECVIM-CA Cardiology Diplomate. If the PD is an ECVIM-
CA Cardiology Diplomate, that individual must be part of an RTP located in the United States
or Canada. The PD must keep the ACVIM home office and CRTC apprised of any changes to
the approved RTP or changes in the status of any resident.
5.A.4.h Resident Advisor
Defined in Part One. For the Cardiology Specialty, the Resident Advisor (RA) must be an
ACVIM Cardiology Diplomate or an ECVIM-CA Cardiology Diplomate. If the RA is an ECVIM-
CA Cardiology Diplomate, that individual must be part of an RTP located in the United States
or Canada.
5.A.4.i Supervising Diplomate
Defined in Part One. For the Cardiology Specialty, the Supervising Diplomate (SD) must be an
ACVIM Cardiology Diplomate or an ECVIM-CA Cardiology Diplomate for all cardiology
training. See section 3.DD for rules governing Supervising Diplomates for non-cardiology,
supplemental training.
5.A.4.j Training Week
Defined in Part One. A Cardiology RTP must have a resident working at least 40 hours in the
span of 7 days in order for it to count as one week of a residency. This time includes
emergency duties and patient care on weekends. Four weeks constitute one month of
training. If needed in order to comply with public health restrictions on work-places, a resident
may accumulate work weeks in ½ week increments by working a minimum of 25 hours in a 4
day period.
5.A.5 Roles and Responsibilities
5.A.5.a Environment and Supervision Required at the Sponsoring Institution
In order to become an approved RTP, the RTP must be located at a veterinary medical facility
with ACVIM Cardiology Diplomate(s) and/or ECVIM-CA Cardiology Diplomate(s) and an
engaged faculty/staff active in a variety of disciplines and specialties. Each RTP must be
registered with and approved by the CRTC prior to the resident beginning the RTP.
Cardiology training must include active (direct) supervision with the resident seeing cases.
Such active supervision must be provided for at least twenty-four (24) months by at least one
ACVIM Diplomate in Cardiology or an ECVIM-CA Cardiology Diplomate in good standing.
Training that is not under the direct or indirect supervision of an ACVIM or ECVIM-CA
Diplomate in Cardiology must be detailed in the individual resident's application and approved
by the CRTC in advance of the start of the resident’s program. Video or other electronic
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Specific Requirements for the Specialty of Cardiology
38
conferencing by a Cardiology Diplomate may fulfill the requirements for either direct or indirect
supervision if needed to meet public health requirements. In those cases there must be an
approved diplomate in another specialty that is present on-site to serve in lieu of the SD for
the purposes of direct contact, while the SD is reviewing the patient care remotely.
An SD who comes to the SI on a part-time basis and provides direct supervision to a
candidate during that time must advise the CRTC of this in writing at least 10 business days
before the intended start of the period of direct supervision. The RA is also responsible for
notifying the RTC in writing, at least 10 business days before the intended start of the period
of direct supervision, of the SD’s role in the RTP. Both communications need to specify the
start and end dates of the supervision and the number of complete training weeks that the
visiting SD will directly supervise for which resident(s). Failure to meet these requirements will
lead to the period of interaction between the visiting cardiologist and the resident not being
approved or counted as direct supervision.
The RTP must not have more than 2 residents per ACVIM or ECVIM-CA Diplomate. If a
Diplomate leaves the RTP and the program has more than 2 residents per Diplomate, the
CRTC must be notified and the program will go on probation until the RTP restores the
required resident to mentor balance.
If a PD leaves the RTP, the Sponsoring Institution (SI) must notify the CRTC of the proposed
change in director at least seven days before the change occurs. Failure to do so results in
the RTP being placed on probation. Failure to respond satisfactorily to CRTC requests for
information will result in program termination. Time served by residents in an unapproved or
terminated RTP cannot count toward the completion of a Cardiology residency.
5.A.5.b Responsibilities of the Program Director
The PD ensures that substantive changes within a Cardiology RTP affecting compliance with
Cardiology Specialty requirements are reported to the CRTC for approval before implementing
the changes. Substantive changes include the following:
● Change of SDs who are Cardiology Diplomates of the ACVIM or ECVIM-CA or
changes in their reported contact hours with residents;
● Change of RAs;
● Addition or removal of resident (e.g., dismissal of a resident, withdrawal of a
resident);
● Any change in a resident’s status (e.g. the resident is placed on probation);
● Alteration of program duration or resources, e.g. addition or removal of a secondary
practice location (any such change would require RTC approval prior to the resident
participating in any added locations);
● Resident switching to or from a dual board program (this includes non- ACVIM
residencies, e.g. American College of Veterinary Emergency and Critical Care);
● Resident enrolling in an institutional graduate program.
Reporting inaccuracy may result in Cardiology RTP probation (Part 1 – Part 2) or termination.
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5.A.5.c Responsibilities of the Resident Advisor
The RA must evaluate, in writing, an assigned resident at least semiannually and discuss the
results of each evaluation with the resident. The resident must sign the RAs copy of the
written evaluation to indicate that the resident has received a copy of the evaluation. The RA
signs and verifies all documentation related to resident/candidate completion of program
requirements. The CRTC may request copies of these evaluations if there is a discrepancy
between the candidate’s and the RA’s records.
5.A.6 Required Facilities and Equipment
Diagnostic equipment and facilities must include access to laboratories for clinical pathology,
microbiology, parasitology, and pathology (gross and microscopic). On- site radiography,
cardiac catheterization and angiocardiography, electrocardiography, and echocardiography
are required. This equipment must be available and functioning at all times at the SI. If an SI
fails to obtain a repair or replacement for nonfunctioning or unavailable equipment for 2 or
more months in a calendar year, or less if the Cardiology RTC believes this shortage is
negatively affecting the RTP, the Cardiology RTC may place the RTP on probation. If there
are multiple equipment issues, the program may be directly terminated.
Availability of facilities for other studies, including intracardiac electrophysiology, computed
tomography angiography, magnetic resonance imaging, and nuclear medicine, is desirable.
Facilities should be sufficient to allow for outpatient, in- hospital, and intensive patient care.
Physical and electronic library facilities that provide access to textbooks and journals in both
human and veterinary medicine are mandatory (see 4.F.3.a).
If the CRTC determines an RTP is deficient in providing training in any area of the program,
the CRTC can require the RTP to correct the deficiency (see 5.A.10.a). Failure to correct
deficiencies may result in an RTP being placed on probation or, if persistent or recurrent, may
result in program termination.
5.A.7 Didactic Learning Opportunities
The SI must provide residents with several didactic learning opportunities. In-depth knowledge
of cardiovascular medicine, especially its basic science aspects, cannot be gained by patient
care alone. Comprehensive knowledge of the field should be gained by the following
structured educational experiences for learning and development.
5.A.7.a Journal Club
Residents must participate in at least 80 hours of Journal Club throughout the course of their
residency as stated in 4.F.10. At least one ACVIM Diplomate, or ECVIM-CA diplomate who is
a Cardiology RTP RA, in any ACVIM specialty, must attend each Journal Club meeting.
Residents must keep a log of Journal Club activities that includes the date, topics discussed,
and those in attendance. The log is submitted as part of the credentials packet reviewed by
the CCC.
These Journal Clubs may be held remotely, provided that there is an ACVIM Diplomate, or
approved ECVIM-CA diplomate as described above, present in each remote meeting. The
Journal Club requirement is specific to the review of articles in scientific periodicals (journals);
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Specific Requirements for the Specialty of Cardiology
40
activities such as resident seminar series, local conferences, meetings, etc. are not
considered part of Journal Club.
This Journal Club requirement is in addition to the 150 hours of cardiology structured
educational experiences outlined below.
5.A.7.b Cardiology Structured Educational Experiences
Formal conferences (structured educational experiences) take many forms, including
cardiology Journal Clubs (covered in section 5.A.7.a above), cardiology case conferences,
cardiology conferences at medical schools and pediatric hospitals, cardiology book reviews,
and cardiology seminar series; online and remote conferences are acceptable when
necessary These conferences are distinct from case assessment and discussion (e.g., daily
case rounds) that are directed by an SD during clinical practice. The CRTC considers
availability of structured educational experiences during review of an RTP’s application.
At minimum, the RTP must provide educational experiences such as those listed in this
section. Residents/candidates must complete 150 hours of cardiology-related education.
Attendance at continuing education conferences outside the SI cannot fulfill greater than ten
hours per year of structured educational experiences. When given at the SI, lectures,
cardiology Journal Clubs, and textbook chapter reviews given by the RTP’s SDs may be
counted towards this requirement for up to a maximum of 3 hours (total daily maximum) in one
day. These requirements are in addition to the 80 hours of Journal Club mandated in the
general ACVIM guidelines and in section 5.A.7.a above.
Residents must document participation in required structured educational experiences in the
Education Log submitted annually with the Echocardiography, Cardiology Procedure and
Summary Logs. The Education Log must indicate the individual structured educational
experiences, with the date, planned duration, and actual duration of each one. A copy of the
Education Log can be obtained from the ACVIM website. Variances of a maximum of 15% in
actual structured educational time can be explained by daily circumstances (e.g., a 60-minute
session that lasts only 50 minutes or less because of patient care obligations) or unforeseen
circumstances (e.g., illness); a difference of >15% in delivered versus scheduled structured
educational time must be rectified by the RTP and candidate.
Supervising Diplomate(s) must participate actively in structured educational activities.
Residents may meet the requirement for structured educational experiences by means other
than those described next. However, the CRTC must approve any deviation from these
requirements in advance of the educational experience.
The types of cardiology structured educational experiences which residents may attend are:
● Cardiology Journal Clubs: Review and critical analysis of the cardiovascular literature
is central to a Journal Club. The cardiovascular literature is broadly defined in the
context of Journal Club to include peer-reviewed medical, comparative, and veterinary
journal articles pertinent to the theory and practice of veterinary cardiology. The
article(s) will have been distributed prior to the Journal Club session for review by
participants;
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Specific Requirements for the Specialty of Cardiology
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● Cardiology Clinical Case Conferences: Case conferences provide a forum for
thorough and detailed consideration of clinical cases. These structured activities
emphasize pathophysiology, clinical presentations, interpretation of diagnostic
studies, therapy, and outcome. Rounds with residents/candidates presiding over
clinical cases do not meet the criteria for clinical case conferences;
● Seminar or Lecture Series: Seminars or lectures in cardiology presented by
Diplomates or residents/candidates provide an opportunity for in-depth study of
cardiovascular topics;
● University Classes: This is formal course work in which a resident participates and
which is pertinent to the RTP. If a resident enrolls in a course that has a direct
relationship to cardiology practice or research such as physiology, pathology,
statistics or other related fields, the resident may log the course as part of cardiology
educational experience. If a physician cardiologist or Cardiology Diplomate (ACVIM or
ECVIM-CA) teaches a course, it can be used to fulfill the education requirements. If a
course covers a cardiology topic, the resident may enter the full number of hours that
the resident attends the course into his/her log. If the resident attends a class in a
related field (e.g., statistics), and wants to use the class as cardiology educational
experience for more than 10 hours per year, then the resident must submit a written
description of the class to the CRTC along with the logs. If the CRTC rejects these
hours, and if the SD or the resident disagrees with the CRTC’s decision, then an
appeal can be made to the ACVIM Appeals Committee.
5.A.7.c Supplemental and Suggested Cardiology Focused Educational
Experiences
Residents may also develop in-depth knowledge of the Cardiology Specialty through the
following educational experiences:
Required of each resident in each RTP:
● Attend/Participate in at least one ACVIM Forum (this may include documented
participation in remotely held ACVIM Forums);
● Develop a structured self-study program in consultation with the resident’s RA.
The Cardiology Specialty Examination Committee provides a comprehensive
reading list, and this list should be reviewed at the start of the RTP. A self-study
program should include standard texts in veterinary and human internal medicine
and cardiology, cardiovascular anatomy, physiology, pharmacology, embryology,
pathology, and appropriate current and past journal articles detailing veterinary
and human cardiology.
Optional for each resident in each RTP:
● Attend/Participate in a cardiology-focused ACVIM Advanced Continuing
Education (ACE) course;
● Examination Review Sessions.
5.A.8 Research Requirement
Residents are expected to participate in clinical or laboratory research projects, including
project design, execution, evaluation, presentation of results as an abstract at the annual
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ACVIM Forum, and publication of results. Completion of this research requirement can include
any of the following:
● Documented (letter from RA) submission of a prospective research grant/project
pertinent to the candidate’s specialty
● Acceptance and presentation at a scientific meeting of an abstract (either oral or
poster) of original work
● Documented completion (letter from RA) of a prospective or retrospective research
project
● Documented completion (letter from RA) of graduate course work in biostatistics,
research methods, and/or research ethics
● Options that residents can do instead of a research project to fulfill the research
requirement include successful completion of at least twenty-five hours of seminars or
classes. These may be offered by the ACVIM, or through online courses, or at other
institutions. These classes will cover subjects such as:
o Critical evaluation of the veterinary medical/biomedical literature;
o Grant writing;
o Study design and participation in clinical trials.
5.A.9 Secondary Training Sites
Secondary Cardiology training sites constitute Off-Site Training experiences that may be used
to provide access to required procedures and to enhance training. Secondary Cardiology
training supervisors must be ACVIM Diplomates or ECVIM-CA Diplomates in Cardiology in
good standing and are expected to provide active (direct) supervision. No more than four (4)
of the required twenty-four (24) months of active (direct) supervision of clinical training can be
obtained at secondary training sites.
If secondary Cardiology site training experiences are used to fulfill a portion of the requirement
for active (direct) clinical supervision or to complete required cardiovascular procedures, the
secondary site Cardiology supervisor must complete a Cardiology Training Agreement Form.
This form must be submitted online to and approved by the CRTC with the RTP application.
The Cardiology Training Agreement Form will indicate clearly the scope and duration of the
proposed training and the specific (single) trainee to which the particular agreement pertains.
Upon completion of the proposed training, the original Cardiology Training Agreement Form
must be updated to describe the actual time spent with the resident and the procedures
performed. Secondary Cardiology site supervisors must sign all appropriate resident logs.
Secondary Cardiology site experiences that are not used to partially fulfill the required active
(direct) supervision of the program do not require completion of the Cardiology Training Form.
Brief descriptions of these experiences should be listed in the residency application.
5.A.10 Residency Training Program Registration and Evaluation
Certification in the Cardiology Specialty requires completion of an RTP that is at least 36
months long (at least 24 months of which must be directly supervised, intensive cardiology
training – see 5.A.5.a above) and that must be approved by the CRTC before the program
starts training residents/candidates.
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The PD and RA in all Cardiology Residency Training Programs must either be an ACVIM
(Cardiology) Diplomate or an ECVIM-CA Diplomate certified in the Specialty of Cardiology.
The ratio of total cardiology residents to on-site Cardiology Diplomates who are actively
involved in resident training cannot exceed 2 to 1.
Variances may be permitted by the Cardiology Residency Training Committee, but a request
for a variance will require a detailed explanation from the PD to the RTC and written
permission from the RTC must be granted. In general, such approval will relate to combined
residency-graduate degree programs or programs that include significant resident research
commitments. Variances must be approved by the CRTC prior to the resident including them
as part of their training program). Any secondary non-Cardiology site supervisor(s) (SSSDs)
must be Diplomates in their respective specialties and approved for their specific programs by
the CRTC.
5.A.10.a Program Probation
The CRTC may place an RTP on probation or, in the case of serious issues, terminated for
various reasons including:
● Increased frequency of reviews by the CRTC which fails to result in resolution of
deficiencies of current residents/candidates
● Serial problems experienced by sequential residents/candidates that are of a similar
nature between resident classes
● Failure to provide sufficient number of Journal Clubs or cardiology structured
educational experiences
● Failure to provide direct resident/candidate supervision
● Failure to provide sufficient case experience as evidenced by resident logs
● The ACVIM office personnel compiles data for each Cardiology RTP on the number
of candidates that pass the General and Specialty Examinations, and on the number
of candidates that must take the examinations more than once to pass them. If an
RTP has continuous issues with candidates failing to pass the examinations after two
attempts, then the CRTC may place the RTP on probation. The CRTC conducts an
intensive review in an attempt to identify and help the program correct the problem. If
the problem cannot be resolved, and if candidates continue to have problems
passing the examinations, the CRTC may terminate the program. If the problems are
determined to be incapable of resolution in a reasonable time-frame, the program
may be terminated without having first been placed on probation.
Failure to submit the appropriate information by the deadlines published in this Certification
Manual may result in the CRTC placing a Cardiology RTP on probation. While on probation,
the RTP may continue to train residents, but may not accept new residents into the program.
If the PD fails to respond to CRTC requests for documentation regarding the RTP within 30
days of the request, that RTP may be placed on probation. If the PD fails to provide an
acceptable response within an additional 30 days, the CRTC will terminate the RTP.
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5.B Cardiology Candidate Requirements
5.B.1 Distribution of Training Time
All Cardiology RTPs are a minimum of 36 months in duration. Twenty-four (24) months of
direct supervision in Cardiology is the minimum requirement for each RTP. The remainder of
the 36 months could be vacation, study time for boards, research, and indirect supervised
clinic time.
The number of cases seen during the training program will vary among training sites. At all
training sites, the majority of case material must emphasize cardiac disorders. Emphasis
should be on quality rather than quantity, although a sufficient caseload must be available to
provide experience with all types of cardiovascular disease in as many different species as
possible.
All residents should receive direct or indirect supervision during their residency unless the
resident is spending time on vacation, study time for boards, research or supplemental
experiences.
5.B.2 Supplemental Experiences
Additional secondary site experiences that do not fulfill a portion of the required twenty-four
months of direct supervision or the required five hundred (500) echocardiograms, 150 hours of
structured educational experiences, 80 hours of Journal Club, or fifteen cardiovascular
procedures are supplemental (optional) experiences and do not require documentation from
Supervising Diplomates. A brief description of these supplemental experiences is asked for in
the RTP registration form. This is used by the CRTC for its annual review of the program.
If the resident is spending time with a physician cardiologist, this time (up to 2 weeks) can be
logged as indirect supervision as long the experience is discussed/reviewed with an SD or the
RA.
5.B.3 External (Affiliated) Rotations
If the PD, RA and/or CRTC deems it necessary to require one or more rotations under the
direct supervision of specialists not available on site (e.g. internist, radiologist,
anesthesiologist, and pathologist), then an outside rotation needs to be included in the RTP
description to satisfy the requirement.
During this time, direct supervision by another specialist is required and must be documented
in writing as having been completed.
5.B.4 Residency Training Interruption
Training interruptions may be unavoidable in circumstances where a resident must switch
from one RTP to another to fulfill all RTP and credentialing requirements. In such cases, the
CRTC must approve the new RTP before the onset of clinical training, and the CCC should be
notified of the approved changes. In addition, the CCC and CRTC must each verify which
portions of the training at the original RTP will be accepted as fulfilling credentialing
requirements. If a resident has been placed on probation at one training site and is accepted
into an RTP at another institution (nontraditional program), the time on probation can only be
counted toward the cumulative training requirements with the consent of the PD at the site
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that implemented probation for the resident. All such requests for approval of prior training
must be reviewed and approved by both the CCC and the CRTC.
5.B.5 Consultation and Supervision
Consultation with qualified specialists, in addition to cardiologists, is an important component
of an RTP. The CRTC considers the availability of board-certified specialists when evaluating
residency program applications. A site that trains cardiology residents should have access to
other board-certified specialists or have a plan to send the resident to other locations to get
this training during the course of the 3-year residency in an effort to improve the residents’
general medical knowledge, to improve their ability to pass the ACVIM General Examination,
and to improve their ability to manage cardiac cases that have problems with other body
systems. The number of rotations will be determined by the PD in concert with the CRTC
based on the individual resident’s background.
The CRTC recommends that residents have the equivalent of a rotation of at least 2 weeks in
duration with a board-certified specialist in each of the following: internal medicine, clinical
pathology and/or anatomic pathology, anesthesiology, and advanced diagnostic imaging (e.g.,
CT, MRI, non-cardiac ultrasonography, etc.). These weeks are not be counted as part of the
minimum of 24 months of direct supervision in the RTP (5.B.1), and are not drawn from weeks
dedicated to exam study time and vacation (5.B.10).
The CRTC prefers that a board-certified surgeon be onsite; however, it is not required.
Telemedicine consultations are not considered adequate training for the cardiology resident in
the specialties listed in the previous paragraph, unless the consult includes a detailed and
complete verbal discussion of the case between the mentor, resident, and radiologist or
pathologist or another specialist giving the consult. The receipt of a written diagnostic imaging
or pathology report via telemedicine is not considered adequate to meet the training
requirements of a resident, and neither is an interaction conducted via email; there must be
one-on- one dialogue between the resident and the consultant.
If an RTP plans to provide supplemental training in internal medicine, clinical pathology,
anatomic pathology, anesthesiology, advanced diagnostic imaging, or direct supervision by
other ACVIM specialties at locations other than the SI, the PD must provide letters of
commitment from the offsite providers to the CRTC.
Updated letters of commitment must be submitted at annual renewal of an existing program.
Additional information about secondary training sites is found in Part One of this Certification
Manual and above in Cardiology Part Two.
5.B.6 Resident Evaluation
Residents should receive a formal written evaluation from their RA at least semiannually. The
evaluation may be completed using criteria developed by the Sponsoring Institution. The
resident is to sign the RAs copy of the written evaluation, to indicate that the resident has
received a copy and has reviewed it with the RA.
Consultation with the Cardiology Ombudsperson is recommended if a discrepancy exists
among the PD, an SD, the RA, and a resident as to the cause for the unsatisfactory progress
of the resident.
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5.B.6.a Resident Logs
Residents/candidates complete the following logs to verify their fulfillment of the Cardiology
RTP requirements:
● Resident log summary form;
● Echocardiography log;
● Cardiovascular Procedures log;
● Education log.
Log completion begins with the start date of the resident in the RTP and continues throughout
the program. Residents must use the logs ACVIM provides to submit information to the CRTC
and to the ACVIM office. The resident should verify, prior to submission, that he/she is using
the most appropriate logs (either the most current or the one in place at the start of the
residency).
Log entries must be typed in the proper format and signed by the PD and the SD as instructed
on the log forms. Residents submit completed logs online to the ACVIM office, according to
the time-line defined on the ACVIM website by the deadline posted on the ACVIM website.
The exception is for the year before that individual intends to take the Cardiology Specialty
Examination. In that circumstance the resident submits credentials packet, by the date
specified on the ACVIM website, in the year before they plan to take the Cardiology Specialty
Examination. At the time of that submission, the resident submits a copy of all logs completed
through the date specified on the ACVIM website. They will submit their final log after
completion of the residency (which will be after the examination). If the resident elects not to
take the Cardiology Specialty Examination during the last year of residency, then the final log
is to be submitted at the end of the residency, according to the timeline defined on the ACVIM
website, which will be before their examination.
Residents must keep a log of all echocardiograms, cardiovascular procedures, and
educational activities they complete. Periodically, the CRTC updates the log form templates.
Residents must check the ACVIM website yearly and, where appropriate, adapt their logs
accordingly for use moving forward.
Ideally, residents use the most current format for submitting logs. They may also use the
template in use at the beginning of their program.
However, residents may NOT use outdated templates, i.e. templates that were replaced prior
to the start of their RTP.
Residents should also download and use in their log entries the list of acceptable
abbreviations compiled by the CRTC.
5.B.6.b Cardiology Residency Training Committee Log Review
The CRTC annually reviews first and second-year resident logs in every RTP, and third and
fourth-year logs in longer RTPs. The CRTC assesses the status and accomplishments of a
resident/candidate in the training program and considers the content of the resident logs in the
annual review for program renewal. If satisfactory progression is not observed, the CRTC
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notifies and works with the PD and RA of the RTP to ascertain why performance is not
satisfactory and what to do to rectify the situation. The CRTC may approve the program
depending on the degree of concern and providing the resident/candidate and the PD give an
adequate response regarding the deficiencies. If the deficiency in the progress of the resident
or if the explanation provided is unsatisfactory, the CRTC may recommend a more intensive
review of the RTP (e.g., increase in the frequency of log submissions, submission of a
scheduled plan for the remainder of the educational sessions for the residency, plan for
additional outside rotations). After this more intensive review of the program, the CRTC may
place the program on probation and indicate how that program must proceed to regain
reinstatement (Part 1 – Part 2). Each resident is notified no later than eight weeks after review
of the logs regarding their acceptability.
5.B.6.c Cardiology Credentials Committee Log Review
During the credentials approval process the CCC reviews a resident’s logs, after which the
CCC Chair notifies individuals with any deficiencies in any area and indicates which action(s)
the resident must take to remedy the deficiencies. After correcting the deficiencies, the
resident submits a final log to CCC for review and completion of verification. Once verified,
the CCC Chair notifies the ACVIM office the resident completed all requirements.
No candidate can become a Diplomate, even if the candidate passes the General and
Cardiology Specialty Exams, until the candidate has completed all requirements.
5.B.7 Publication Requirement
There is no publication requirement for the Cardiology Specialty.
5.B.8 Complaints by Residents or Candidates
Residents with complaints regarding program noncompliance, especially concerns that are not
sufficiently resolved by the RTP’s PD, should direct concerns in writing to the Cardiology
Ombudsperson and to the current CRTC Chair. Residents can obtain the names and contact
information of these individuals from the ACVIM office. A response to the complaint can be
expected within four weeks. Assistance from the Cardiology Ombudsperson can also be
sought for situations that are difficult to resolve. The Cardiology Ombudsperson can be
contacted directly by email at CardiologyOmbuds@ACVIM.org. It is important to note that the
ACVIM can only address matters related to adherence to CM requirements. Personnel
matters are unique to each institution and are not subject to ACVIM review.
5.B.9 Vacation and Study Time
The RTP sets vacation times for residents. The CRTC recommends that a resident take at
least two weeks of vacation per year. The RTP also determines the amount of time off to
study for the General Exam and the Cardiology Specialty Exam. The CRTC would generally
like to see specific time earmarked for candidates to study for exams, with representative
examples being 3-4 weeks off for the General Exam and 5-8 weeks off for the Cardiology
Specialty Examination.
5.B.10 Clinical Milestones for First Year Residents
First-year residents should meet the following milestones to continue to the second year of
their RTP. The CRTC considers extenuating circumstances on a case-by-case basis, provided
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the RA or the SD to whom the impacted resident is assigned submits a letter explaining the
circumstances.
Because the CRTC reviews logs residents submitted by the dates specified on the ACVIM
website, a full year of work is not normally reviewed in a resident’s first year; this will vary
based on a resident’s start date. Typically, a resident includes seven to eight months of first
year logs. Therefore, the number of items in the log is prorated for that amount of time.
● Register with ACVIM within 90 days of beginning the RTP;
● Demonstrate competency, as determined by the RA, in cardiovascular examination
and physical diagnosis;
● Demonstrate satisfactory progression in the program on semi-annual written review of
the resident by the RA;
● Complete 40-50 structured educational hours, realizing that 50 hours is the goal to
achieve each year of residency for a total of 150 hours at the end of three years;
● Attend 25-27 hours of Journal Club (in addition to the structured educational hours
above), realizing that 20-30 hours is the goal to achieve each year for a total of at
least 80 hours at the end of three years;
● Perform two to five cardiovascular procedures. Relative to second- and third- year
residents, first year residents might not have the opportunity to perform as many
procedures, which explains why this number is fairly low;
● Perform 100-150 echocardiograms in the first year. Because most first-year
residents/candidates are learning to do echocardiograms, this number is prorated to
50-100 echocardiograms by the time of log submission on the date specified on the
ACVIM website;
● Determine with the RA a plan to achieve the research requirement as outlined by Part
1 of this document and above. This may consist of ideas for a research project and/or
planned coursework to attend, depending on the option selected.
5.B.11 Clinical Milestones for Second Year Residents
Second year residents should reach the following milestones to continue to the third year of
their RTP:
● Demonstrate competency, as determined by the SD and the RA, in clinical
cardiology; demonstrate satisfactory progression on the RAs annual review of the
resident;
● Complete 100 educational hours cumulatively, realizing that 50 hours is the goal to
achieve in each year of residency for a total of 150 hours at the end of three years;
● Attend 52-54 hours of Journal Club meetings cumulatively, realizing that 20-30 hours
is the goal to achieve in each year to allow for a total of at least 80 hours at the end
of three years;
● Perform additional cardiovascular procedures for a cumulative total of six to 10
procedures by the end of the second year of residency; roles as primary or
secondary operator as described in 5.A.3;
● Perform additional echocardiograms for a cumulative total of 300-350
echocardiograms performed by the end of the second year of residency;
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● Continue the plan developed to fulfill the research requirements. For example,
completion of data collection in a research project or completion of coursework now
or in the next 12 months.
5.B.12 Credentials Items to be Submitted for the Cardiology Specialty Examination
***Always check the ACVIM website prior to submission; this list is subject to change.***
Each resident must prepare and submit a set of questions suitable for use in future Cardiology
Specialty Examinations. The intent of these questions is to demonstrate the candidate’s
knowledge of cardiovascular medicine and to demonstrate that individual’s clarity of scientific
communication. In addition, it gives residents input for future examinations. All questions must
be typed in a standard word processing program. The questions and their correct answers
must be referenced from the veterinary literature. No human medical journals may be used as
references, unless veterinary references also exist for the same question or unless an ACVIM
Cardiology Diplomate wrote the article. The candidate should not use the same references for
more than one question.
The directions contained in the Guidelines for Cardiology Credentials are the most updated
directions. They supersede the following requirements for question preparation if a conflict
exists between the two. The CCC reviews and grades the set of questions a resident prepares
and submits based on content, level of difficulty, references, and clarity of graphics. A score of
0 to 5 will be assigned to the submitted questions, and this score will constitute 5% of the total
score for the Cardiology Specialty Examination. The required materials that must be submitted
with the credentials application include:
● Five (5) multiple-choice questions that follow the American Board of Internal Medicine
guidelines for writing examination questions. Questions must be from at least four of the
subcategories designated by capital letters in the Cardiology Subject Category Study
Outline. No more than two questions can address a single subcategory. The subject
category and subcategory must be clearly indicated for each question;
● Three (3) essay questions. The questions may relate to any three different categories in
the Cardiology Subject Category Study Outline. The subject categories may include
those addressed by the candidate’s multiple choice questions. The subject category and
subcategory must be clearly identified. A suitable answer must accompany each
question. This answer must be referenced;
● Three (3) high quality, publishable electrocardiograms (ECGs), each of which allows a
candidate to evaluate it within two to three minutes. An ECG may be obtained from any
species, other than humans. Questions and referenced answers regarding the
interpretation of the ECG must accompany the submission. The ECGs should be
submitted as high quality digital images (dpi of 300 or higher is recommended). ECGs
should be optimized for amplitude and paper speed where possible;
● Three (3) questions with accompanying answers that require the interpretation of
submitted graphic material, such as (but not limited to) radiographs, cardiac
catheterization data, ultrasound exams, gross or microscopic pathology, or other special
studies. These still graphics must be of publishable quality. Images should be 300 dpi or
higher to ensure publishable quality. Images where color is important should be
provided as color images. A single image sufficient to make a diagnosis is preferred. If a
single image is insufficient to allow a diagnosis, then it is strongly recommended that
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each image submission consists of no more than two parts (i.e., image #1A and image
#1B);
● A single high quality (at least 300dpi) digital video recording of an echocardiogram, or an
angiogram or other fluoroscopic procedure. This is to be accompanied by a description
of the findings and an appropriate question regarding the submission with an accurate
answer(s) to the question proposed. Multiple recordings are unacceptable for
submission in this section; however, an edited compilation of several echocardiographic
views from a single patient’s examination that is contained in a single clip (i.e. a video
montage) is acceptable. The candidate should ensure that a diagnosis can be made
using a single digital video loop. The image and diagnosis should be referenced as
described above;
● A single case study with multiple high-quality images or videos, such that multiple
questions/answers about the case can be developed. The ideal submitted case should
have some complexity and should not be a “simple” case (e.g., a congenital case with
more than 1 defect might be a possibility for submission).
● A submitted case study would need to have a minimum of 3 of the diagnostic tests, but
more than 3 of the following is acceptable and strongly encouraged. The 3 diagnostic
tests can be comprised of a heart sound recording or phonocardiogram, ECG, thoracic
radiographs, diagnostic echocardiogram (multiple loops and stills), angiogram, pressure
tracings, or other forms of imaging or diagnostics (computed tomography, magnetic
resonance imaging, oximetry, EP study). The candidate should submit a minimum of 3
questions that can be answered from these case materials, including the diagnosis, and
the answer to the questions should be referenced as described above;
● A letter signed by the candidate's RA and the candidate stating that the candidate did
not have any direct help in preparing the questions must accompany the set of
questions;
● Three (3) letters of reference from cardiology associates with whom the candidate has
worked during the training program. At least one must be from either an ACVIM
Cardiology Diplomate or an ECVIM-CA Cardiology. It is preferred that a second
reference also come from either an ACVIM Cardiology Diplomate or an ECVIM-CA
Cardiology and the third from an ACVIM Diplomate certified in the Specialty of Small
Animal Internal Medicine or Large Animal Internal Medicine. Each referee must submit
the reference letter or form as directed in the credentials packet;
● An application must be completed and fees paid online;
● Candidates must submit their final, updated Echocardiography, Cardiovascular
Procedures and Education Logs and a completed Summary Form to the ACVIM
office as soon as they have completed any deficiencies as identified by the CCC.
Logs need to be submitted and approved by the CCC prior to the time the resident
finishes the residency. Failure to complete the deficiencies and have the logs
reviewed and approved by the CCC will result in the candidate not being awarded
Diplomate status.
5.B.12.a Procedures for Submitting Credentials
***Always check the ACVIM website prior to submission; this process is subject to
change.***
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Candidates may submit complete credentials packet and the credentials fee online to
the ACVIM office to the attention of the CCC Chair following completion of 27 months
of the residency. If an individual is ACVIM board- certified in a different specialty and is
participating in an ACVIM registered Cardiology RTP, that individual may submit
credentials within the final 12 months of the Cardiology RTP. Applicant instructions,
specific Specialty Examination details and instructions for meeting the credentials
requirements are available on the ACVIM website or by request in writing from the
ACVIM office. If a resident has any questions regarding the application process, that
individual should request clarification in writing from the CCC Chair before the
submission deadline.
A candidate who intends to take the Cardiology Specialty Examination must submit
credentials for the Cardiology Specialty Examination so that the ACVIM office receives
the credentials packet no later than the date specified in the ACVIM website of the year
preceding the year in which the candidate intends to take the examination. Each
candidate is notified no later than 60 days after the submission deadline regarding the
acceptability of the submitted credentials packet for the Cardiology Specialty
Examination.
Inadequate attention to detail or fundamental errors or omissions may cause the entire
application to be rejected.
Residents who submit credentials packets by the date specified on the ACVIM website
in one year do not submit their logs to the CRTC on the date specified on the ACVIM
Website the following year. See the website for specific details for each year of
residency.
The candidate must meet or surpass the following requirements toward receiving board
certification in cardiology:
● Complete 150 structured educational hours;
● Complete 80 Journal Club hours (not included in the 150 hours above);
● Complete 15 catheterization procedures;
● Complete 500 echocardiograms;
● Complete the research requirement.
If the resident fails to complete or surpass these requirements by the date specified on
the ACVIM website of the year that individual submits the credentials packet, the CCC
identifies deficiencies. The CCC requests that the resident resubmit the applicable logs
after correcting the deficiencies for final approval before the resident finishes the RTP.
Once the CCC has determined that all deficiencies have been completed, the CCC
Chair will notify the ACVIM office that the resident has completed all requirements.
Failure to correct the deficiencies and have logs reviewed and approved by the CCC
results in the resident not being awarded Diplomate status. The resident is ineligible to
receive board certification until all requirements are completed, even if that individual
successfully passes the General and Specialty Examinations.
5.B.13 Specialty Examination Registration and Fee
Once the credentials required to take the Specialty Examination are submitted, candidates
may register for the Cardiology Specialty Examination and pay the fee online to the ACVIM
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office by the date specified on the ACVIM website of the year that they intend to take the
examination. Candidates taking or retaking the Cardiology Specialty Examination must
complete an application and pay online by the date specified on the ACVIM website of the
year they plan to take the examination. Candidates can expect a response to their requests to
take the Specialty Examination within 30 days of applying.
5.B.14 Cardiology Specialty Examination Content and Format
***Always check the Candidate’s Webpage information on the ACVIM website; the
examination format is subject to change. Any changes will be reflected in the current
examination blueprint.***
ACVIM Cardiology Diplomates use subject matter experts and, in the multiple choice section,
statistical equating to maintain the standard of the specialty examination and cut score
determination. The Cardiology Specialty Examination consists of six parts taken over two
days. The subjects covered in the examination are listed in the Cardiology Category Study
Outline, which candidates can obtain from the ACVIM website, or by request from the ACVIM
office. No special equipment is required for the examination.
However, examinees may bring calipers, a calculator, and a watch without Wi-Fi, cellular data,
or data/digital memory capabilities to assist them in evaluating some material and monitoring
time spent on various portions of the examination. ***The preceding list is subject to change if
the ACVIM moves to remote testing.***
The score given by the CCC to the credentials packet submitted by the candidate will
comprise 5% of the candidate’s final score. The remaining 95% of the score is generated from
the following six examination parts which include:
● Multiple choice questions (20-25%)
– Covers all aspects of basic and clinical sciences related to cardiovascular
medicine.
● Essay questions (18-25%)
– Covers basic and clinical sciences related to cardiovascular medicine.
● Case studies (20-25%)
– Consists of clinical patient studies, including radiographs and other
noninvasive and invasive examinations (ECG, echocardiograms,
hemodynamics, etc.).
● Cardiac anatomy and pathology (8-12%)
– Covers macroscopic anatomy, microscopic anatomy, cytology, radiographs,
static angiograms, and M-mode echocardiograms, etc.
● Physiologic recordings (15-20%)
– Consists of electrocardiograms, electrophysiological studies,
phonocardiograms, static spectral and color flow Doppler echocardiograms,
hemodynamic studies, pacemaker interrogations, special studies including
computed tomography or magnetic resonance imagining, audio recordings
(heart sounds), etc.
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● Videos (8-12%)
– Consists of real-time recordings of patient examinations; may include
noninvasive (M-mode, 2-dimensional, Doppler echocardiograms,
transesophageal echocardiograms, etc.) and invasive studies (angiograms,
etc.).
A candidate must pass the entire examination with a total score of 70% or better. No specific
minimum score is required on each individual part of the examination. For the multiple-choice
part, the pass point is determined using either the modified Angoff method or statistical
equating, whichever method is determined to be most appropriate by the ACVIM’s
psychometricians. The candidate’s raw score is scaled where the minimum passing score
equals 70% of the points available for this part of the examination. The total score an
examinee achieves is comprised of this scaled score and the raw scores of the other
examination sections.
A blueprint of the Cardiology Specialty Examination is posted on the ACVIM website at least
60 days before the examination date.
5.C Maintenance of Credentials (MOC)
The Cardiology Maintenance of Credentials (MOC) Committee (see also Part 1) maintains a list of
acceptable continuing education experiences and their associated points that count toward renewal
of Cardiology Credentials by ACVIM.
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6 Specific Requirements for the Specialty of Large Animal Internal Medicine
The American College of Veterinary Internal Medicine (ACVIM) certifies specialists in Large Animal
Internal Medicine (LAIM). Large animal internists focus on treating diseases of the internal systems in
horses, cattle, sheep, goats, camelids, and pigs. This section of Part Two explains the requirements for
LAIM residency training programs (RTP), and the requirements for residents and candidates working
toward certification in this specialty that are in addition to the requirements specified in Part 4, which are
required of candidates in all specialties.
6.A Large Animal Internal Medicine Residency Training Programs
The RTP is the foundation for ACVIM training of future Diplomates in LAIM. All of the general
requirements for residents and residency training found in Part One of this Certification Manual
must be met in addition to the specific LAIM requirements contained in this section. Any individual
approved RTP may include additional requirements above the minimum required by the CM. Those
additional requirements then become part of that specific RTP. A resident in such an RTP must
fulfill all the additional requirements of that RTP along with the minimum requirements in this
Certification Manual in order to complete that residency.
A LAIM RTP ensures residents provide primary patient care to which they are capable based on
their level of training. They manage cases in all facets of veterinary internal medicine, including
clinical pathology, pathology, radiology, ultrasonography, advanced imaging, and endoscopy.
6.B Process for Achieving ACVIM LAIM Diplomate Status
At a minimum, achievement of LAIM Diplomate status requires that residents meet the following
criteria:
● Successfully complete an ACVIM RTP in LAIM;
● Attain a passing score on the ACVIM General Examination;
● Attain a passing score on the LAIM Specialty Examination;
● Complete the publication requirement for the Specialty of LAIM as specified in this section
of the Certification Manual and in the LAIM Publication Requirement Guidelines in effect
the year the resident started their RTP;
● Complete the clinical writing assessment (CWA) as specified in the LAIM Clinical Writing
Assessment documents on the ACVIM Website;
● Receive verification that the LAIM RTCC certifies the credentials submitted by the
resident are complete and meet all requirements;
● Residents have a maximum of five (5) years from the end date of their RTP to become
board-certified or their status changes from active to inactive.
6.C General Objectives of the LAIM Residency Training Program
6.C.1 Patient Care and Technical Skill
A LAIM RTP will meet objectives related to patient care and technical skill so that upon
successful completion of the RTP, residents will be able to do the following:
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● Design a comprehensive diagnostic and treatment plan for either one animal or for a
group of animals as appropriate for the circumstances;
● Design a plan to relieve the pain and suffering of patients;
● Provide emergency and intensive care for patients;
● Competently employ all medical, diagnostic, and treatment procedures considered
essential in the LAIM job/task analysis.
6.C.2 Knowledge of Large Animal Internal Medicine
A LAIM RTP will meet objectives related to large animal internal medicine so that upon
successful completion of the RTP, residents will be able to do the following:
● Demonstrate in-depth knowledge of large animal medical diseases, etiology,
epidemiology, pathophysiology, immunology, pathology and therapy;
● Demonstrate competency in the problem-oriented approach to patient diagnosis that
includes:
o Collecting signalment and history;
o Performing a thorough physical examination;
o Developing an appropriate problem list;
o Listing differential diagnoses for the identified problems;
o Knowing which follow-up procedures or tests are required to rule in or
out each of the differential diagnoses (e.g., laboratory tests and
imaging);
● Demonstrate knowledge of the disposition of drugs used to treat a food animal
including the potential for adulteration of the food supply, and know how to mitigate
the potential for residues in meat and milk;
● Demonstrate a working knowledge of the Animal Medicinal Drug Use Clarification Act;
● Design and implement disease prevention and biosecurity protocols.
6.C.3 Teaching Skills and Lifelong Learning
A LAIM RTP will meet objectives related to teaching skills and lifelong learning so that upon
successful completion of the RTP, residents will be able to do the following:
● Demonstrate effective clinical teaching/instructional skills that result from participating
regularly in ward rounds, giving seminars to veterinary students, supervisors or
resident peers, and being involved in other educational endeavors;
● Evaluate and assimilate scientific evidence as a life-long learner to continually
improve patient care.
6.C.4 Interpersonal and Communication Skills
A LAIM RTP will meet objectives related to interpersonal and communication skills so that
upon successful completion of the RTP, residents will be able to do the following:
● Use skills for clearly communicating with clients, students, colleagues, staff, and the
public;
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● Clearly articulate findings in writing as demonstrated by medical record- keeping,
patient discharge summaries, and peer-reviewed publications.
6.C.5 Professionalism
A LAIM RTP will meet objectives related to professionalism so that upon successful
completion of the RTP, residents will be able to do the following:
● Demonstrate professionalism including tact and diplomacy, composure under
pressure, initiative, organization, and receptiveness toward guidance;
● Demonstrate compassion and practice excellent patient care while adhering to ethical
principles.
6.C.6 Scholarly Activities
A LAIM RTP will meet objectives related to scholarly activities so that upon successful
completion of the RTP, residents will be able to do the following:
● Extend their knowledge of the basic principles of research for testing hypotheses and
answering clinically important questions;
● Understand the principles of evidence-based medicine;
● Participate regularly in critical review of the LAIM literature (Journal Club);
● Participate in scholarly activities e.g. research projects and peer-reviewed publication;
● Present their findings at scientific meetings.
6.D Definitions for LAIM Residency Training Programs
6.D.1 LAIM Residency Training and Credentials Committee
The LAIM Residency Training and Credentials Committee (LAIM RTCC) establishes the
standards for LAIM RTPs, determines the equivalency of accredited training programs, and
oversees RTP registration and resident credentialing. The LAIM RTCC reviews all RTP
registration requests. The LAIM RTCC must approve all new and continuing RTP requests
before the RTP begins training residents to ensure that any time a resident serves in the RTP
counts towards meeting training and credentialing requirements. The LAIM RTCC also
reviews and approves credentials packets submitted by candidates. If a candidate desires to
change RTPs, the RTCC will be responsible for determining what portions of training (if any)
may be carried over to the new program. They will also be responsible for approving the new
program, as a transfer automatically results in the resident moving into a non-traditional
program.
6.D.2 LAIM Clinical Writing Assessment Documentation Committee (CWAD)
The Clinical Writing Assessment (CWA) requirement now replaces the previous case report
requirement for all residents. Although an exercise similar to case reports and also designed
to develop/improve resident written communication skills, the CWA will not be scored. The
CWA requirement will be satisfied when the resident completes two case management
documents that meet the requirements of his/her specific RTP. Once deemed acceptable by
the Resident Advisor (RA) or Supervising Diplomate (SD), CWA documents must be
submitted to the ACVIM office.
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The CWA documents will undergo a brief review by members of the CWAD committee. The
LAIM credentials packet provides more detailed guidelines for preparing and submitting CWA
documents.
6.D.3 Non-traditional Training
Defined in Part One. For the Specialty of LAIM, it is possible to achieve certification in a non-
traditional RTP. The Sponsoring Institution (SI) must provide thorough justification for a non-
traditional RTP to the LAIM RTCC, including:
● Details of how all training requirements of a traditional RTP will be satisfied,
including training that may occur at multiple sites;
● Documentation that training will occur in blocks of no less than two consecutive
weeks per block;
● Documentation by the PD, RAs, and SDs that training occurred as specified in the
RTP proposal;
● Requests for approval of a nontraditional RTP must be submitted to the RTCC at
least 90 days in advance of a resident start date. The LAIM RTCC must approve the
program before a candidate can receive credit for time spent in a non-traditional
RTP.
For all RTPs, the maximum length of the training period is five (5) years and the total time
period to achieve Diplomate status after successful completion of all RTPs may not exceed
five (5) years
6.D.4 Ombudsperson
Defined in Part One. Residents may contact the LAIM Ombudsperson at
LAIMOmbudsperson@ACVIM.org to discuss any questions or concerns that may arise during
(or after) their RTPs. All communications are held in strict confidence.
6.D.5 Training Week and Training Hour
Defined in Part One. Time must be accrued in Training Weeks for all RTP activities except for
imaging and pathology. For training in imaging and pathology, time may be accrued in
Training Hours (See 6.D.5 below).
6.E Roles and Responsibilities of the Sponsoring Institution
6.E.1 Documentation and Verification
Described in Part One under Registration of the Residency Training Program. Failure to
respond to LAIM RTCC requests for information may result in program probation or in program
termination.
6.E.2 Facilities and Equipment
The SI must ensure the primary training site or hospital has the following:
● Standard ultrasonographic radiographic, electrocardiographic, and endoscopic
equipment;
● Ability to provide resident instruction in ultrasonography, endoscopy, blood pressure
measurement, and electrodiagnostics by appropriate specialists;
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● Clinical pathology services, including CBC, serum chemistries, blood gases,
urinalysis, cytology, parasitology, microbiology, and endocrinology. If these services
are not available through the primary training site or hospital, the SI must have
arrangements with local or regional laboratories to provide these services;
● A 24-hour emergency and intensive care facility with adequate staffing as allowed by
state practice acts.
Access to magnetic resonance imaging, computed tomography, and nuclear medicine is
highly recommended, but is not required.
6.E.3 Didactic Learning Opportunities
The SI must provide residents with the following didactic learning opportunities; remote
delivery of didactic learning is acceptable when necessary:
● Formal conferences: residents are expected to attend conferences in LAIM and
related disciplines during the residency. Examples include clinicopathologic
conferences or seminars in internal medicine and related disciplines. Conferences
given within a veterinary practice or hospital or at a medical school or medical
teaching hospital are also acceptable. Participation in remote conferences and
meetings is acceptable. Currently, there is no formal requirement to document
attendance at these conferences. The resident is required to give a formal
presentation at such a conference at least once per year and documentation of these
presentations must be included in the LAIM credentials packet. A presentation at a
regional, state, or national meeting may also fulfill this requirement; a copy of the
program must be included in the LAIM credentials packet if the presentation is being
counted towards the training requirement. Remote presentations at approved
conferences and meetings are acceptable.
● Continuing education conferences: residents must attend/participate in at least one
major state, regional, national, or international veterinary medical or human medical
continuing education conference during their residency. Documentation of attendance
at the conference must be included in the LAIM credentials packet.
Residents are strongly encouraged to give a scientific presentation at a national meeting at
least once during the RTP. These may include remote presentations at approved meetings.
Formal review/examination preparation sessions: a LAIM RTP must provide intensive review
sessions or courses for residents on topics covered in the General and Specialty
Examinations. The resident must attend/participate in at least 80 hours of such review
sessions or courses during the RTP. Attending daily clinical rounds does not fulfill this
requirement. This requirement can be met in part by attending an ACVIM advanced continuing
education (ACE) course or an ACVIM Forum or other conferences/meetings, including online
programs, including acceptable remote conferences and meetings.
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6.E.4 Supporting Disciplines Required
The SI ensures at least one board-certified radiologist, one board-certified clinical pathologist,
one board-certified anatomic pathologist, one board- certified neurologist, and one board-
certified cardiologist are available for direct or interactive remote consultation with residents.
For fulfillment of the 40 hours of required training with a board-certified radiologist and 40
hours of required training with a board-certified pathologist, these hours must be spent in
one-on-one consultation (face-to-face or remotely) either in defined blocks of time or during
the course of case management. For these two requirements, the definition of Training Hours
(4.F.12) rather than Training Weeks (4.F.11) may apply.
6.E.5 Secondary and Off-Site Training Sites
If adequate personnel or facilities are unavailable for all required resident training at the
primary training site, the PD must make arrangements at a secondary or off-site training
location to fulfill all requirements. The LAIM RTCC must approve all secondary training and
off-site experiences before residents participate in external rotations that contribute to the
minimum training requirements of the program.
6.F Responsibilities of the Program Director
Defined in Part One. For the specialty of LAIM, the PD must be an ACVIM LAIM Diplomate. When
an SI has more than one LAIM RTP, one PD can be responsible for all RTPs of the SI. There can
also be a unique PD for each RTP (typically one PD for a Food Animal RTP and another PD for an
Equine RTP); however, there will not be more than one PD for each RTP.
Examples of information that a PD must report to the LAIM RTCC:
● Changes (addition or deletion) in supervisory personnel such as having too few RAs or
SDs for the number of residents in the RTP. No program may have more than three (3)
residents for each RA that is listed in the RTP description;
● For programs placed on probation, the PD must provide the LAIM RTCC with an updated
plan for what will happen to any current residents if no resolution occurs within a 12-month
probation period. During that period, the PD provides written updates every three months
to the LAIM RTCC on what is being done to correct the program deficiencies. If the
deficiencies are not resolved within the 12-month probation period, the LAIM RTCC may
terminate the program;
● Alteration of program duration (any proposed alteration must be approved by the RTCC
prior to implementation);
● A resident transferring from one program to another (any proposed transfer requires prior
review and approval by the RTCC);
● A resident either being placed on probation or being dismissed from the program;
● A resident beginning another RTP;
● A resident enrolling in an institutional graduate program.
At the time of annual program renewal, PDs and RAs may be asked to verify resident activities.
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If the PD, regardless of RTP standing, fails to acknowledge LAIM RTCC’s request for
documentation regarding the RTP within 14 days of the request or fails to provide requested
documentation within 30 days of the request, the LAIM RTCC will place the RTP on probation.
Failure to comply with LAIM RTCC requests or recommendations in a timely manner while on
probation may lead to program termination.
6.G Responsibilities of the Supervising Diplomate
Defined in Part One. For the Specialty of LAIM, the SD regularly reviews, generally on a daily
basis, the medical care of patients assigned to a resident. The SD conducts these reviews face-to-
face with the resident. If necessary for public health reasons, these reviews may be conducted
remotely. Consultation with other qualified individuals is encouraged; however, it does not replace
the regular reviews with a LAIM SD. During after-hours periods (evenings and weekends) the SD
should also be available for electronic discussion/consultation, e.g. telephonic or video
conversations, on care of patients assigned to a resident.
6.H Responsibilities of the Resident Advisor
Defined in Part One. For the Specialty of LAIM, the RA must be an ACVIM LAIM Diplomate. An RA
may not be the primary advisor for more than three residents concurrently. The RA must also be
actively involved as an SD for the residents and be substantially involved in the clinical supervision
of assigned residents.
The RA monitors the progress of residents and ensures all clinical milestones are achieved in a
timely manner. The RA must provide each resident with at least two comprehensive written
performance evaluations per year and the results of these evaluations must be shared in person
with the resident. Residents should also receive a copy of the written evaluations and the resident
is to sign the SIs copy of the evaluation to document that the resident has received the
assessment. If needed to reconcile discrepancies, the LAIM RTCC may request copies of these
evaluations.
6.I Responsibilities of Residents
6.I.1 Patient Care
Residents must actively participate in patient management, including initial evaluation,
diagnostic test selection and interpretation, case management and decision-making, client
(owner) communication, appropriate follow-up, and prompt professional communication with
referring veterinarians. An ACVIM SD or other approved specialists must directly supervise
and review case management.
Residents must maintain complete medical records for all patients. These records must be
retrievable and searchable.
6.I.2 Journal Club
The goal of Journal Club is to foster critical thinking and improve the resident’s understanding of
scientific and clinical data, including statistical analysis. teleconferencing and programs having a joint
Journal Club is acceptable when necessary.
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Residents must participate in at least 80 hours of Journal Club throughout their residency. Journal Club
typically consists of a one-hour period of protected time at which at least one ACVIM LAIM Diplomate
or supporting specialist must be in attendance unless extenuating circumstances develop. Specialists
in other disciplines, including statistics, should also be invited to attend.
Residents are encouraged to keep a log of Journal Club activities that includes the date,
journal articles discussed, and attendance.
6.I.3 Clinical Case Conferences (Rounds)
During LAIM clinical training involving patient management, residents must attend and
participate in daily (weekday) clinical rounds with at least one LAIM SD present. In an RTP
where veterinary students are integral to and participating in hospital activities, residents
should lead rounds discussions at least once weekly (with a SD present).
6.I.4 External (Affiliated) Rotations
Residents may participate in external rotation(s) during LAIM clinical training that is not
specified in the RTP registration document. However, the PD or the RA must request approval
for these rotation(s) from the LAIM RTCC before the resident starts the formal rotation for the
rotation to count as part of the 104 weeks of clinical training described under Distribution of
Time in Training.
6.I.5 Case Reports (No longer applicable)
Residents that previously had the option to complete case reports no longer have that option.
They must now complete Clinical Writing Assessments (see section 6.I.6 below).
6.I.6 Clinical Writing Assessment
The purposes of the CWA are to:
● verify that the resident has been working in the area of LAIM;
● demonstrate the resident’s ability to use medical principles in the diagnosis, treatment
and prevention of animal disease;
● display the resident’s ability to communicate medical observations and data to
colleagues in a clear, concise, and organized written manner.
The CWA requirement is both a training exercise and an assessment tool. It is expected that
residents will learn and benefit from the experience by reviewing cases in depth and
communicating their thought processes in a clear and professional manner. Through a back
and forth-writing process with one or more internal reviews by their RA and/or SDs, residents
are expected to improve their written communication skills by developing concise and
organized writing skills. Additionally, the CWA is used by the RA for assessment of the
resident’s ability to reach an acceptable level of expertise in written communication of medical
principles in the diagnosis, treatment, and prevention of animal disease.
Each resident must write two CWA documents to be eligible for certification.
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After the internal review process has been completed, CWA documents can be submitted for
processing to ACVIM on the dates specified on the ACVIM website. A rolling submissions
cycle is now used, rather than an annual dual deadline.
Specific directions for CWA case selection, formatting, and submission, as well as information
on how CWAs are processed, is available from the ACVIM website or upon request from the
ACVIM office.
6.I.7 Publication Requirement
As part of the requirement for a resident to become board-certified in LAIM, that individual
must publish at least one first author scientific manuscript relevant to LAIM in a refereed
scientific, medical, or veterinary medical journal. The purpose of the publication requirement is
to ensure that candidates demonstrate skill in written scientific medical communication, in
particular that they display the ability to organize scientific data, communicate these data
accurately in writing, and are capable of discussing the scientific findings in the context of the
current medical literature. Ideally, the manuscript documents a completed laboratory or clinical
investigative research project undertaken during the RTP. Retrospective studies and
comprehensive reviews may also be acceptable. Manuscripts that were published within the
three (3) years before the resident’s start date may also be submitted to the LAIM RTCC for
consideration toward fulfillment of the publication requirement. The resident must submit to the
LAIM RTCC Chair in writing any questions concerning the acceptability of a publication before
submitting the publication as part of the LAIM credentials packet.
The manuscript must be written in English and published in a refereed journal. A refereed
journal is one governed by policies and procedures established and maintained by an active
editorial board that requires critical review and approval of papers submitted by at least one
recognized authority on the manuscript’s subject. Mainstream journals of major disciplines are
acceptable, providing they adhere to the principles of peer review, and providing the
manuscript’s subject is in the field of LAIM.
A resident may submit a published scientific manuscript or a copy of the final acceptance
notification from the journal editor to the ACVIM office at any time after the resident
successfully registers and enrolls in an approved LAIM RTP.
An accepted manuscript is not required before the resident takes the LAIM Specialty
Examination. However, the resident is strongly encouraged to meet this requirement before
taking the examination.
Each resident must submit an electronic copy of one published or accepted manuscript with
the resident as first author, relevant to the discipline of LAIM that demonstrates critical thinking
and expertise in LAIM. If the manuscript has not been published, then the resident must
submit an electronic copy of the accepted manuscript and acceptance notification. Otherwise,
the publication will not be considered by the LAIM RTCC. The manuscript must be accepted
for publication no more than five (5) years after the resident completes their RTP.
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The ACVIM Board of Regents (BOR) adopted a standard definition of a manuscript accepted
for publication. A manuscript is deemed as accepted for publication when the corresponding
author receives one of the following:
● An email from the official email address of the journal or a letter on the journal’s letterhead
from the editor stating that the manuscript has been accepted for publication.
● An email from the official email address of the journal or a letter on the journal’s letterhead
from the editor stating that all reviewers have approved the manuscript for publication and
the manuscript awaits editing before publication.
● A galley proof of the manuscript with an email from the official email address of the journal
or a cover letter from the editor on the journal’s letterhead stating that the manuscript is
scheduled for publication.
A notice from an editor that states the corresponding author must address reviewer comments,
no matter how minor, is considered unacceptable for credentialing purposes. Such a notice
implies final review of the manuscript is incomplete and that it has not yet been accepted.
The LAIM RTCC determines relevance of the manuscript to the topic of LAIM by assessing
whether it meaningfully impacts the scientific understanding of a subject relevant to LAIM, or
the diagnosis or management of a clinical condition by a specialist in LAIM. The manuscript
should demonstrate the proficiency of the resident in understanding scientific method and
study design including statistics, and in conducting a comprehensive literature review. The
LAIM RTCC Publication Requirement Guidelines contains current information on factors the
LAIM RTCC considers in assessing the quality of a manuscript. As Publication Requirements
are certification policies, not residency training requirements, they may change during a
residency. As such, every resident and RA should check the most current Publication
Requirements Guidelines before submitting a paper for publication, to ensure that it will be
acceptable to the LAIM RTCC. A publication is subject to the Guidelines in effect at the time
the article was submitted to the journal. If Guidelines changed after submission of the
manuscript, the candidate can provide proof of submission date to ensure that the original
guidelines will be used in evaluation of the submission.
If a resident is unsure whether a response from a journal is final acceptance, then that
individual should petition the LAIM RTCC Chair in writing for a determination.
Due to variability in editorial quality and process and due to the proliferation of online journals,
the LAIM RTCC must approve all journals not listed on the Acceptable Journal List used to
meet the publication requirement by a resident, preferably before the resident submits the
manuscript for publication. The LAIM Publication Requirement Guidelines contain details on
the LAIM RTCC journal review process and a list of acceptable journals. Residents seeking
approval of a journal not on the Acceptable Journal List must provide documentation as
described in the Publication Requirement Guidelines to the RTCC. The LAIM RTCC reviews
and may update the Acceptable Journal List annually based on changes in journal availability,
editorial process, and impact factor.
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Book chapters and conference proceedings are not acceptable to fulfill the publication
requirement. Case reports, clinical vignettes, short communications, brief communications,
and serial features (e.g., ECG of the Month, Drug Topic of the Month) are also unacceptable.
If the resident fails to complete the publication requirement within the stated time, that
individual’s status changes from active to inactive and he/she is no longer eligible to become
board-certified.
6.J LAIM Residency Training Program Registration and Evaluation
6.J.1 Program Registration
An RTP must be registered with the ACVIM and approved by the LAIM RTCC before
accepting residents for training. In addition to the specialty specific section of this Certification
Manual, each approved RTP must comply with all requirements as specified in Part One of
this Certification Manual. RTP registration forms are available on the ACVIM website.
6.J.2 Program Probation
Defined in Part One. Consistent poor performance (low certification rate) or negative feedback
provided to the Ombudsman or other LAIM Diplomates may lead to an investigation of the
program that could ultimately result in probation.
In addition, failure to submit RTP documents, failure to respond to requests for additional
information from the RTCC in a timely manner, or failure to meet the requirements of the CM
for a valid residency may result in a program either being placed on probation or terminated.
6.K Distribution of Time in Training
An approved LAIM RTP must have a minimum duration of 104 weeks and the SI must have at
least two ACVIM Diplomates, one of whom must be an ACVIM LAIM Diplomate.
No program may have more than three (3) residents for each RA that is listed in the RTP.
If a resident is unable to participate in the RTP continuously, then the time in training must be
arranged in blocks of time of no less than two (2) weeks each with a minimum of twelve (12) weeks
of training in any residency year (a residency year is the 12-month period which immediately
follows a resident resuming their training program). The maximum duration of an RTP is five (5)
years.
6.K.1 Intensive Clinical Training in LAIM
At least 52 weeks of the RTP must consist of intensive clinical training in LAIM, and additional
weeks spent in LAIM training are desirable. During this time, the resident must be under direct
supervision of one or more ACVIM LAIM SDs.
6.K.2 Clinical Training in Other Specialties
At least 16 additional weeks of clinical training must occur under direct supervision of one or
more SSSDs who are ACVIM Diplomates or ACVIM Associate Members (e.g. ECEIM
Diplomates).
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At least 6 of these weeks must be under the supervision of Diplomates other than the primary
SDs, which can include ACVIM Diplomates in SAIM, Cardiology, Neurology, Oncology or
additional ACVIM LAIM Diplomates or Associate Members (different from the SDs supervising
the 52 weeks if the RTP has less than two ACVIM LAIM Diplomates or Associate Members) at
either the primary or other sites.
6.K.3 Additional Clinical Training in LAIM or Related Fields
An additional 36 weeks should consist predominantly in LAIM or related fields, not necessarily
under the direct supervision of an ACVIM Diplomate. This may include rotations in related
clinical fields such as dermatology, ophthalmology, surgery, theriogenology, emergency
medicine and critical care, clinical nutrition, clinical pharmacology, or anesthesiology.
Some of these 36 weeks may also include non-clinical responsibilities such as writing,
research, teaching, attendance at scientific meetings, study time for examinations, and
vacation. However, no more than 2 weeks (10 business days) of vacation per year can be
counted toward these 36 weeks. The required experiences in radiology and pathology can
also be counted within these 36 weeks.
6.K.3.a Diagnostic Imaging Training
During their residency, the resident must spend the equivalent of at least 80 hours
(the equivalent of two full training weeks) training in diagnostic imaging; remote
training acceptable when necessary. A minimum of forty (40) hours must be in direct,
one-on-one contact with a board-certified veterinary radiologist interpreting
radiographs, learning and evaluating the results of special imaging techniques, and
attending radiology rounds and/or seminars. The other forty (40) hours of diagnostic
imaging during the residency must be spent being directly, one-on-one trained in
ultrasonographic imaging either by a board- certified radiologist and/or by one or more
LAIM Diplomate(s) with advanced skills in ultrasonography. The Diagnostic Imaging
Training may be accrued as Training Hours rather than Training Weeks.
6.K.3.b Pathology Training
During the residency, the resident must spend the equivalent of at least 40 hours in
direct, one-on-one contact with a board- certified veterinary clinical pathologist or
anatomic pathologist; remote training acceptable when necessary. The training
includes evaluating clinical pathologic findings, performing necropsy examinations,
reviewing cytology preparations and biopsies, and attending clinical pathologic
conferences or seminars. These hours may be accrued as Training Hours.
6.K.4 Research, Scholarly Activity, and Study Time
At least 12 weeks of the RTP must be allocated for research and scholarly activity in the
pursuit of publication.
Residents are encouraged to participate in clinical or laboratory research projects, including
the design, execution, evaluation, presentation of an abstract at the annual ACVIM Forum,
and publication. Completion of this research requirement can include any of the following:
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● Documented (letter from RA) submission of a prospective research grant/project
pertinent to LAIM;
● Acceptance and presentation at a scientific meeting of original scientific work as an
abstract (either oral or poster) or research report;
● Documented completion (letter from RA) of a prospective or retrospective research
project;
● Documented completion (letter from RA) of graduate course work in biostatistics,
research methods, and/or research ethics;
● Options that residents can do instead of a research project that fulfill the research
requirement include:
o Successful completion of at least 6 hours of seminars or classes, offered
by ACVIM or through online courses/other institutions and covering
subjects such as:
– Evaluation of the veterinary medical/biomedical literature;
– Grant writing;
– Study design and participation in clinical trials.
Documentation of the completion of at least one of the above activities is required as part of
completion of the Residency Training Overview form that is submitted as a component of the
credentials packet; remote delivery acceptable when necessary.
At least four (4) weeks (preferably without emergency duty) of study time must be allocated to
the resident to prepare for the ACVIM General Examination. An additional minimum of four (4)
weeks (preferably without emergency duty) of study time must be allocated to prepare for the
LAIM Specialty Examination. Study time should be scheduled to precede an examination date
by as much time as is practical.
6.K.5 Vacation
Vacation time varies between SIs, but no more than 6 weeks in total can be included in the 36
weeks detailed in 6.K for 3-year RTPs and no more than 4 weeks in total can be included in
the 36 weeks detailed in 6.K for 2-year RTPs.
6.L Clinical Milestones
6.L.1 First Year Residents
By the end of the first year, residents must meet the following clinical milestones:
● Register with ACVIM within 90 days of beginning the RTP;
● Complete online learning objectives or webinar series on the following:
o Understanding the credentialing process;
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● Submit RTO by posted deadline. Candidates who began their RTP off-cycle and have
not completed 4 months RTP by the submission deadline are exempt from this
requirement.
6.L.2 Second Year Residents
By the end of the second year, residents should meet the following clinical milestones:
● Complete at least one (1) training week equivalent of 40 training hours of the
diagnostic imaging requirements.
● Complete one training week equivalent of 40 training hours of the pathology
requirement.
● Take the ACVIM General Examination (strongly recommended);
● Submit credentials packet after completing at least 20 months of the RTP. In order
for credentials to be reviewed, the candidate must first pay the credentials fee.
6.L.3 Third Year Residents
By the end of the third year, residents should meet the following clinical milestones:
● Have two CWAs submitted (to have been submitted together or separately throughout
course of second and third year. First years not eligible to submit CWA).
● Complete the remaining training week equivalent of 40 training hours of the diagnostic
imaging requirements
● Submit a manuscript (strongly recommended) to a peer reviewed journal for
consideration as a publication;
● Take the LAIM Specialty Examination (strongly recommended).
● Submit Credentials Final Documentation, if applicable:
During the credentials review period, the LAIM RTCC reviews a Resident’s
Credentials, after which the Chair will notify individuals with any deficiencies in any
area and indicates which action(s) the resident must take to remedy the deficiencies
(via a Credentials Results Letter). After correcting/completing all deficiencies, the
resident submits a Final RTO for the RTCC to review. Once verified, the RTCC Chair
notifies the ACVIM office the resident completed all requirements. No candidate can
become a Diplomate, even if the candidate passes the General and LAIM Specialty
Exams, until the candidate has completed all requirements, including the successful
completing of their RTP.
6.M Resident Evaluation
RTPs are responsible for conducting performance evaluations (verbal and written) of each
candidate every 6 months, preferably including feedback from all SDs and other supervisors who
have overseen training in the preceding 6 months.
Evaluations should include a rubric that measures various aspects of clinical performance,
teaching ability (when applicable), communication skills, and scholarly activity as well as progress
towards Clinical Milestones.
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The resident must sign the RAs copy of the written evaluation to document that the RA has
reviewed the evaluation with the resident and provided the resident with their own copy of the
evaluation. The LAIM RTCC may request copies of these evaluations during a program review.
RAs must also ensure that residents who have completed 6 months or more of their program and
have not/are not submitting their credentials submit Annual Progress Reports to ACVIM by the
required deadline.
6.M.1 Resident Case Logs
Residents are encouraged to keep a log of their cases for presentation to their RAs and to
other SDs during a progress review.
6.M.2 Resident Procedure Logs
Residents are encouraged to keep a log of all procedures they complete for presentation to
their RAs and other SDs during a progress review.
6.M.3 Education Logs
Residents are encouraged to keep a log of all seminars and didactic lectures they attend for
presentation to their RAs and other SDs during a progress review. Each log entry should
include the seminar or lecture date, topic, and presenter.
6.N Residency Training Interruption
In some circumstances, a resident may need to take a leave of absence, which prevents that
individual from successfully completing an RTP on time. In such cases, the LAIM RTCC must be
contacted in order to approve an extension of the RTP. When residency training resumes, training
must be accomplished in blocks of at least two (2) consecutive weeks, with at least 12 weeks of
training completed in each residency year (a residency year is the 12 month period immediately
following the resident resuming their training program). When a leave of absence is necessary, the
resident has a maximum of five (5) years from the end of successful completion of the RTP to
achieve board certification in LAIM.
Training interruptions may also occur if a resident must switch from one RTP to another to fulfill all
RTP and credentialing requirements. In such cases, the following steps must be taken:
● A new training program must be identified and that RTP’s PD must submit a proposal for a
non-traditional RTP for that resident to the LAIM RTCC;
● The resident must reregister with ACVIM in the new RTP;
● The LAIM RTCC must approve the new RTP before the onset of clinical training.
6.O ACVIM General Examination
6.O.1 ACVIM General Examination Registration and Fee
Defined in Part One.
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6.P Credentials Submission and LAIM Specialty Examination
6.P.1 Procedures for Submitting Credentials
***Always check the ACVIM website prior to submission; this process is subject to change.***
The information listed in this section provides an overview of the procedures for submitting
credentials. Specific guidelines are in the LAIM credentials information packet. Because
application requirements change periodically, candidates must be certain that they are using
the most current application and credentials packet. If a candidate has any questions
regarding the application process, he/she should request clarification in writing from the
ACVIM office or from the LAIM RTCC Chair before the submission deadline.
Candidates may submit the completed credentials packet and credentials fee online to the
ACVIM office following completion of 20 months of the residency. The LAIM RTCC only
evaluates credentials packets for candidates that have paid the credentials fee. Payment of
the fee triggers review of the submitted credentials packets for completeness and accuracy.
A candidate who intends to take the LAIM Specialty Examination must submit credentials for
the LAIM Specialty Examination so that the ACVIM office receives the credentials packet no
later than the date specified on the ACVIM website in the year preceding that examination
date. THERE ARE NO EXCEPTIONS TO THIS DEADLINE – CREDENTIALS PACKETS
MUST BE SUBMITTED ON THE DUE DATE TO ALLOW ADEQUTE TIME FOR REVIEW
BY THE RTCC. CREDENTIALS PACKETS WILL NOT BE REVIEWED IF THE
CREDENTIALS FEE HAS NOT BEEN PAID PRIOR TO SUBMISSION OF THE
CREDENTIALS PACKET. Each resident or candidate is notified no later than 60 days after
the submission deadline regarding the acceptability of the credentials packet as a prerequisite
for the LAIM Specialty Examination. All candidates must submit the current standard LAIM
application form, along with the other required documents.
They must carefully follow the instructions provided in the credentials packet. Inadequate
attention to detail may cause the entire credentials packet to be rejected.
6.P.2 Credentials Items to Submit
***Always check the ACVIM website prior to submission; this list is subject to change.***
Candidates must include the following items in their credentials packets and submit them online to the
ACVIM office by the date specified on the ACVIM website of the year preceding the date of the special
examination (it is the candidate’s responsibility to submit all credential items before the
deadline as late applications will not be reviewed):
● The completed credentials LAIM Specialty Examination application packet as
described in the LAIM information packet;
● The completed current standard specialty application form;
● One peer-reviewed published manuscript, manuscript and acceptance letter from a
journal, or a signed “letter of understanding” stating that a publication and
documentation of its acceptance will be submitted upon acceptance of a publication
by a journal;
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● Reference forms or letters;
● Applicants must have three references that meet the criteria specified on the
candidate’s webpage of the ACVIM’s website for acceptable referees and submission
format;
6.P.3 Evaluation of Credentials for LAIM Specialty Examination
The ACVIM office and the LAIM RTCC review all eligible (i.e. fees paid) candidate credentials
packets.
A reviewer assigned by the LAIM RTCC evaluates and rates a candidate’s credentials as
acceptable or unacceptable. The reviewer records the evaluation results on a standard form,
which the ACVIM office retains. The LAIM RTCC chair compiles the reviewer’s comments
about whether or not a candidate’s credentials packet is complete and acceptable. The LAIM
RTCC notifies candidates regarding acceptance or rejection of their credentials within 60 days
of the deadline for credentials submission.
Conditional acceptance of credentials may be attained if a candidate has not met the
publication requirement, the case report/CWA requirement, or both. With conditional
acceptance, the candidate may take the LAIM Specialty Examination. However, the candidate
cannot achieve Diplomate status or receive a certificate until that individual completes the
approved RTP, and fulfills the publication and case report/CWA requirements.
6.P.4 LAIM Specialty Examination Registration and Fee
Once credentials are approved, candidates may register for the LAIM Specialty
Examination and pay the fee online by the date specified on the ACVIM website of the year
preceding the examination date. Late registration and fee payment will result in the candidate
being unable to sit the examination that year. Also, see Part One for procedures common to
all candidates.
6.P.5 LAIM Specialty Examination Content and Format
***Always check the ACVIM website, as the examination format is subject to change.
Any changes will be reflected in the current examination blueprint.***
ACVIM LAIM Diplomates use subject matter experts and statistical equating to maintain the
standard of the specialty examination and cut score determination.
The current LAIM Specialty Examination consists of three sections that cover all aspects of
LAIM. The sections are:
● Section One - Multiple choice questions on mechanistic/basic knowledge from
current text and journal articles.
● Section Two - Multiple choice questions on case-based knowledge from current
text and journal articles.
● Section Three - Case management questions that test the candidate’s ability to
diagnose, treat and develop prevention strategies for large animal diseases.
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The LAIM Specialty Examination is graded in sections. A candidate must pass each section of
the examination to become certified. Candidates that do not pass all sections on the first
examination attempt need only retake the failed section(s) on a subsequent examination
attempt(s).
A blueprint of the LAIM specialty examination is posted on the ACVIM website at least 60
days before the examination date. More specific information on grading the examination is
provided in the instructions distributed to candidates taking the examination at least 60 days
before the examination date.
6.Q Maintenance of Credentials (MOC)
The LAIM Maintenance of Credentials (MOC) Committee maintains a list of acceptable continuing
education experiences and their associated points that count toward renewal of LAIM credentials
by ACVIM.
6.R Online Exit Interview Survey
Within 90 days of completing an RTP, residents are strongly encouraged to fill out an online survey
regarding the quality of their training experience.
Responses are shared with the appropriate PD with the goal of providing important feedback
regarding their RTP. Data, held strictly confidential, will be published as five-year rolling average
score per surveyed category calculated for each RTP and will be released every three (3) years to
ensure anonymity of candidates that completed smaller programs.
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7 Specific Requirements for the Specialty of Neurology
The American College of Veterinary Internal Medicine (ACVIM) certifies Specialists in Neurology. This
section of Part Two explains the requirements for Neurology Residency Training programs (RTPs), and
the requirements for residents and candidates working toward certification in this specialty that are in
addition to the requirements specified in Part 4, which are required of candidates in all specialties.
7.A Process for Achieving ACVIM Neurology Diplomate Status
At a minimum, achievement of Neurology Diplomate status requires that residents meet the
following criteria:
● Successful completion of an ACVIM registered and approved Neurology RTP;
● Attain a passing score on the ACVIM General Examination;
● Receive verification from the Neurology Credentials Committee (Neurology CC) that the
credentials submitted by the resident for the neurology specialty are complete and meet
all requirements;
● Attain a passing score on the Neurology Specialty Examination;
● A resident has a maximum of eight (8) years from starting a traditional three (3) year RTP
without interruption or seven (7) years from starting a traditional two year RTP without
interruption to achieve board certification in neurology. If an individual fails to become
board-certified within seven or eight years, that person’s status changes from active to
inactive. An inactive candidate may not resubmit credentials or participate in additional
examination attempts and is ineligible to become board-certified. For candidates with
interrupted (non-contiguous) residencies, the rules for completion of training and
completion of the certification process, as stated in Sections 4.D and 4.E in this manual,
apply.
7.B Neurology Residency Training Programs
A Neurology RTP is more than completing the requirements contained in this section of this
Certification Manual. It embodies the spirit inherent to training highly capable neurologists whose
capabilities build upon those of their mentors. ACVIM expects Neurology RTPs to be cohesive,
integrated, stable, ongoing programs that continually raise the standards in veterinary neurology.
The standards contained in this section of this Certification Manual are the minimum requirements
for the Specialty of Neurology. Any individual approved Neurology RTP may also include additional
requirements above the minimum required by the CM. Those additional requirements then become
part of that specific RTP. A resident in such an RTP must fulfill all the additional requirements of
that specific RTP, along with the minimum requirements in this Certification Manual, in order to
complete the residency and receive a Residency Certificate.
7.B.1 Neurology Residency Training Program Objectives
A Neurology RTP will provide intensive training in clinical neurology, internal medicine,
neurosurgery, imaging, clinical pathology, emergency medicine, critical care, anesthesiology,
anatomy, pathology, and physiology. In addition, the Neurology RTP will ensure that resident
will have obtained the following upon completion of their training:
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● Skills to care for patients with neurological diseases;
● Broad working knowledge of anatomy, physiology, and pathology for all body
systems;
● In-depth knowledge of the effects of neurological disorders on the patient;
● Proficiency in clinical neurology by exposure to a sufficient number and variety of
cases representing all facets of neurology in a hospital equipped for the practice of
veterinary neurology;
● Exposure to basic science and clinical research;
● Training in internal medicine to ensure that resident develop an understanding of
common medical problems and are competent in their clinical management;
● Understanding of the fundamentals and applications of diagnostic methods including,
but not limited to, hematology, clinical pathology, cytology, radiography,
myelography, computerized tomography (CT), magnetic resonance imaging (MRI),
electrodiagnostic techniques (e.g., electromyography, motor and sensory conduction
studies, spinal cord and brain evoked potentials, late waves and repetitive nerve
stimulation, electroencephalography (EEG)), immunology, gross and microscopic
neuropathology, muscle and nerve biopsy techniques, immunopathology, and gross
and surgical pathology as related to the nervous system;
● In-depth knowledge of treatment methods including pharmacotherapy,
chemotherapy, radiation therapy, immunotherapy, and surgery; as well as
awareness of important investigational methods of therapy;
● Awareness and understanding of the importance of neurological diseases in food
and fiber animal and common laboratory species, in addition to companion animals
(dogs, cats, and horses);
● Exposure to clinical trial design and implementation.
7.B.2 Neurosurgical Procedures and Techniques
A Neurology RTP may elect to offer additional training in neurosurgical procedures and
techniques beyond the 50 required hours of training. A Neurology RTP that offers additional
neurosurgical training will ensure that upon completion, residents will have obtained the
following:
● Broad working knowledge of surgical anatomy, physiology, and pathology of the
nervous system;
● In-depth knowledge of the effects of disorders on patients that have neurosurgery as
a treatment option;
● Proficiency in clinical neurosurgery gained by exposure to and performing surgery on
a sufficient number and variety of cases representing all facets of neurosurgery in a
hospital equipped for the practice of veterinary neurology and neurosurgery;
● Awareness of and ability to complete a neurosurgical log.
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7.C Definitions for Neurology Residency Training Programs
7.C.1 Non-traditional Neurology Residency Training Program
Non-traditional RTPs must satisfy all training requirements of traditional Neurology RTPs. The
only allowable exception is the training may occur in non-contiguous blocks of time over an
extended period. If the 96-week clinical training program is not contiguous, the resident must
complete the residency in blocks of time with each block being no less than four weeks in
length and must also complete a minimum of 20 weeks (5 blocks) of training per residency
year for those portions of training which must be completed in Training Weeks, rather than
Training Hours. The training period may not exceed a total of five (5) years (see sections 4.D
and 4.E above). One year extensions may be granted by the RTC due to extenuating
circumstances upon petition by the PD. Under exceptional circumstances, e.g. pandemic
imposed travel restrictions, the RTC may allow a one-time variance in the required minimum
of 5 training blocks in a residency year, upon petition by the PD.
7.C.2 Ombudsperson
Defined in Part One. For the Specialty of Neurology, the ombudsperson is available to
residents still in training and to candidates that have completed training but have not achieved
Diplomate status. Residents may contact the Neurology Ombudsperson with any questions
and concerns they have about their residency experience. The ombudsperson may provide
advice and assistance with these issues. Residents can contact the ombudsperson at
neurologyombuds@ACVIM.org.
All communications are held in strict confidence.
7.C.3 Program Director
Defined in Part One. For the Specialty of Neurology, the Program Director (PD) must have
been board certified for a minimum of five years, either in any ACVIM specialty or by the
European College of Veterinary Neurology (ECVN) prior to becoming a PD. In addition, the
PD must have had at least three years of experience training residents prior to becoming a
PD. If the PD is in a specialty other than Neurology, that PD may not also be a PD in another
specialty.
7.C.4 Resident Advisor
For the Specialty of Neurology, each Resident Advisor (RA) must be active in the practice of
neurology and must maintain clinical competency in the field. The RA must be either an
ACVIM Neurology Diplomate or an ECVN Diplomate. The RA is actively involved as a
Supervising Diplomate (SD) and is substantially involved in the clinical supervision of
assigned resident advisees. The RA must have been board-certified in neurology for at least
one year before becoming an RA. Each RA advises and supervises no more than two
residents at one time.
7.C.5 Supervising Diplomate
Defined in Part One. For the Specialty of Neurology, each supervising SD in neurology
training must be active in the practice of neurology and must maintain clinical competency in
the field.
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The SD for neurology training must be either an ACVIM Neurology Diplomate or an ECVN
Diplomate. See Section 3.DD above for rules governing Supervising Diplomates for non-
neurology, supplemental training. Remote supervision is acceptable when necessary.
7.C.6 Traditional Neurology Residency Training Program
A traditional Neurology RTP is a multiyear postgraduate training program under the
supervision of a PD, RA, and SD. The length of a Neurology RTP ranges from two to three
years. The program entails a minimum of 96 weeks of supervised clinical training, at least 75
weeks of which comprises clinical neurology.
7.C.7 Training Week
A directly or indirectly supervised training week is defined as a minimum of four (4) ten-hour
days or five (5) eight-hour days to account for forty (40) hours per week. Training must occur
in blocks of time that consist of 4 or 5 consecutive days (one full week); except as specified in
7.C.8 below.
Under unique circumstances, e.g. hospital restrictions due to quarantine, time may be accrued
in half week divisions and accruing two half weeks in the same calendar week are
acceptable. The circumstances requiring such a variance must be documented by the RA.
7.C.8 Training Hour
For the purpose of meeting the specified training time in specified fields or activities (i.e.
clinical pathology, imaging, neurosurgery, neuropathology, electro-diagnostics, and
emergency) time will be defined as Training Hours, rather than Training Weeks. A Training
Hour will be defined as a minimum of one continuous hour of direct contact time with a
supervising specialist while engaged in that field/activity, with the exception of electro-
diagnostics and neurosurgery. In electrodiagnostics and neurosurgery, where time is
determined by the length of the procedure, credit for time may be earned in contiguous 15-
minute blocks, with four (4) blocks equaling one (1) Training Hour.
7.D Roles and Responsibilities
7.D.1 Responsibilities of the Sponsoring Institution
7.D.1.a Documentation and Verification
Described in Part One under Registration of the Residency Training Program.
7.D.1.b Facilities and Equipment
The supervising institution (SI) must ensure the primary training site or hospital has the
following facilities and equipment:
● Radiographic, ultrasonographic, and electrocardiographic equipment (onsite access
to MRI, CT, and nuclear medicine is highly recommended but is not required)
● Electrodiagnostic equipment for nerve stimulation and electromyography (onsite
access to EEG is highly recommended but is not required)
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● Clinical pathological services, including CBC, serum chemistries, blood gas
analysis, urinalysis, cytology, parasitology, microbiology, and endocrinology. If these
capabilities are unavailable within the hospital, then the SI must make arrangement
with local or regional laboratories
● Surgical facilities
● A veterinary medical library that contains the textbooks and current journals the
Neurology RTC specifies
7.D.1.c Didactic Learning Opportunities
The SI provides the resident with the following didactic learning opportunities; allowing
remote, online, electronic conferences, primary RACE, acceptable when necessary:
● Formal conferences
o Residents must attend/participate in formal teaching conferences such as
resident seminars, grand rounds sessions, medicine journal clubs,
neurobiology classes, etc. Residents must participate in these activities an
average of four times per month, regardless of their duty status;
o Conferences given within a veterinary practice or hospital or at a medical
school or medical teaching hospital are acceptable. The RTP application
should include the format and schedule of these conferences and
presentations;
o The resident must give at least three (3) presentations at a formal conference
during their residency. Presentations may include lectures in departmental
courses for veterinary students, grand rounds or morbidity and mortality
rounds, whereby the presentation format is to a hospital-wide, multi-specialty
audience. Presentations may also include those of research and manuscript
findings, or seminars at regional (e.g. Midwest Veterinary Conference or Mid-
Atlantic Veterinary Conference), state, national or international conferences, or
participation in continuing education programs. Presentation at a formal
conference does not include resident rounds (defined as a presentation to the
institutional neurologists and/or resident-only audience) or presentations to
veterinary school clubs. The resident may give a presentation at least once per
year or more than one in any given year. Documentation of these
presentations must be included in the resident’s neurology credentials
submission. A copy of the presentation program must be included in the
neurology credentials packet of the resident;
o Electronic /Online / Digital opportunities (seminars, conferences, neurology
specific continuing education, neuropathology courses, Journal Club
conferences, etc.) may be utilized as preapproved by the Neurology RTC. The
format and schedule of these conferences and presentations should be
included in the written proposal to the Neurology RTC
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● Continuing education conferences
o Residents must attend/participate in at least one state, regional, national, or
international veterinary medical or human medical continuing education
conference (ACVIM Neuroscience Course (Brain Camp) would qualify) during
their residency. Remote attendance at these conferences is permitted.
Documentation of attendance at the conference must be included in the
neurology credentials packet of the resident.
● Formal examination review sessions
o A Neurology RTP must provide at least 40 hours per year of intensive formal
review sessions for residents on topics covered in the General and Specialty
Examinations. Attending daily clinical rounds does not meet this requirement.
The requirement could be met in part by attending an ACVIM Advanced
Continuing Education (ACE) course, the ACVIM Neuroscience Course (Brain
Camp), or an ACVIM Forum. Remotely held formal review sessions are
permitted. A Neurology RTP must provide a listing of these formal reviews to
the Neurology RTC in their annual update for their continued approval of an
RTP.
7.D.1.d Neurology Diplomates
The SI must provide the resident with the onsite presence of any combination of at least
two ACVIM or ECVN Neurology Diplomates with full-time clinical responsibilities.
7.D.1.e Supporting Disciplines Required
The SI ensures residents have daily access to consultation with board- certified
specialists in Internal Medicine, Oncology, Cardiology, Surgery, Ophthalmology,
Emergency Medicine, Critical Care, Nutrition, Anesthesiology, Clinical and Anatomic
Pathology, and Diagnostic Imaging.
The SI ensures that residents have access to a board-certified veterinary clinical
pathologist and anatomic pathologist for evaluation and consultation, at least by timely
phone calls, about clinical material submitted.
The SI ensures that during the course of the residency, residents will have at least 50
hours each of direct contact with a board-certified anatomic pathologist, clinical
pathologist, and radiologist to facilitate the required supported discipline-specific training.
These contact hours are defined as Training Hours (4.F.12)
7.D.1.f Secondary Training Sites
If the SI schedules training at secondary training sites during the RTP, the provider(s) of
this training must submit training agreement forms to the Neurology RTC. These forms
must accompany the Neurology RTP registration form for each new program request and
for each annual renewal of registration. Each form must specify the number of weeks
scheduled and the rotation time requirement satisfied at the secondary training site.
If, for example, a resident has a clinical pathology rotation at another institution, the
supervising clinical pathologist at that institution must provide a signed statement
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confirming the name of the resident, rotation duration and proposed dates, and the
institution with which the resident is affiliated.
A secondary training site may not provide either of the two full-time ACVIM or ECVN
Neurology Diplomates required onsite. Additional information about training sites is found
in Part One of this Certification Manual.
7.D.2 Responsibilities of the Program Director
A SI may have only one Neurology PD. In Neurology the PD may be a Diplomate of an
ACVIM specialty other than neurology. The PD remains current on residency training
requirements outlined in this Certification Manual. The PD maintains the highest integrity in
representing the SIs Neurology RTP.
The PD must report substantive changes within a Neurology RTP affecting compliance with
Specialty of Neurology requirements to the Neurology RTC Chair within 14 days. This must be
done in writing through the ACVIM office before the changes are made to ensure they are
acceptable to the Neurology RTC. The time between changes made in the RTP and
Neurology RTC approval does not count toward residency completion by a resident.
Substantive changes include, but are not limited to, the following:
● Changes (addition or deletion) in supervisory personnel such as having too few RAs
or SDs for the number of residents in the RTP;
● The PD must provide the Neurology RTC with an updated plan for any current
residents if no resolution occurs within a 12-month probation period. During that
period, the PD provides written updates every three months to the Neurology RTC
on what is being done to correct the deficiencies. If the deficiencies are not resolved
within the 12-month probation period, the Neurology RTC may terminate the
program;
● Alteration of program duration (this must be approved by the RTC before it can be
implemented);
● A resident relocating from one program to another (such relocation requests involve
review by both the Neurology CC and the Neurology RTC to determine if any transfer
of credit is permitted);
● A resident either being placed on probation or being dismissed from the program;
● A resident beginning another RTP (for a second neurology residency, this would
require approval by the RTC, as it would entail transitioning to a non-traditional
program);
● A resident enrolling in an institutional graduate program.
At the time of annual program renewal, PDs and RAs may be asked to verify resident
activities. Activities include, but are not limited to:
o Satisfactory clinical training;
o Interaction with consultants;
o Documentation of study and education participation.
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If adequate personnel or facilities to fulfill requirements involving anatomic or clinical
pathology, radiology, imaging, or direct supervision in other specialties are unavailable onsite,
the PD must make special arrangements at other facilities for a resident to fulfill all
deficiencies. The Neurology RTC must approve such arrangements in advance. Letters of
commitment for the provision of offsite training must be submitted when requesting approval
of a new program. Updated letters of commitment must be submitted at annual renewal of an
existing program.
The PD ensures signed letters of commitment of required time for secondary training sites are
submitted annually with application for program renewal.
Specialists with whom the resident has trained must provide the PD or the RA with
documentation of these interactions.
The Neurology RTC can request further information or documentation from the PD, RA,
SSSD, and SD at any time, if such information is deemed necessary to verify that residency
training is occurring as described in the neurology program description form. Reporting
inaccuracy may result in the Neurology RTP probation or termination.
7.D.3 Responsibilities of the Resident Advisor
The RA must be a full-time, onsite ACVIM Neurology Diplomate or a full- time, onsite ECVN
Diplomate with clinical responsibilities. Although no restriction exists regarding the number of
RAs within a neurology program, a RA may not train more than two residents concurrently.
The RA, with appropriate input from PD and all SD, must evaluate an assigned resident at
least once every six months and discuss the result of each evaluation with the resident. The
RA is encouraged to use the clinical milestones found later in this section to aid in assessment
of resident strengths and deficiencies, and to monitor the success of the RTP.
The RA completes an evaluation form, such as the one that is posted on the ACVIM website
for each assigned resident. It is permissible to use other evaluation forms if that is the
preference of the RA. The RA must have the resident sign the RAs copy of the written
evaluation as documentation that the resident received a copy of the evaluation and that it
was discussed with the resident. The RTC or the CC may request copies of the evaluation
forms if there is a dispute regarding a resident’s evaluations.
The RA also ensures that the resident receives directly supervised, in-person training from
board-certified specialists as described in the Distribution of Time in Training section later in
this section. Telephone or electronic consultations are not normally considered appropriate for
these training purposes; however, under unique circumstances, such as health related travel
or hospital access restrictions, remote consultations may be utilized.
These experiences should occur in full training weeks as part of the 24 weeks devoted to
training in allied specialties as defined in specific clinical rotations found under Distribution of
Time in Training section.
The RA and the assigned resident must document that training occurred as specified. The RA
signs and verifies all documentation related to resident’s completion of program requirements.
The RA provides copies of resident evaluations to the PD who provides them to the Neurology
RTC if requested. The purpose of Neurology RTC review is to allow the RTC, the PD, RA, and
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the resident to identify and correct any programmatic issues that might place a program in
jeopardy of suspension.
7.D.4 Responsibilities of the Supervising Diplomate
The maximum number of neurology residents that a SD may routinely supervise at any one
time is two. The SD may directly or indirectly supervise the resident. Direct supervision
requires the SD to be in clinics with the resident. Indirect supervision does not require the SD
to be on clinics with the resident. During indirect supervision, the SD must be in contact in
person with the resident at least one hour each day. The SD must ensure that any resident on
clinic duty has access to video-conferencing consultation capability. Review of patient care
performance by the resident should be conducted directly between the SD and the resident.
Contact between the SD and the resident exclusively by telephone or computer is
unacceptable.
The SD ensures the resident has daily access to consultation with board- certified specialists
in Internal Medicine, Oncology, Cardiology, Surgery, Ophthalmology, Emergency Medicine,
Critical Care, Nutrition, Anesthesiology, Clinical and Anatomic Pathology, and Imaging.
7.D.5 Responsibilities of Resident
Residents can access registration forms, lists of approved traditional RTPs, and specialty
credentials packets from the ACVIM website, or request them from the ACVIM office.
Completed applications and credentials packets are to be submitted online via the ACVIM
website. Residents may contact the Neurology RTC Chair to ensure their programs are in
compliance with ACVIM and the requirements of the Specialty of Neurology.
7.D.5.a Patient Care
Residents must actively participate in management of small and large animal neurology
patients. This includes receiving patients, supervising daily patient care, coordinating
neurology clinical teaching, providing optimal client service, communicating with clients
(owners), and engaging in appropriate follow-up and professional communication with
referring veterinarians. An RA or SD must directly supervise and review case management.
The number of cases a resident sees depends on the species, the kinds of problems, and the
depth of study required. Emphasis should be on quality of cases rather than on quantity of
cases.
Residents have primary responsibility for their cases. They maintain complete medical records
for all patients. The problem-oriented veterinary medical record system is strongly
encouraged. Records must be retrievable and searchable.
7.D.5.b Journal Club
Residents must participate in at least 80 hours of Journal Club throughout their residency. At
least one board-certified neurologist must attend each Journal Club meeting. This may include
remote participation by either residents or SDs. Residents must keep a log of Journal Club
activities that includes the date, topics discussed, and those in attendance. The log is to be
submitted as part of a resident’s credentials review.
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7.D.5.c Clinical Case Conferences (Rounds)
During neurology clinical training, residents must attend and participate in daily patient-
oriented rounds with at least one neurology SD present. In an RTP where veterinary students
and interns are integral to and participating in hospital activities, residents should be
encouraged to supervise cases and lead rounds discussions with an SD present until the SD
deems a resident capable of leading student rounds independently.
7.E Neurology Residency Training Program Registration and Evaluation
Each RTP, whether traditional or non-traditional, must register with ACVIM and be approved prior
to a resident beginning their training. Completed and submitted registration forms must include
information about personnel (names of RAs and SDs), facility and equipment available to support
the resident training.
The designated PD must submit a completed RTP registration form online for review by the
Neurology RTC by the date specified on the ACVIM website. The Neurology RTC either approves
the program or provides details of those deficiencies that must be corrected before the program
can be approved. At the time of registration, the PD must provide a written plan for allowing
resident to continue their training should the RTP be terminated for any reason.
Each year, the PD must update and reregister the neurology RTP to ensure each program remains
approved and in good standing to train residents in neurology.
7.E.1 Program Probation
Failure to submit the appropriate information by the deadlines published in this Certification
Manual may result in a Neurology RTP being placed on probation. While on probation, the
RTP may continue to train residents, but may not accept new resident(s) into the program.
If the PD fails to respond to Neurology RTC requests for documentation regarding the RTP
within 30 days of the request, that RTP may be placed on probation. If the PD fails to provide
an acceptable response within an additional 30 days, the Neurology RTC will terminate the
RTP.
7.E.2 Program Termination
An RTP may be terminated if that program is on probation and fails to correct the deficiencies
identified by the RTC in a timely manner. In addition, if a program is found to have serious
deficiencies that prevent adequate training of a resident (e.g. loss of all neurologists) or if it is
determined that a PD submitted false or misleading documents, that program may be
terminated directly, without a probationary period. A terminated residency training program
may not be renewed.
However, a previously terminated program may reapply as a new program. Time served by
the resident in a terminated RTP cannot count toward the completion of a neurology
residency.
7.E.3 Notifications
If the Neurology RTC places an RTP on probation or terminates the program, ACVIM notifies
the PD and all residents currently in the program.
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7.E.4 Acceptable Neurology RTPs
A list of current Neurology RTC approved residency training programs is available on the
ACVIM website or upon request from the ACVIM office.
7.E.5 Distribution of Time in Training
An approved Neurology RTP is at least 104 weeks in length in a traditional two-year RTP or
156 weeks in length in a traditional three-year RTP and entails at least 96 weeks of supervised
clinical training. Non-traditional Neurology RTPs or Neurology RTPs that are interrupted must
be completed a maximum period of five years beginning with the first day of the residency.
Intensive Clinical Training in Neurology
At least 75 of the 96 weeks must consist of clinical neurology service rotations. A resident is
assigned to a clinical neurology service. The resident provides patient care during these
rotation (see 7.D.5.a above). The 75 weeks includes no less than 50 weeks of direct
supervision by a SD. The 75 weeks may also include up to 25 weeks of indirect supervision
(face to face contact at least four days per week) between the resident and the SD. A resident
may spend up to 25 weeks of the 75 weeks managing a clinical neurology service.
Academic degree programs (master’s or doctorate) cannot be substituted for intensive clinical
training in neurology.
Clinical Training in Other Fields
Because neurology is a multimodal discipline, residents must receive additional clinical training
under direct supervision of the affiliated board-certified specialist in the fields of radiology,
clinical pathology, anatomic pathology, and emergency medicine. Additionally, specific training
in neurosurgery, electrodiagnostic testing, and neuropathology (anatomic pathology) are
required. The required rotations are as follows; partial weeks are acceptable when necessary:
Imaging
● Residents must spend at least 50 hours in direct contact time with a board-
certified veterinary radiologist interpreting images, learning and evaluating the
results of special imaging techniques, and attending radiology rounds or
seminars – this time may be completed in Training Hours, rather than Training
Weeks (see 4.F.12 above). Direct contact may include one-on-one remote
learning experiences for this training requirement.
Clinical pathology
● Residents must spend at least 50 hours in direct contact time with a board-
certified veterinary clinical pathologist or anatomic pathologist with experience
in clinical pathology evaluating clinical pathologic findings, attending
clinicopathological conferences, and examining surgical sections– this time
may be completed in Training Hours, rather than Training Weeks (see 4.F.12
above). Direct contact may include one-on-one remote learning experiences
for this training requirement.
Neuropathology
● Residents must spend at least 50 hours in the review of veterinary
neuropathology with a board-certified anatomic pathologist through lecture
series, in seminars, or in a formal training program – this time may be
completed in Training Hours, rather than Training Weeks (see 4.F.12 above).
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Direct contact may include one-on-one remote learning experiences for this
training requirement.
Neurosurgery
● Residents must spend at least 50 hours participating in veterinary
neurosurgical procedures – this time may be completed in Training Hours,
rather than Training Weeks (See 4.F.14 above). There are specific areas, e.g.
nerve biopsies, where the training hours may be acquired in blocks of quarter
hours (15-minute increments).
Electro-diagnostics
● Residents must spend at least 50 hours participating, reviewing, evaluating,
and interpreting different aspects of electro-diagnostics; including, but not
limited to, electroencephalography, electromyography, motor and sensory
nerve conduction study, and evoked potentials – this time may be completed in
Training Hours (including quarter hour increments), rather than Training
Weeks (See 4.F.12 above). For didactic portions of this requirement, direct
contact may include one-on-one remote learning experiences.
Emergency clinic
● Residents must participate in emergency service duties. Acceptable
emergency clinic duties include rotations on an ER or ECC service, after-
hours on-call, or evaluation of daytime or nighttime neuro-emergency cases
through a neurology service. Cases seen may be limited to neurology. This
contact may occur either at the primary training site or at a secondary training
site. The SI provides in the written program proposal to the Neurology RTC
the names of the SDs involved, their areas of specialization, and details about
the anticipated professional interaction.
For each offsite rotation for clinical training in other fields, a resident obtains written approval
from the RA to which that individual is assigned and ensures the Neurology RTC receives
documentation of the approval.
Research and Scholarly Activity
A resident is expected to participate in a laboratory or clinical investigative research project
during the Neurology RTP. The resident must complete a basic science or clinical research
project that follows the scientific method approach and receives approval by the RA. Suitable
projects can be retrospective or prospective in nature. A letter from the RA is required to
document satisfactory completion of the project before certification is awarded.
Unsupervised Time
At least eight weeks of a neurology residency may include unsupervised time that is
considered a part of the RTP. The following qualify as unsupervised time for resident:
● Attendance at/participation in continuing education meetings related to
neurology;
● Uncompromised time to study for examinations;
● A minimum of 4 continuous weeks of protected study time must be allocated
to the resident for preparation for the ACVIM General Examination and an
additional minimum of 4 weeks of continuous protected time for the Specialty
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Examination (for a minimum of 8 weeks of protected study time). Protected
and uninterrupted study time should be scheduled to precede the examination
date as much as is practical;
● Independent study (external rotations in other hospitals or laboratories);
● Vacation time during a residency should be a minimum of 2 weeks per year of
RTP time that is independent of protected study time.
7.F Clinical Milestones for First Year Neurology Residents
7.F.1 Patient Care
First year residents should meet the following milestones related to patient care to continue to
second year of RTP:
● Provide patient care that is compassionate, appropriate, and effective;
● Demonstrate comprehensive history taking and physical examination skills;
● Demonstrate the ability to evaluate and prioritize data into a problem list and
formulate a diagnostic plan with some supervision;
● Assess daily patient progress accurately, and perform appropriate and timely follow-
up of diagnostic tests and interventions;
● Have daily communication with the supervising attending veterinarian, including
attending daily service and house officer rounds;
● Demonstrate effective communication skills accompanied by respectful and
professional behavior in all interactions with patients, owners, referring veterinarians,
and colleagues.
7.F.2 Medical Knowledge
First year residents should meet the following milestones related to medical knowledge to
continue to second year of RTP:
● Demonstrate acceptable knowledge about established and evolving biomedical and
clinical sciences, apply this knowledge to patient care;
● Have basic knowledge of pathophysiology, pharmacology, and clinical disease states;
● Demonstrate an analytical approach to clinical situations;
● Demonstrate self-directed learning and reading of pertinent medical literature;
● Participate in organized educational activities designed to develop or expand medical
knowledge base and to teach analytical thinking and problems solving such as:
o Attending daily clinical service and house officer rounds when on neurology
clinical service;
o Attending scheduled Journal Club and structured learning activities such as
departmental seminars, morbidity and mortality rounds, and other related
sessions;
o Attending rounds when rotating through internal medicine other specialty
services (i.e., Cardiology, Oncology, Critical Care, etc.);
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o Attending rounds specific to any service or specialty rotation in which the
resident participates (e.g., diagnostic imaging, clinical pathology, or other
activities related to the neurology residency training program).
7.F.3 Learning and Improvement
First year residents should meet the following milestones related to learning and improvement
to continue to second year of RTP:
● Investigate and evaluate their patient care practices, appraise and assimilate scientific
evidence, and improve their patient care practices because of these activities;
● Demonstrate a willingness to acknowledge and to learn from errors;
● Participate in didactic rounds, daily house officer rounds, Journal Club, and other
performance improvement activities (see Medical Knowledge), including presentation
of ACVIM review topics and presentation in Journal Club at least five times per year;
● Use available medical databases or evidence-based medicine resources to support
clinical decision making;
● Participate in the clinical training (case supervision, daily ward rounds, etc.) of
students, interns, and other health care professionals as applicable;
● Demonstrate an interest in and ability to participate in various didactic learning
opportunities;
● Assist in clinical teaching of veterinary students, externs and interns (if applicable),
and other house officers, including providing feedback to these individuals regarding
performance, knowledge, medical record keeping, and patient care as applicable.
7.F.4 Interpersonal and Communication Skills
First year residents should meet the following milestones related to interpersonal and
communication skills to continue to second year of RTP:
● Demonstrate interpersonal and communication skills that result in effective
information exchange and engagement with owners and professional associates;
● Develop language and documentation skills (e.g., succinct and comprehensive case
presentations, progress notes, and comprehensive patient care plans) as they
progress in training;
● Provide efficient, but comprehensive information exchange with colleagues, health
care professionals, and owners;
● Develop effective listening skills;
● Establish professional and ethically sound relationships with owners and referring
veterinarians.
7.F.5 Professionalism
First year residents should meet the following milestones related to professionalism to
continue to second year of RTP:
● Demonstrate a commitment to carrying out professional responsibilities, adhering to
ethical principles, and possessing sensitivity to cultural differences and
orientations;
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● Demonstrate respect, compassion, and integrity in all interactions with patients,
owners, colleagues, and other health care professionals;
● Maintain a professional appearance;
● Demonstrate a commitment to ethical principles pertaining to confidentiality of patient
information and informed consent;
● Demonstrate commitment to professional responsibility in completing all medical
records in a timely fashion;
● Begin to develop skills in conflict resolution.
7.F.6 Clinical Research
First year residents should meet the following milestones related to research and publication
productivity to continue to second year of RTP:
● Identify a research study under the supervision of their Resident Advisor (RA) or a
Supervising Diplomate (SD) during the first six months of residency, and prepare a
detailed research proposal by the end of the first year;
● Assist research mentor in study design, literature review, grant preparation (if
applicable), and submission of selected research projects;
● Comply with the ethical principles of research and actively participate in writing an
animal care and use protocol (if applicable).
7. G Clinical Milestones for Second and Third Year Neurology Residents
7.G.1 Patient Care
Second year residents should meet the following milestones related to patient care to continue
to third year of RTP:
● Fulfill all requirements expected of a first year resident;
● Formulate independent diagnostic and therapeutic plans with the supervision of an
attending veterinarian;
● Coordinate patient care among all members of the healthcare team;
● Counsel and educate owners and referring veterinarians;
● Develop competence in performing the core procedural skills essential to the practice
of neurology.
7.G.2 Medical Knowledge
Second year residents should meet the following milestones related to medical knowledge to
continue to third year of RTP:
● Fulfill all requirements expected of first year resident;
● Develop a deeper understanding of disease states and their management;
● Continue to develop skills in critical assessment, reading, and interpretation of the
medical literature with application to patient care;
● Apply knowledge of study designs and statistical methods to the appraisal of clinical
studies (i.e., skills emphasized in clinical rotations and rounds discussions).
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7.G.3 Learning and Improvement
Second year residents should meet the following milestones related to practice-based learning
and improvement to continue to third year of RTP:
● Fulfill all requirements expected of a first year resident;
● Develop competence in educating owners;
● Facilitate the learning of students and interns (if present), other residents, and other
health care professionals.
7.G.4 Interpersonal and Communication Skills
Second year residents should meet the following milestones related to interpersonal and
communication skills to continue to third year of RTP:
● Continue interpersonal and communication skills developed as first year resident;
● Develop effective negotiation and leadership skills that facilitate conflict avoidance
and resolution.
7.G.5 Professionalism
Second year residents should meet the following milestone related to professionalism to
continue to third year of RTP:
● Continue to refine and demonstrate professionalism skills developed as a first year
resident.
7.G.6 Clinical Research and Publication
Second year residents should meet the following milestone related to clinical research and
publication to continue to third year of RTP:
● Fulfill all requirements expected of a first-year resident;
● Initiate study implementation, including active participation in patient recruitment and
sample collection, data analysis, and manuscript preparation;
● Maintain focus on study completion and troubleshoot any problems that may arise
with mentor(s);
● Research productivity can, for example, be demonstrated by having a published
abstract, conference presentation, or accepted peer-reviewed publication. Research
productivity needs to be completed to the RAs satisfaction with appropriate input from
the research mentor. The Specialty of Neurology does not have a formal publication
requirement.
7.H Resident Evaluation
The RA and PD, or the SI Residency Training Committee, review the progress of all residents for
the duration of the program, and provide written evaluation to the resident. Residents are evaluated
by the RA on the criteria listed in Neurology Clinical Milestones. Evaluation occurs at least every
six months for the duration of the RTP. The RA maintains a copy of each review until a candidate
receives board certification. The RA should have the resident sign the RAs copy of the written
evaluation, as documentation that the resident has received a copy and that the results of the
evaluation were discussed with the resident.
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Residents initiate and maintain an annual report of their activities and credentials (see neurology
credentials information packet) for the duration of their residencies. Each annual report includes
the weekly schedule of activities and summary of their schedule for the year. The resident and the
RA must sign each report. Residents retain the original reports and update the progress reports in
their entirety every 12 months. The PD and the RA receive a copy of the credentials report. A list of
required submissions, along with the procedures for submitting training documents, is provided on
the candidates’ webpage on the ACVIM website. If deficiencies are found in a resident’s activities,
they will be notified of their deficiencies. If the deficiencies are not corrected, it may result in the
resident not being allowed to take their specialty examination during their 3
rd
year of training.
The Resident and their RA document that training occurred as specified. RAs ensure that the
resident submit annual reports of their progress to the Neurology RTC by the date specified on the
ACVIM website following the end of each year of residency and upon completion of the program.
In addition, the resident must submit the annual program reports to the Neurology RTC by the date
specified on the ACVIM website of the year before the date the resident plans to take the
Neurology Specialty Examination. The appropriate SD signs off on this report. The report follows
the standardized spreadsheet format found on the ACVIM website. The resident submits this
information via the website for review by the Neurology RTC. The resident ensures that their RAs
keep these standardized evaluations on file in case the Neurology RTC requests the information.
7.I Residency Training Interruption
Training interruptions may be unavoidable in circumstances where a resident must switch from one
RTP to another to fulfill all RTP and credentialing requirements. In such cases, the following steps
must be taken:
● A new training program must be identified
● The Neurology RTC must approve the new RTP before the onset of clinical training
● The resident must reregister with ACVIM in the new RTP
● The resident must complete training in continuous blocks of time once training resumes
In some circumstances, a resident may need to take a leave of absence, which prevents that
individual from completing the traditional RTP on time. When a leave of absence is necessary, the
resident has a maximum of four years if enrolled in a traditional two-year RTP or five years if
enrolled in a traditional 3-year RTP to achieve board certification.
Residents in interrupted programs when actively engaged in the residency must attend full time in
no less than 20 weeks of training in any residency year, e.g. the 12 month period beginning with
the first day of their residency. If a resident interrupts their training, a new residency year begins on
the first day in which they resume training.
Training must occur in 5 blocks of time with four continuous weeks in each block for those portions
of the residency that must be completed in Training Weeks (see Section 4.F.11). Blocks may run
consecutively or be separated, but each block must be 4 weeks in length.
In some cases, a resident may complete a portion of training at another approved RTP or research
unit/mentor. In those cases, the second RTP or the research unit/research mentor is considered a
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secondary training site. The Neurology RTC must approve that relationship as part of the RTP
submission, along with all appropriate supporting documents from the primary training site.
7.J Neurology Credentials for the Specialty Examination
Candidates must include the following credential items in their Neurology Specialty Examination
applications:
● The completed credentials specialty examination application packet as described in the
neurology information packet
7.J.1 Procedures for Submitting Credentials
***Always check the ACVIM website prior to submission; this process is subject to change.***
The information listed in this section provides an overview of the procedures for submitting
credentials. Specific guidelines are in the neurology credentials information packet. Because
application requirements change periodically, candidates must be sure they are using the
most current application and credentials packet. If a candidate has any questions regarding
the application process, that individual should request clarification in writing from the
Neurology RTC chair or from the ACVIM office before the submission deadline.
Residents must be registered in an approved traditional or non-traditional RTP and be trained
under the supervision of a RA before submission of their credentials application packet.
Candidates certified in the ACVIM specialties of Large Animal Internal Medicine (LAIM), Small
Animal Internal Medicine (SAIM), Cardiology, or Oncology who aspire to become Neurology
Diplomates must complete a minimum of a 75-week Neurology RTC-approved Neurology
RTP. They must receive training under the supervision of a RA.
Candidates may submit complete credentials packets and the credentials fee online to the
ACVIM office following completion of a two-year residency, after 22 months of a three-
year residency, or after the equivalent time in any other approved residency provided these
candidates are in the final year of that program. Candidates in approved non-traditional
residencies may submit completed credentials packets and fees following completion of
equivalent time, provided it is in the final year of the program.
If an individual is ACVIM board-certified in a specialty other than neurology and is participating
in an ACVIM registered neurology residency, that individual may submit credentials within the
final 12 months of the Neurology RTP. The Neurology RTC evaluates submitted credentials
packets for completeness and accuracy.
A candidate who intends to take the Neurology Specialty Examination must electronically
submit credentials including letters of reference for the Neurology Specialty Examination so
that the ACVIM office receives the credentials packet no later than the date specified on the
ACVIM website of the year preceding that examination date. Materials are forwarded to the
Neurology Credentials Committee chair. Each candidate is notified no later than 60 days after
the submission deadline regarding the acceptability of the submitted credentials packet for the
Neurology Specialty Examination. All candidates must submit the current standard neurology
application form along with the other required documents. They must carefully follow the
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instructions provided in the credentials packet as inadequate attention to detail may cause the
entire application to be rejected.
7.J.2 Credentials Items to be Submitted
***Always check the ACVIM website prior to submission; this is only a partial list and is
also subject to change.***
Candidates must include all items that are specified on the Candidate’s Webpage on the
ACVIM website to have a complete credentials packet.
The Resident’s Report of Annual Progress form will provide much of the required information
and so must be filled out completely and accurately:
● The completed application form;
● Letters documenting successful completion of rotations outside the SI, if applicable.
The person from the outside facility who had oversight of an applicable rotation must
sign the letter;
● Reference forms or letters;
● Candidates must have three associates with whom they have worked in their training
program submit either an ACVIM Neurology Referee Form or a letter of reference,
which may be used in lieu of the form. At least one reference must be from the RA
who supervised the major part of the resident’s training. The reference forms or
letters and copies are forwarded as directed in the credentials packet. The candidate
ensures the reference letters arrive at the ACVIM office by the date specified on the
ACVIM website of the year before that the candidate intends to take the examination.
7.J.3 Evaluation of Credentials for the Neurology Specialty Examination
The ACVIM office and the Neurology Residency Credentials Committee (RCC) review all
candidate applications and credentials packets. A reviewer assigned by the Neurology RCC
evaluates and rates a candidate’s credentials as acceptable or unacceptable. The reviewer
records the evaluation results on a standard form, which the ACVIM office retains. The
Neurology RCC Chair compiles the reviewer’s evaluation comments for unsuccessful
candidate’s credentials. The ACVIM office sends the compiled comments to the candidate.
The ACVIM office notifies candidates regarding acceptance or rejection of their credentials
within 60 days of the deadline for credentials submission. Candidates can expect a response
to their requests to take the Neurology Specialty Examination within 30 days of applying.
7.J.4 Neurology Specialty Examination Registration and Fee
Once credentials are approved, candidates may register for the Neurology Specialty
Examination and pay the fee online to the ACVIM office by the date specified on the ACVIM
website in the year before that they intend to take the examination. Candidates retaking all or
part of the Neurology Specialty Examination must pay online by the date specified on the
ACVIM website of the year they plan to take the examination.
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7.J.5 Neurology Specialty Examination Content and Format
***Always check the ACVIM website; the examination format is subject to change.
Any changes will be reflected in the current examination blueprint.***
The Neurology Specialty Examination is comprehensive and composed of multiple-choice questions on
aspects of all areas of neurology. The examination emphasizes neuroimaging, neuropathology,
electrophysiology, neurosurgery and clinical cases. These sections require candidates to interpret actual
case materials presented as images in various formats, specimens, imaging modalities, electrodiagnostic
results, or videography recordings.
ACVIM Neurology Diplomates use subject matter experts and statistical equating to maintain the standard
of the specialty examination and cut score determination. A candidate must pass the entire examination to
become certified.
A blueprint of the Neurology Specialty Examination is posted on the ACVIM website at least 60
days before the examination date. More specific information on grading the examination is
provided in the instructions distributed to candidates taking the examination at least 60 days before
the examination date.
7.K ACVIM Diplomate Certification
Defined in Part One.
7.L Maintenance of Credentials
The Neurology Maintenance of Credentials (MOC) Committee maintains a list of acceptable
continuing education experiences and their associated points that count toward renewal of
neurology credentials by ACVIM. This information is available on the ACVIM website.
7.M Online Exit Interview Survey
After completing an RTP (new Diplomate or candidate), you are strongly encouraged to fill out an
online survey regarding the quality of the training experience within 90 days of completion of the
RTP.
Responses are shared with the appropriate PD with the goal of providing important feedback
regarding their residency training. Data, held strictly confidential annually, will be published as a
five-year rolling average score per surveyed category calculated for each RTP and will be released
every three years to ensure anonymity of candidates that completed smaller programs.
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8. Requirements for the Specialty of Oncology
The American College of Veterinary Internal Medicine (ACVIM) offers certification of specialists in
Oncology. The residency training program (RTP) is the foundation of training for ACVIM Diplomates in
Oncology. This section of Part Two explains the requirements for oncology RTPs, and for residents and
the requirements for candidates working toward certification in this specialty that are in addition to the
requirements specified in Part 4, which are required of candidates in all specialties.
8.A Abbreviations
CC: Credentials Committee
PD: Program Director RA: Resident Advisor
RTC: Residency Training Committee
RTP: Residency Training Program
SD: Supervising Diplomate
SI: Sponsoring Institution
8.B List of Required Specialty of Oncology Forms
Oncology RTP Registration Form Standardized Weekly Spreadsheet
Standardized Resident Evaluation Form Credentials Packet
Specialty Credentials Application Form ACVIM Oncology Reference Form
Application to take the Specialty of Oncology Examination
List of reading / study resources for the Specialty of Oncology Examination
Blueprint for the Oncology Specialty Examination (60 days before the Examination date)
8.C Process for Achieving ACVIM Oncology Diplomate Status
At a minimum, achievement of ACVIM Oncology Diplomate status (“Board Certification”) requires
that candidates meet the following criteria:
● Register with the ACVIM at the start of their Residency Training Program (RTP);
● Successfully complete an approved ACVIM RTP in Oncology. The resident should
complete the entire RTP within three years, but under extenuating circumstances (a non-
traditional RTP may be approved by the RTC), within a maximum period of five years
beginning with the first day of the residency; (see sections 4.D and 4.E above);
● Submit annual reports of their progress in the RTP;
● Register with the ACVIM to take the ACVIM General Examination (after a minimum of 18
months of the RTP is completed);
● Attain a passing score on the ACVIM General Examination;
● Register with the ACVIM to take the ACVIM Specialty of Oncology Examination;
● Submit Credentials for evaluation by the Specialty of Oncology CC;
● Attain a passing score on the ACVIM Specialty of Oncology Examination;
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● Complete the publication requirement for the Specialty of Oncology as specified in the
Certification Manual version that was in effect the year the resident started their RTP.
Although the publication requirement is specific to the year that a resident begins their
RTP, there may be procedural changes that become effective during a residency. Those
procedural changes, which may include updates in the approved journal list, are in effect
from the date of approval. So, all residents/candidates should verify that they are following
the most current procedures prior to submission of their publication to a journal;
● Receive Specialty of Oncology CC certification that the credentials submitted by the
candidate are complete and meet all requirements.
If a candidate fails to complete the board certification process within eight years of starting their
continuous three-year traditional RTP or within five years from the end date of a non-traditional
residency, that person’s status changes from active to inactive. The candidate may not resubmit
credentials or participate in additional examination attempts and becomes ineligible to become
board-certified (see sections 4.D and 4.E above).
8.D Annual Report during the RTP
Residents are required to submit an annual report of their progress for evaluation by the CC,
consisting of a record of completed weeks with each requirement signed by the appropriate SD. A
standardized spreadsheet will be provided for this purpose by the CC. The RA must keep the
residents standardized schedule forms on file (forms available on the ACVIM website) should the
information be requested by the CC.
8.E Registering for the ACVIM General Examination
The application (including examination questions, application document, and supporting RA letter)
must be submitted online to the ACVIM office before the date specified on the ACVIM website of
the year preceding the exam. The ACVIM office reviews all of the application materials and notifies
the candidate of status within 30 days of the submission deadline.
8.F Procedures for Submitting Credentials for the Specialty Examination in Oncology
***Always check the ACVIM website prior to submission, as this process is subject to change.***
Because application requirements change periodically, candidates must be sure they are using the
most current application and credentials packet when submitting their registration form. The
residency training requirements in effect at the beginning of a residency will remain in effect for the
duration of each candidate’s RTP, there may be changes in specific forms, dates of submission of
information, fees, etc. that will take place during an RTP and that will be effective for all
residents/candidates at the time of implementation. If there are any questions regarding the
application process, the candidate should request clarification in writing from the Oncology CC
chair or the ACVIM office before the submission deadline.
Residents may submit credentials in the final twelve (12) months of their program.
Candidates must submit credentials (including reference letters) to the ACVIM office by the date
specified on the ACVIM website of the year before they will attempt the ACVIM Specialty
Examination in Oncology. (See also: Part 1 – ACVIM website).
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8.F.1 Credential Items to be Submitted
***Always check the ACVIM website prior to submission, as this list is subject to change.***
The following must be included in the application to be submitted online:
The completed application form & credentials fee;
●
A copy of the resident’s first author or dual first author (e.g. a resident and a
graduate student) publication or signed letter from an CC approved journal indicating
full acceptance;
● An updated curriculum vitae;
● Letters documenting successful completion of rotations at facilities other than the SI
(if applicable). These letters must be signed by the SD who was responsible for
oversight of the rotation;
● Reference forms or letters: Applicants must have three associates with whom they
have worked in their training program submit either an ACVIM Oncology Referee
Form or a letter of reference. At least one reference letter must be from an ACVIM
Diplomate certified in the Specialty of Oncology. The reference forms or letters
should be forwarded as directed in the credentials packet;
● A complete weekly record of the candidate’s RTP contact time, including Journal
Club and rounds schedules. This should be complete and include any previously
submitted Annual Reports.
8.F.2 Evaluation of Credentials for Specialty Examination in Oncology
The ACVIM office and the Oncology CC review all applications and credentials packets. The
candidate credentials will be evaluated and rated as acceptable or unacceptable by the CC.
The CC reviewers will record the evaluation on a standard form that will be retained by the
ACVIM office. Reviewer comments will be compiled by the Chair of the CC and sent by the
ACVIM office to each unsuccessful candidate. The ACVIM office will notify the candidate of
the acceptance or denial of his/her credentials within sixty (60) days of the deadline for
submission of credentials.
8.F.3 Registration and Fee for Taking the Specialty Examination in Oncology
Once credentials are approved, residents may register for the Specialty Examination in
Oncology. Candidates attempting or re-attempting all or part of the Specialty Examination in
Oncology must pay online by the date specified on the ACVIM website of the year they plan to
take the examination. Candidates will receive confirmation or denial of eligibility to sit the
exam within 30 days.
8.F.4 The Specialty Examination in Oncology Content and Format
***Always check the ACVIM website, as the examination format is subject to change. Any
changes will be reflected in the current examination blueprint.***
ACVIM Oncology Diplomates use subject matter experts and statistical equating to maintain
the standard of the specialty examination and cut score determination.
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The Specialty Examination in Oncology consists of two sections that cover all aspects of
oncology and that are graded separately. The sections are:
● Basic Science
o Multiple choice questions on aspects of basic science relevant to oncology
● Applied Clinical
o Multiple choice questions on aspects of applied science relevant to oncology
● Multiple choice questions on clinical application and patient management
The scores for these two Clinical parts are combined for a final grade.
In the Applied Clinical Section, case histories are used to present diagnostic and therapeutic
problems. Interpretation of clinical pathology, diagnostic imaging, and cytology images is
required. Problem solving is emphasized.
The examination includes all aspects of oncology with special emphasis on medical oncology,
but will include questions related to radiation oncology, surgical oncology, and tumor biology.
A current list of reading/study resources is available for candidates.
An examinee must pass each section of the Specialty of Oncology Examination. Failure of
one, or both, section(s) of the examination will require retaking and passing the failed
section(s). Once a section of the Oncology Specialty Examination has been passed, it does
not need to be retaken.
A blueprint for the Specialty of Oncology Examination will be posted on the ACVIM website at
least 60 days prior to the examination date.
8.F.5 Publication Requirement
To become board-certified in the Specialty of Oncology, the candidate must have a minimum
of one publication in print or accepted for publication in a refereed scientific journal. The
subject of the paper must be in the field of veterinary oncology. A literature review or a case
report does not qualify. The candidate must be the first author or a dual first author (e.g. a
resident and a graduate student) and a copy of the publication must be submitted
electronically with the rest of the required credentials.
The publication must be written in English (or a translation provided) and be in a refereed
scientific, medical or veterinary medical journal. A refereed journal is one that is governed by
policies and procedures established and maintained by a standing editorial board which
requires critical review of all papers and approval by at least one recognized authority on the
subject.
Book chapters or conference proceedings do not fit these criteria. Acceptable Journals adhere
to the principles of peer review and are MEDLINE® indexed.
Published manuscripts that were used to meet the credentialing requirements of other ACVIM
specialties cannot be used to meet the oncology requirements.
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However, the candidate may use an otherwise acceptable manuscript that is based on work
completed during programs other than their oncology residency, including, but not limited to
internships, non-ACVIM residencies, MS, and PhD programs. Manuscripts from previous
programs must be published within five (5) years (either direction) of the candidate’s oncology
residency start date.
For the purposes of meeting the credentialing requirements of the Specialty of Oncology, an
article is deemed as accepted for publication when the author has received one of the
following:
● A letter, on the journal’s letterhead, or electronic communication from the editor
stating that the article has been accepted for publication;
● A letter, on the journal’s letterhead, or electronic communication from the editor
stating that the article has been approved for publication by all reviewers and is now
only awaiting editing prior to publication;
● A galley proof of the article with a cover letter from the editor, on the journal’s
letterhead or an electronic communication stating that the article is scheduled for
publication.
The article and acceptance letter or electronic communication (if the article has not yet gone
to print) should be sent electronically to the ACVIM. Any letter or communication from an
editor that states there are reviewer comments to be addressed, no matter how minor the
comments, will be considered unacceptable for credentialing purposes as that letter implies
final review by the reviewers has not been completed.
If a candidate is unsure if a response from a journal is considered as “final acceptance,” the
Chair of the CC should be petitioned in writing. A minimum of six (6) weeks may be needed
for the CC to respond to a request for clarification.
An accepted publication is not required to take the Oncology Specialty Examination; however,
the Certification process is not complete until acceptance of publication is documented. The
publication must be in print, online, or accepted with no revisions required before the
candidate will receive a Diplomate certificate.
8.G The Residency Training Program
8.G.1 Oncology Residency Training Committee
The Oncology Residency Training Committee (Oncology RTC) consists of at least five
members appointed by the specialty president and is responsible for monitoring the
satisfactory progress of all residents and compliance with CM requirements for all RTPs in the
Specialty of Oncology.
The Oncology RTC expects RTPs to be cohesive, integrated, stable, ongoing programs that
continually raise the standards in oncology, while training highly capable oncologists whose
capabilities build upon those of their mentors.
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8.G.2 Acceptable Oncology RTPs
A listing of the current Oncology RTPs approved by the RTC is available from the ACVIM
website or upon request from the ACVIM office.
8.G.3 Correspondence and Inquiries
Registration forms, lists of approved Oncology residencies, and Specialty credentials packets
are available online or by request from the ACVIM office. Residents may contact the Chair of
the RTC to ensure that their program is in compliance with the ACVIM and the Specialty of
Oncology requirements.
8.G.4 Institutional Requirements for Approved Oncology Residency Training Programs
● Oncology RTPs are a minimum of three (3) years;
● There must be a minimum of two ACVIM Oncology Diplomates with clinical SD
responsibility at the primary training site of the residency for an Oncology residency to be
approved or to maintain approval (annual renewal of the residency);
● There shall be no more than two Oncology residents per ACVIM Oncology Diplomate (full
time employees) in an RTP;
● It is essential that the resident have face-to-face contact, in person with their SD in the
Specialty of Oncology. Remote supervision is acceptable when necessary, e.g. to
promote safe physical distancing for health reasons. The definitions of Direct and Indirect
Supervision are found in Part One.
8.G.5 Objectives of the Residency Training Program
● To provide intensive training in oncology, including major responsibility for the care of
patients with neoplastic disease. During training the resident should acquire a broad
working knowledge of anatomy, physiology, and pathology of all body systems, and in-
depth knowledge of the effects of cancer on the tumor-bearing host;
● To ensure that the resident will acquire proficiency in oncology by exposure to a sufficient
number and variety of cases representing all facets of oncology in a hospital equipped for
a specialty practice of Oncology;
● To ensure that the resident will acquire a comprehensive understanding of safe handling
of chemotherapy agents in veterinary practice;
● To provide experience and training sufficient for the resident to understand the
fundamentals and applications of diagnostic methods including hematology, blood
chemistry and urinalysis, surgical pathology, cytopathology, radiology and other imaging
methods and immunology;
● To provide experience and training sufficient for the resident to gain in- depth knowledge
of cancer treatment methods including surgery, chemotherapy, radiation therapy,
cryosurgery, and immunotherapy and be aware of important investigational methods of
therapy;
● Although clinical training will, in most cases, emphasize small companion animals, the
resident should gain awareness and understanding of the important neoplastic diseases
in other domestic species and common laboratory animals;
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● To provide designated time for residents to gain experience in the following:
o Basic science and/or clinical research as part of a residency-based project;
o Clinical trial design and implementation.
8.G.6 Clinical Milestones for First Year Oncology Residents
● Basic understanding of cancer biology, chemotherapeutics, and cancer patient care;
● Ability to effectively manage clinical aspects of internal medicine and oncology patients;
● Understand safe handling practices for chemotherapy in veterinary oncology practice to a
level sufficient to inform other clinicians and support staff;
● Ability to effectively co-manage radiation oncology and surgical oncology patients with
their respective specialty clinicians;
● Communicate effectively and clearly to build rapport and trust with clients and referring
veterinarians;
● Become highly skilled in working collaboratively with clients regarding treatment options
including palliative therapies and euthanasia;
● Ability to perform a literature search and review;
● Develop an idea for investigation, design a research project, obtain funding if necessary
and begin investigational procedures.
8.G.7 Clinical Milestones for Second Year Oncology Residents
● Attain an advanced understanding of cancer biology, chemotherapy, radiation therapy,
immunology and cancer patient care;
● Become highly skilled in referring veterinarian and client communication skills, including
client grief counseling;
● Understand study design and read, understand and critique published clinical studies;
● Develop a basic understanding of grant design and writing, and public speaking;
● Give a scientific presentation to professional peers;
● Continue progression with a research project;
● Take and pass the ACVIM General Examination.
8.G.8 Clinical Milestones for Third Year Oncology Residents
● Develop a more advanced understanding of cancer biology, chemotherapy, radiation
therapy, immunology and have become proficient at their application to patient care;
● Develop advanced public presentation skills;
● Ability to communicate in a work setting with challenging individuals in a manner that
supports the best possible outcome for the oncology patient;
● Well-developed understanding of study design and ability to read, understand and critique
published studies;
● Complete a research project with data collection and analysis and prepare a manuscript
for publication;
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● Take and pass the Specialty Examination in Oncology;
● Publish a manuscript that is accepted by the Oncology CC.
8.H Distribution of Time in Training
An approved RTP requires a minimum of 108 weeks of clinical training following at least one year
of training (internship or equivalent) in general medicine and surgery.
The resident should complete the entire RTP within three years, but under extenuating
circumstances and with RTC approval, within a maximum period of five years from the start of the
residency. Under unique circumstances, a PD may petition to have extra weeks added to the end
of an RTP to allow a resident to complete a residency. Part-time RTPs in Oncology will not be
approved, although in exceptional circumstances a non-traditional RTP may be approved which will
consist of non-contiguous blocks of full-time training (see sections 4.D and 4.E above and 8.T
below).
8.I Training Week
A directly or indirectly supervised work week is defined as a minimum of four, ten- hour days or
five, eight-hour days to account for the 40 hours per calendar week. Normally, Training weeks are
acquired in 2-week blocks. If needed, to meet physical distancing requirements, 1-week blocks
may be accrued.
Training must occur in a minimum of two-week blocks, except where specified. Partial weeks and
split weeks, one-part specialty clinical and second part another requirement will be acceptable
when necessary to meet physical distancing requirements, in order to allow a resident to continue
forward progress. A full week is defined as more than 32 hours and a partial week is defined as
more than 16 hours in those circumstances where a resident is accruing time in either split weeks
or partial weeks. Under all other circumstances, the 40 hour definition of a Training Week remains
in effect.
8.J Patient Care
The resident will actively participate in the management of oncology patients, including patient
receiving, diagnostic testing, patient management and decision-making, client communication,
appropriate follow-up and professional communication with the referring veterinarian. Patient
management should be supervised and be reviewed by the SD.
8.K Clinical Case Conferences (Rounds)
While on clinic duty, residents are required to participate in daily patient-oriented rounds with the
appropriate SD. These rounds may include remote communication between the SD and the
resident.
8.L Intensive Clinical Training in Oncology
Academic degree programs (MS or PhD) cannot be substituted for intensive clinical training.
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A minimum of seventy-four (74) weeks must involve intensive training in oncology supervised by
ACVIM board-certified Diplomate(s) in the Specialty of Oncology.
These 74 weeks are comprised of Direct supervision for a minimum of 50 weeks and Indirect
supervision for an additional number of weeks to total 74 weeks under an Oncology SD. Direct
and Indirect supervision may include one-to-one remote communications.
8.M Clinical Training in Other Specialties
Because oncology is a multimodal discipline, the resident must also have clinical training under the
direct supervision of SSSDs in other disciplines. This contact may occur at a secondary training
site; however, in the written program proposal to the Oncology RTC the SI must provide the names
of the SDs involved, their areas of specialization, and details about the anticipated professional
interaction.
A minimum of 32 weeks must be spent actively receiving patients in affiliated rotations or meeting
requirements through rounds. During that time, the resident must be under the direct supervision
of the affiliated board-certified specialist and must participate in the affiliated specialty to the level
at which they are capable. For each off-site rotation included in the 32 weeks of clinical training in
other specialties, the resident should obtain written approval from their RA, who will forward
documentation of this approval to the RTC. The CM allows for remote training with appropriate
specialists as SD (only if that specialty is NOT available at the training institution – the RTC will
need a letter from the RA supporting the virtual format, including documentation of intended daily
interactions/how the time will be spent. The expectation is that the resident attends daily
rounds/case discussions, performs literature reviews/attends virtual JC and discusses cases under
(remote) supervision of RA just like that resident would do in person. A full week is considered a
minimum of 32 hours during the pandemic so we would expect the resident to spend that amount
of time working on rotation related matters. The CC will also need a letter from the resident post
rotation documenting how the time was spent, with the letter signed off by the RA to ensure
satisfactory completion). The CM now allows for 1-week blocks. It also allows for use of guided
case studies, case rounds, etc. as supervised by the RA and appropriate SDs if cases are not
actively being seen at the SI due to health restrictions.
8.M.1 Required Affiliated Rotations
Radiation Oncology
● At least eight weeks (completed in blocks of at least two weeks) of direct supervision
with a veterinary radiation oncologist to develop an understanding of clinical
management of patients receiving radiation therapy, radiation planning, dosimetry
and physics related to clinical radiation therapy. See 8.M above for acceptable
variances in meeting the two week block requirement.
Clinical Pathology
● Two weeks (40 hours) of clinical pathology; this may be met through weekly/biweekly
rounds. To satisfy this requirement, the resident may accumulate Training Hours
(see 4.F.14 above) with 40 Training Hours being equal to one Training Week. One-
on-One remote communication may be used in meeting this requirement.
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Surgical Pathology
● Two weeks (40 hours) of surgical pathology; this may be met through
weekly/biweekly rounds. To satisfy this requirement, the resident may accumulate
Training Hours (see 4.F.14 above) with 40 Training Hours being equal to one
Training Week. One-on-One remote communication may be used in meeting this
requirement.
Diagnostic Imaging
● Two weeks of diagnostic imaging with direct supervision by a board-certified
radiologist in addition to any interactions during case rounds – This requirement may
NOT be satisfied by accumulation of Training Hours, it requires two (2) formal
Training Weeks. See section 8.M above for acceptable variances in meeting the two
week block requirement.
Small Animal Internal Medicine
● Four weeks with direct supervision by an ACVIM Small Animal Internal Medicine
(SAIM) Diplomate. This may be a single four-week rotation or two blocks of two-
weeks apiece. See section 8.M above for acceptable variances in meeting the two-
week block requirement.
8.M.2 Other Rotations
Fourteen (14) additional weeks of other rotations with an ACVIM Diplomate in the Specialty
of Oncology, or training under the supervision of a member of an American Board of
Veterinary Specialties (ABVS) or European Board of Veterinary Specialisation (EBVS)
approved specialty (such as, but not limited to, the American College of Veterinary
Radiology, the American College of Veterinary Radiology (Radiation Oncology), European
College of Veterinary Neurology, the American College of Veterinary Pathology, ACVS, or
ACVECC) may also occur during these 14 weeks.
With the exception of clinical and surgical pathology, all of the affiliated rotations must be
completed in two (2) week blocks, unless there are extenuating circumstances (such as
illness or family emergency), and the exceptions are approved by the Oncology RTC. In
this case, specifically approved one-week blocks would be acceptable. See section 8.M
above for allowed variances in the two week block requirement.
If a resident is board-certified in one of the required affiliated specialties, they are not
required to complete additional directly supervised time in that specialty. For example, a
SAIM Diplomate is not required to complete additional rotations in small animal internal
medicine as part of an Oncology residency. Instead, the resident spends four weeks of
directly supervised time receiving patients in one or more of the other approved affiliated
rotations.
For each off-site rotation to be included in the 32 weeks of clinical training in other
specialties, the resident should obtain written approval from their Resident Advisor (RA),
who will forward documentation of this approval to the RTC.
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8.N Unsupervised Time
Six weeks of an oncology residency may include unsupervised time. Attendance at continuing
education meetings related to oncology, uncompromised time to study for examinations and
independent study are categorized as unsupervised time that may be considered part of the
residency training.
8.O Research
The resident is expected to actively participate in a laboratory or clinical investigative research
project during the residency. A minimum of eight weeks (320 hours) of an oncology residency
should be dedicated to this aspect of training.
Research time should be scheduled as either weekly time (hours per week) or in blocks of time
sufficient to complete the research, perform data analysis and prepare a manuscript for publication
by the third year of their residency (see Recommended Milestones). This experience must be
documented, with dates, and signed by the SD.
8.P Journal Club
An organized and routinely scheduled Journal Club of at least 80 hours over the course of the RTP
must be an integral part of all RTPs. Teleconferencing and programs having a joint Journal Club is
acceptable when necessary. Journal Club must be attended and supervised by a SD. The RTP
application requires a schedule of proposed Journal Club for Oncology RTC approval and the RTC
may ask for documentation that Journal Club actually met, e.g. dates and articles discussed, if
there are questions raised during a program’s annual evaluation.
The purpose of the Journal Club is to provide structured learning time and to facilitate the
residents’ abilities to critique and appraise peer-reviewed, evidence- based publications that
pertain to aspects of veterinary oncology. This may take the form of reviewing a single publication,
or a group of publications in one aspect of veterinary oncology. Supervision by the SD is important
to guide critical evaluation of each journal article. One suggested approach is to:
● provide a description of the study (identifying the research question and or problem);
● evaluate the literature review/introduction for completeness;
● describe and evaluate the appropriateness of study design used to evaluate the
research question, the effectiveness of the sample size and the statistical methods
used;
● review the results of the research and comment about the appropriateness of the
authors interpretations of those results;
● discuss how the publication may change the approach to the disease or process
and how the results may lead to new questions or research.
8.Q Seminar or Lecture Series and Formal Conferences
Residents must attend/participate in formal teaching conferences in oncology and related
disciplines throughout the residency. Unless these are formal lectures or classes, an Oncology SD
supervises the conferences; these should occur an average of four times per month. These may
include remotely presented conferences or classroom experiences.
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Examples of these are clinical pathology conferences, resident seminars, and grand rounds
sessions, Journal Clubs, and tumor biology classes. Conferences given within a veterinary practice
or hospital or at a medical school or medical teaching hospital are acceptable. The RTP
application includes the format and schedule of these conferences and presentations for Oncology
RTC approval.
The resident must give a formal presentation at such a conference at least once per year.
Documentation of these presentations must be included in the oncology credentials packet of the
resident. A presentation at a regional, state, or national meeting may substitute for this
presentation; a copy of the program must be included in the oncology credentials packet of the
resident.
8.R Continuing Education Conferences
Residents must attend/participate in at least one state, regional, national, or international
veterinary or human medical continuing education conference during their residency.
Documentation of attendance/participation at the conference must be included in the oncology
credentials packet of the resident/candidate.
8.S Formal Examination Review Sessions
An Oncology RTP must provide at least 40 hours per year of intensive formal review sessions for
residents/candidates on topics covered in the general and specialty examinations. Attending daily
clinical rounds does not meet this requirement. The requirement could be met in part by
attending/participating in an ACVIM course, by attending an ACVIM Forum, or formal resident
review sessions at a Veterinary Cancer Society Annual Meeting. These may include on-line
reviews and remotely presented conferences, e.g. ACVIM ACE Science of Oncology course. An
oncology RTP must provide annual documentation of these formal reviews to the Oncology RTC.
8.T Non-Traditional Training Programs
It is possible to achieve certification in the Specialty of Oncology in a non- traditional RTP, but all
of the training requirements of a traditional residency must be satisfied. Thorough justification must
be made for a non-traditional residency to be approved by the Oncology RTC, and the training
period may not exceed 5 consecutive years. If the 108-week clinical training program is not
continuous, it must be arranged in blocks of time no less than 2 weeks of full-time training per
block with a minimum of 20 weeks per year. Non-traditional residency RTPs must be submitted by
the PD to the Oncology RTC for approval at least 90 days in advance of the residency start date.
The candidate resident and his/her PDs, RAs, and SDs are responsible for documenting that the
training has occurred as specified. If a residency occurs at multiple sites, all training requirements
for both direct and indirect supervision, as well as requirements for rounds and conferences,
equipment, and staffing must be met at each site. Such programs will be required to provide lists of
SDs and schedules of conferences in which the resident participates for each site.
Candidates have up to five (5) years after successful completion of a non- traditional residency to
complete the certification process. Failure to complete the certification process within 5 years will
result in that individual’s status changes from active to inactive and is no longer eligible to become
board-certified (see sections 4.D and 4.E above).
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8.U Responsibilities of the Sponsoring Institution
8.U.1 Documentation and Verification
Outlined in Part One. Specific to Oncology, the Sponsoring Institution should fulfill the
following criteria.
8.U.2 Facilities and Equipment
The resident must have routine on-site access to adequate diagnostic facilities including
standard radiographic, ultrasonographic, electrocardiographic, and endoscopic equipment.
Access to nuclear medicine, computerized tomography (CT) or magnetic resonance imaging
(MRI) is strongly recommended, although it is not required to be on-site.
The resident must have access to a facility which provides radiation therapy and to a
veterinary radiation oncologist who is board-certified in Radiation Oncology for the required 8
weeks of supervised training.
The resident must have access to 24-hour emergency and critical care facilities on-site. A
board-certified veterinary clinical pathologist or anatomic pathologist and a fully equipped
clinical laboratory facility should be routinely available for evaluation of and consultation about
clinical material submitted, at a minimum for timely phone consultation. In addition, there
should be at least eighty (80) hours of direct contact with a board-certified pathologist to
facilitate the required training in diagnostic clinical cytology, and a minimum of eighty (80)
hours of direct contact with a board-certified pathologist to facilitate the required training in
surgical histopathology. The resident should have access to a veterinary medical library with
on-line searching capacity and, at a minimum, access to all textbooks and full text access to
all journals on the current examination committee reading list.
8.U.3 Supporting Disciplines Required
There must be an ACVIM SAIM Diplomate with ≥50% FTE at the primary training site of the
residency for an Oncology RTP to be approved or to maintain approval (annual renewal of the
residency). There must be an ACVS Surgery Diplomate with ≥50% FTE at the primary training
site of the residency for an Oncology RTP to be approved or to maintain approval (annual
renewal of the residency).
8.V Responsibilities of the Program Director
8.V.1 Oncology Residency Training Program Registration and Evaluation
The PD must be an ACVIM Diplomate, although it is not required that the PD be a Diplomate
in the Specialty of Oncology. Each Oncology RA and SD in Medical Oncology must be an
ACVIM Diplomate in Oncology. The PD must submit a completed Oncology RTP Registration
Form to the ACVIM office for review by the Specialty of Oncology RTC by the date specified
on the ACVIM website of each year. The Oncology RTC will approve the program or provide
details of those deficiencies that must be corrected before the program is approved.
As part of the RTP registration, the PD must provide a written plan for allowing residents to
continue their training should the RTP be placed on probation or terminated for any reason.
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Each year, the PD must update and re-register each RTP to ensure each program remains
approved and in good standing to train residents/candidates in oncology.
8.V.2 Resident Evaluation
The RA and PD, or Residency Training Committee at the SI will review the progress of all
residents for the duration of the program and provide written evaluation to the residents.
Resident evaluation occurs no less frequently than every six months. See more to follow
under Responsibilities of Resident Advisor. The RA must have the resident sign the RAs copy
of the written evaluation to confirm that the resident received a copy of the evaluation and had
the opportunity to discuss it with the RA (or SI Residency Training Committee). The Oncology
CC may ask for copies of these evaluations if there are questions raised during a program’s
annual review.
8.V.3 Program Probation
Failure of the PD to submit the appropriate information regarding their RTP (whether the
program is in good standing or on probation) to the RTC within 30 days of the deadlines
published in this Certification Manual may result in a program being placed on probation.
While on probation the RTP may continue to train residents but will not be able to accept any
new residents.
If the program is on probation, and the PD does not respond to the RTC’s request for
documentation regarding their residency within 30 days, the RTP can be terminated.
8.V.4 Program Termination
An RTP may be terminated if that program is on probation and fails to correct the deficiencies
identified by the RTC in a timely manner. In addition, if a program is found to have serious
deficiencies that prevent adequate training of a resident (e.g. loss of all oncologists) or if it is
determined that a PD submitted false or misleading documents, that program may be
terminated directly, without a probationary period. If a program is terminated, it may not be
renewed. A previously terminated program may re-apply as a new program; however, any
time served by a resident after the program was terminated will not count towards completion
of his or her residency.
8.V.5 Substantive changes to an RTP
Substantive changes to an RTP that could lead to non-compliance with the requirements of
the Specialty of Oncology or ACVIM, which will result in probation must be reported to the
Oncology RTC within fourteen (14) days. Such changes include (but are not limited to):
● Having too few ACVIM Oncology Diplomates for the number of residents being
trained;
● If there are too few ACVIM Oncology Diplomates for the number of residents being
trained; the PD will provide the RTC an updated plan for residents currently in
training. A residency trained individual, who has not yet successfully attained Board
Certification, may not be counted as an SD for the purposes of meeting training
requirements;
● Unless a new permanent ACVIM Oncology Diplomate is hired full-time, probation will
continue. A suitable RTC- approved resolution that will allow probation to continue would be
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for the resident to fulfill training at another site (see RTC approval of secondary training
site, or for an RTC-approved ACVIM Oncology Diplomate locum to provide training within
the probation period. During that period, the PD will provide written updates to the RTC in
regards to correcting the deficiencies every three (3) months;
● If locum-training is substituted, probation will continue, and the resident teaching
experience of the locum should be detailed and submitted to the Oncology RTC;
● If the deficiency is not resolved to the RTC’s approval, the RTP will be terminated by
the RTC;
● Having no SAIM Diplomate at the primary training site;
● Having no ACVS Diplomate at the primary training site;
● If one or more of the supporting specialists (listed above) are not at the primary
training site; the RTP will be placed on probation for the remainder of the training
period for all residents currently in training. During that period, the PD will provide
written updates to the RTC with regards to correcting the deficiencies every 3
months. If the deficiency is not resolved at the end of remainder of the training period
of all current residents, the RTP will be terminated by the RTC. If a program is placed
on probation or terminated, ACVIM will notify the PD and all residents currently in the
program of the action against the program;
● In addition, the PD must report the following events to ACVIM, if they occur, within 14
days of their occurrence:
o A resident relocating from one program to another (such relocations require
review and approval by both the Oncology RTC and CC prior to their
occurrence);
o A resident either being placed on probation or being dismissed from the
program;
o A resident beginning another RTP;
o A resident enrolling in an institutional graduate program.
At the time of annual program renewal, PDs and RAs may be asked to verify resident
activities.
8.W Responsibilities of the Resident Advisor
The Resident Advisor (RA) is an ACVIM Oncology Diplomate responsible for the resident during
their RTP. An individual RA may not train more than two oncology residents concurrently. The RA
may also be an SD and/or the PD. The RA signs and verifies all documentation related to a
resident’s completion of program requirements.
In conjunction with the PD, the RA must periodically evaluate the resident (a minimum of once
every six (6) months) and discuss the results of those evaluations with the candidate. The RA is
encouraged to use the Oncology Milestones as an aid in assessment of the strengths and
deficiencies of the resident as well as to monitor the success of the RTP. The RA maintains a
copy of each review until a candidate receives full board-certification, and should be prepared to
submit those copies to the CC, if requested. The resident will sign the RAs copy of the written
review, as documentation that they have been informed of the results of the review.
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In addition to the above evaluations, for each resident the RA will complete the ACVIM
standardized annual Resident Evaluation Form that is available from the ACVIM website. The RA
will provide copies of resident evaluations to the PD who provides them to the Oncology CC, if
requested. The purpose of the evaluation by the CC is to allow the CC, the PD, and the resident
to identify and correct programmatic problems before they would place a program in jeopardy of
probation or termination.
RAs inform the residents to submit annual reports of their progress to the Oncology CC by the
date specified on the ACVIM website following the end of each year of residency and upon
completion of the program.
8.X Responsibilities of the Supervising Diplomate
The SD for oncology training must be an ACVIM Oncology Diplomate (a residency trained
individual whom has not completed Board-Certification is not acceptable as an SD). The SD for all
supplemental training should be an ABVS-approved or EBVS-approved board- certified specialist,
but not necessarily an ACVIM Oncology Diplomate. The SD in the discipline oversees the activities
of the resident during each rotation, (for example the ACVR radiologist during the imaging rotation
is considered the SD). An SD in supplemental rotations must have full-time status during the
period of supervision, even if they have a less than 100% FTE the remainder of their time at the SI.
Residency training in oncology requires the onsite presence of at least two full-time ACVIM
Oncology Diplomates with clinical responsibility for the RTP to be approved or to maintain approval
at annual renewal of the program. These individuals will be the SDs in Oncology.
The SD ensures that the resident receives directly supervised, in-person training from board-
certified specialists in radiation oncology, clinical pathology, diagnostic imaging, surgical
pathology, small animal internal medicine, small animal soft- tissue surgery, and small animal
emergency and critical care. These experiences should occur as defined in specific clinical
rotations found under Distribution of Time in Training.
Direct supervision requires the SD to be on clinics with the resident for clinical rotations, e.g.
clinical and surgical pathology are the exceptions. Review of patient care performance by the
resident should be conducted directly between the SD and the resident. Remote communication
between the SD and the resident may be accepted if necessary to meet public health
requirements.
Indirect supervision is only acceptable by an ACVIM Oncology SD as defined above.
In addition, Journal Club must be attended and supervised by a SD. This may include remote
supervision and participation by both SD and residents.
8.Y Responsibilities of Residents
Residents can access registration forms, lists of approved traditional residency training programs,
examination information and specialty credentials packets online, or from the ACVIM office.
Residents may contact the Oncology RTC to ensure their programs are in compliance with ACVIM
and the Specialty of Oncology requirements.
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Residents and their RA document that training occurred as specified. Residents must initiate and
maintain an annual report of their progress and submit that report online for the Oncology CC by
the date specified on the ACVIM website following the end of each year of residency. The resident
and the RA must sign each report.
Residents retain the original reports and update the progress reports in their entirety every 12
months. In addition, upon completion of the program residents must submit the annual program
reports to the Oncology CC by the date specified on ACVIM Website of the year before the date
the resident or candidate plans to take the Specialty of Oncology Examination. The report follows
the standardized spreadsheet format found on the ACVIM website. The resident submits a copy to
the ACVIM website for the Oncology CC. Residents ensure that their RA keeps these standardized
evaluations on file in case the Oncology CC requests the information.
8.Y.1 Off-site Rotations
For each off-site rotation included in the 32 weeks of clinical training in other specialties, the
resident should obtain written approval from their RA, who will forward documentation of this
approval to the CC.
8.Y.2 Residency Training Interruption
Training interruptions may be unavoidable in circumstances where a resident must switch from
one RTP to another to fulfill all RTP and credentialing requirements. In such cases, the
following steps must be taken:
● A new training program must be identified;
● The Oncology RTC must approve the new RTP before clinical training begins;
● The resident must re-register with ACVIM in the new RTP;
● The resident must complete training in continuous blocks of time once training
resumes.
In some circumstances, a resident may need to take a leave of absence, which prevents that
individual from completing the RTP in three years.
However, when actively engaged in the residency, the resident must attend full time. The
residency must be completed in contiguous blocks of at least 20 weeks of training in any
residency year (a residency year is the 12 month period beginning on the date when a
residency is resumed). When a leave of absence is necessary and approved by the RTC, the
resident has a maximum of five years from the end of the RTP to achieve board certification in
oncology (see sections 4.D and 4.E above).
8.Y.3 Secondary Training Site
In some cases, a resident may complete a portion of training at another approved RTP or at a
separate research facility, which is considered a secondary training site. The Oncology RTC
must approve that relationship as part of the RTP submission, along with all appropriate
supporting documents from the primary and secondary training sites.
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8.Z Maintenance of Credentials (MOC)
The Specialty of Oncology MOC Committee maintains a list of acceptable continuing education
experiences and their associated points that count toward re-credentialing by ACVIM. This
information is available on the ACVIM’s website.
8.AA Frequently Asked Questions for ACVIM Oncology RTPs & Board Certification
What is the difference between direct supervision and indirect supervision?
With direct supervision, the SD must be on clinics with the resident. With indirect
supervision, the SD does not need to be on clinics with the resident but must have at least
one hour of in-person contact time (not by telephone or computer) with the resident each
day (either 4 or 5 days per week). If necessary to meet public health requirements, remotely
conducted one-on-one communication may be permitted.
What procedures should be followed if a resident is going to modify their program, change from
one program to another, or if the faculty members associated with the program change?
Any change in the RTP must be brought to the attention of the Oncology RTC in writing,
before the changes are made to ensure that the proposed changes are acceptable. Any
proposed changes should be submitted to the RTC through the ACVIM Central Office.
Significant changes could include, but are not limited to, transferring from one program to
another, alterations in program duration, changes in supervising personnel
(additions/deletions), beginning another residency training program, or enrolling in an
institutional graduate program. If changes are not approved by the RTC prior to the changes
in the program, the time between the start of the change and approval of the revised
program will not count towards a candidate’s residency.
How many residents can be in a residency training program at any given time?
The RA is an ACVIM board-certified Diplomate in the specialty that the resident is seeking
certification in who is responsible for signing all documentation and verifying the completion
of the program requirements for that resident.
There is no restriction on the number of RAs that a program can have but each RA can be
responsible for a maximum of two residents (i.e. two residents for each Oncology
Diplomate).
What needs to be done to gain approval of off-site rotations?
A letter of support needs to be submitted by the SD of that off-site rotation to the RTC at the
time the program is being approved AND during the annual update (this step is often
overlooked and causes delays in program renewals and approvals).
Each letter of support should specify the number of weeks scheduled at the site and the
rotation requirement that is satisfied. This letter needs to be submitted as part of the
application process for a new program and re-submitted each year with the program renewal
application. For example, if a resident is doing a clinical pathology rotation at another
institution, the clinical pathologist should sign a letter confirming the name of the candidate,
duration and proposed dates of the rotation, and their institutional affiliation.
When can a publication be considered as accepted?
The CC may approve a publication in press (not yet published but accepted for publication)
when there is a letter from the editor on the journal’s letterhead or an electronic
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communication that states that the article has been accepted for publication, or has been
approved by all reviewers and is only waiting for editing prior to publication, or when there is
a galley proof with a letter or electronic communication from the editor stating the article is
scheduled for publication.
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9 Specific Requirements for the Specialty of Small Animal Internal Medicine
The American College of Veterinary Internal Medicine (ACVIM) certifies specialists in Small Animal
Internal Medicine (SAIM). Small animal internists focus on systemic diseases and diseases of internal
organs in dogs and cats. This section of Part Two explains the requirements for SAIM residency training
programs (RTP), and the requirements for residents and candidates working toward certification in the
Specialty of SAIM that are in addition to the requirements specified in Part 4, which are required of
candidates in all specialties.
9.A Small Animal Internal Medicine Residency Training Programs
The RTP is the foundation for ACVIM training of future Diplomates in SAIM. The components of a
SAIM RTP are:
● Sponsoring Institution (SI)
● Program Director (PD)
● Resident Advisors (RAs)
● Other Supervising Diplomates (SDs)
● Residents
The standards contained in this section of the Certification Manual are the minimum requirements
for the SAIM specialty. An individual approved RTP may include additional requirements that then
become part of that specific RTP. A resident must fulfill all the additional requirements that are part
of their approved RTP along with the minimum requirements in this document to successfully
complete their residency.
An SAIM residency embodies more than fulfilling the requirements in this document. The SAIM
Residency Training Committee (RTC) expects RTPs to be cohesive, integrated, stable, and
ongoing programs that continually raise the standards in SAIM, while training highly capable
internists whose capabilities build upon those of their mentors.
At a minimum, achievement of SAIM Diplomate status requires that candidates meet the following
criteria:
● The candidate successfully completes an ACVIM approved RTP in SAIM;
● The candidate attains a passing score on the ACVIM General Examination;
● The candidate attains a passing score on the SAIM Specialty Examination;
● The candidate completes the publication requirement for the SAIM specialty as specified
in this Certification Manual and in the SAIM Information Packet that were in effect the year
the candidate started his/her residency program;
● The SAIM Credentials Committee (CC) certifies that the credentials submitted by the
candidate for the SAIM specialty are complete and meet all requirements.
The candidate has a maximum of eight (8) years from starting a continuous three (3) year RTP to
achieve board certification in SAIM. In circumstances of an interrupted program, the resident has a
maximum of five (5) years from the end date of the resident’s RTP to become board-certified.
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Residents also have up to five (5) years from the end date of a non-traditional residency to achieve
board certification (see sections 4.D and 4.E above). If a candidate fails to become board-certified
within the specified time, the candidate’s status changes from active to inactive.
The inactive candidate may not resubmit credentials or participate in additional examination
attempts and is ineligible to become board-certified.
Residency training in SAIM requires the equivalent onsite presence of at least two full-time ACVIM
SAIM Diplomates; or the presence of at least one full-time ACVIM SAIM Diplomate and at least
one full-time ECVIM-CA Diplomate. No RTP may be deliberately designed without the primary
location having the equivalent of two full-time Diplomates at that site. It is not necessary that the
two full-time Diplomates be simultaneously present at that primary location at all times, although
there should be some overlap in schedules. It is acceptable and often beneficial that multiple
SAIM or ECVIM-CA onsite Diplomates contribute to a combined training time that equals at least
two full-time Diplomates.
A SAIM residency must take place at a specialty clinical facility where the resident provides primary
patient care appropriate to that individual’s level of training; and where the resident manages cases
involving all facets of SAIM including, but not limited to, clinical pathology, pathology, diagnostic
imaging, critical care, and endoscopy. Medical care of each patient under the resident’s care must
be reviewed at least once a day by the SD. Review of the resident patient care performance should
be conducted directly between the SD and the resident.
9.A.1 General Objectives of the SAIM Residency Training Program
● When applicable, residents should participate in the emergency service on a rotating
basis. The RTP will describe the nature of these rotations on the RTP description
submission form;
● Where applicable, the RTP will encourage residents to participate in clinical teaching
(case supervision, daily rounds, etc.) of interns, veterinary students, or veterinary
technician students;
● Where applicable, residents will be involved in classroom and laboratory teaching;
● Where applicable, residents will prepare and deliver continuing education seminars
and participate in scientific meetings;
● Where applicable, residents in conjunction with the SD will guide and oversee interns,
veterinary students, or veterinary technician students in the operation of the specialty
clinics. This will include supervising interns and students in the operation of the
hospital emergency service;
● Residents will gain a comprehensive understanding of pathophysiology as it relates to
SAIM;
● Residents will develop and promote interest in and understanding of the SAIM
specialist’s role as a clinician scientist;
● Residents will receive instruction and experience in research, publication,
communication, and education.
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9.A.2 Specific Objectives of the SAIM Residency Training Program
● An RTP must provide a well-rounded experience and caseload with direct
supervision;
● An RTP must provide rotations other than Internal Medicine rotations supervised by
board-certified ACVIM specialists other than SAIM, by European College of
Veterinary Internal Medicine-Companion Animal (ECVIM-CA) specialists other than
Internal Medicine, or by European College of Veterinary Neurology (ECVN)
specialists so that residents receive mentored training in other ACVIM specialties (see
9.F.2.a). This will enhance the training experience, and will provide residents with
opportunities to work one-on-one with board-certified specialists in areas outside of
SAIM;
● An RTP must provide diagnostic imaging and clinical pathology training. This will
include at least two weeks of instruction under the direct supervision of a board-
certified veterinary radiologist in diagnostic imaging (one week each in diagnostic
ultrasound and in diagnostic radiology), and one week of instruction in clinical
pathology under the direct supervision of a board-certified clinical pathologist. This
training must be done in dedicated training weeks in addition to being integrated into
the overall RTP. The goal for this training is for the resident to fully immerse
themselves in the discipline being studied;
● Residents will participate in Diplomate-attended Journal Clubs and Clinico-pathology
conferences (as identified in the literature, the clinicopathological conference primarily
relies on case method of teaching medicine. These may include participation in
remote conferencing. It is a teaching tool that illustrates the logical, measured
consideration of a differential diagnosis used to evaluate patients. Cases that are
unusual presentations of common diagnoses or typical presentations of unusual
diagnoses make the best cases for CPC presentation. Cases for such a conference
must be relevant, solvable, and should be open to discussion);
● The RTP will keep records of dates and articles reviewed that may be requested for
review by the RTC if there are questions during a program’s annual review;
● An RTP will develop a resident’s clinician-scientist skills through activities such as
Diplomate-attended Journal Clubs, research projects participation, mentored grant-
writing, and publication of peer-reviewed manuscripts;
● An RTP will provide and require resident participation in preparation and presentation
of formal talks in continuing education and scientific presentation styles.
9.B Definitions for SAIM Residency Training Programs
9.B.1 Non-Traditional Training
Defined in Part One. For the Specialty of SAIM, non-traditional training programs are
discouraged, but it is possible to achieve board certification by successfully completing a non-
traditional RTP.
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The Sponsoring Institution (SI) must provide thorough justification and a comprehensive plan
for a non- traditional training residency to the SAIM RTC, including:
● How all requirements for a traditional RTP in SAIM will be met during the non-
traditional RTP including:
o onsite full time supervision by two (2) ACVIM Diplomates or one ACVIM and
one (1) ECVIM-DA Diplomate at the SI,
o supporting disciplines and facilities and equipment required onsite at the SI,
o didactic learning opportunities,
o research and scholarly activities,
o vacation, release time for General and SAIM Specialty Examinations and
Journal Club,
● If any training that may occur at secondary sites, their locations, schedules of
attendance by the resident and letters from all SDs at the SI and all secondary
training sites must be provided confirming their commitment to the non-traditional
RTP;
● Commitments that training that occur in non-contiguous blocks of time occur in no
less than two continuous weeks of time for each training period during the non-
traditional RTP;
● Residents and their Program Directors (PD), RAs, and SDs must document that
training occurred as specified;
● Request for approval of a non-traditional RTP must be submitted at least 90 days in
advance of a residency’s start date. The SAIM RTC must approve the program in
advance of the start date;
● The total time allowed to complete a non-traditional residency must not exceed five
(5) years;
● The total time period to achieve Diplomate status after successful completion of the
non-traditional RTP may not exceed five (5) years;
● Any changes to the non-traditional RTP that deviates from the training schedule of the
approved plan for the RTP must be reported to the SAIM RTC within 14 days.
9.B.2 Ombudsperson
Defined in Part 1. Candidates and residents may contact the SAIM Ombudsperson at
SAIMOmbudsperson@ACVIM.org. All communications are held in strict confidence.
9.B.3 Program Director
Defined in Part 1. In the Specialty of SAIM each SI has to name one PD for the SAIM RTP.
The PD must meet SD requirements below and must be an ACVIM-SAIM Diplomate. The PD
must have been board-certified for at least four years and must have at least three years of
experience training residents. The requirement of three years of experience training residents
will be waived for the first three years of a new RTP.
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However the PD must still have been board certified a minimum of four years. A PD in an
SAIM RTP may not simultaneously serve as a PD for a RTP in a different specialty. If a
qualified PD leaves the RTP, the SAIM RTC together with ACVIM will place the RTP on
probation until the RTP employs another qualified PD full-time.
9.B.4 Resident Advisor
Defined in Part 1. In the Specialty of SAIM, the RA must meet SD requirements for the SAIM
portion of training. The RA must also be actively involved as a SD and be substantially
involved in the clinical supervision of assigned residents. The RA must be board-certified by
ACVIM (SAIM) for at least two years, and must have at least one year’s experience training
residents. The requirement for three years’ experience training residents will be waived for the
first three years of a new RTP. Each RA may not advise and supervise more than two
residents at any one time.
9.B.5 Supervising Diplomate
Defined in Part 1. In the Specialty of SAIM, all SDs for the SAIM component of training must
be a board-certified specialist by either ACVIM (SAIM) or ECVIM – CA (Internal Medicine),
must be active in the practice of SAIM, and must maintain clinical competency in the field. For
supplemental training, the SD must be a board-certified specialist as identified in Section
9.A.2 above.
9.B.6 Program Probation
Failure of the PD to submit the appropriate information regarding their RTP that is in good
standing to the RTC within 30 days of the deadlines published in this Certification Manual may
result in a program being placed on probation. While on probation the RTP may continue to
train residents, but will not be able to accept any new residents.
If the program is on probation, and the PD does not respond to the RTC’s request for
documentation regarding their residency within 30 days, the RTP may be terminated.
9.B.7 Program Termination
An RTP may be terminated if that program is on probation and fails to correct the deficiencies
identified by the RTC in a timely manner. In addition, if a program is found to have serious
deficiencies that prevent adequate training of a resident (e.g. loss of all Internists) or if it is
determined that a PD submitted false or misleading documents, that program may be
terminated directly, without a probationary period. If a program is terminated, it may not be
renewed. A previously terminated program may re-apply as a new program; however, any
time served by a resident after the program was terminated will not count towards completion
of his or her residency.
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9.C Roles and Responsibilities
9.C.1 Responsibilities of the Sponsoring Institution
9.C.1.a Documentation and Verification
The PD must submit a completed RTP Registration Form online to the ACVIM office for
review by the SAIM RTC by the date specified on the ACVIM website. The SAIM RTC
either approves the program or provides details of those deficiencies that must be
corrected before the program can be approved. The SAIM RTC must approve an RTP
before the RTP accepts residents for training.
If a PD plans to leave the RTP, the SI must notify the SAIM RTC Chair of the proposed
change in directors at least seven days before the change occurs. Failure to do so may
result in the RTP being placed on probation. Failure to respond to SAIM RTC requests for
information will result in program suspension or termination. Time served by residents in
an unapproved or suspended RTP cannot count toward the completion of an SAIM RTP.
9.C.1.b Facilities and Equipment
The SI must ensure the primary training site or hospital has the following capabilities:
● State of the art ultrasonographic, radiographic, electrocardiographic, and endoscopic
equipment;
● Laboratory facilities for performing CBCs, serum chemistry profiles, blood gas
analysis, urinalysis, cytology, parasitology, microbiology, and endocrinology. If these
facilities and capabilities are not available at the training site, then the SI must make
arrangement with local or regional laboratories.
● A 24-hour intensive care facility;
● Access to computed tomography;
● Access to magnetic resonance imaging and nuclear medicine is highly
recommended, but is not required.
The SI must also ensure residents can receive instruction in ultrasonography,
echocardiography, and endoscopy by appropriate board-certified specialists.
9.C.1.c Didactic Learning Opportunities
The SI must provide residents with the following didactic learning opportunities: formal
conferences, continuing education conferences, and formal examination review sessions.
The CM allows remote, online, and electronic conferences (primarily RACE acceptable)
when necessary.
Residents must attend weekly formal conferences in small animal internal medicine and
related disciplines. Examples of these are clinicopathologic conferences or seminars.
These may include remotely presented conferences. Conferences given within a
veterinary practice or hospital or at a medical school or medical teaching hospital are
acceptable. The resident must give a formal presentation at such a conference at least
once per year. Documentation of these presentations must be included in the resident’s
Credentials Packet.
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A presentation at a regional, state, or national meeting may substitute for this
presentation; a copy of the program must be included in the resident’s Credentials Packet.
Residents must participate in/attend at least one state, national, or international veterinary
medical or human medical continuing education conference during their residency. This
may include a remotely presented conference, such as ACVIM presented ACE
conferences. Documentation of attendance/participation at the conference must be
included in the Credentials Packet. A SAIM RTP must provide at least 40 hours per year
of intensive formal review sessions for residents on topics covered in the General and
SAIM Specialty Examinations, which may include remotely presented reviews. A SAIM
RTP must provide annual documentation of these formal reviews to the SAIM CC.
Attending daily clinical rounds does not meet this requirement, although structured
courses and seminars may. If adequate formal review sessions are not available on-site, a
resident may meet this requirement in part by attending or participating remotely an
ACVIM advanced continuing education (ACE) course, an ACVIM Forum, or another high
quality continuing education meeting (with prior approval by the SAIM CC).
9.C.1.d Supporting Disciplines Required
The SI must ensure residents have daily access to consultation with board-certified
specialists in clinical pathology, imaging, and surgery. Specific training required in other
specialties is outlined in section 9.F.2 and 9.F.2.a.
The presence of at least one full time on-site board-certified veterinary surgeon at the
primary training site is required.
9.C.1.e Secondary Training Sites
A secondary training site may not supplant onsite requirements for the two full-time on-site
ACVIM SAIM or ECVIM-CA (SAIM) Diplomates.
If the RTP schedules training at secondary training sites during the residency, the
provider(s) of this training must complete training agreement form(s) with the SAIM RTP
Registration Form for each new program request and at each annual renewal of
registration.
If adequate personnel or facilities to fulfill requirements involving clinical pathology, basic
imaging, ultrasonography, or direct supervision in other ACVIM specialties are unavailable
onsite at the SI, the PD must make special arrangements at other facilities for a resident to
fulfill all requirements. The SAIM RTC must approve such arrangements in advance of the
resident’s training at that secondary site, which includes permission to travel. Training
Agreement Forms for the provision of offsite training must be submitted when requesting
approval of a new program. Updated forms must be submitted at the time of annual
renewal of an existing program. Additional information about training sites can be found in
Part One, above.
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9.C.2 Responsibilities of the Program Director
Section 9.B.3 outlines requirements necessary to serve as a PD.
The PD ensures that substantive changes within an SAIM RTP affecting compliance with
SAIM specialty requirements must be reported to the Chair of the SAIM RTC within 14 days of
such a change. Substantive changes include the following:
● Change of SDs;
● Change RA;
● Addition or removal of a resident (e.g., dismissal, withdrawal, or relocation of a
resident between programs); relocation between programs requires review and
approval of the proposed relocation by both the SAIM RTC and CC prior to the
relocation occurring;
● Alteration of program duration;
● Resident switching to or from a dual specialty training program;
● Resident enrolling in an institutional graduate program;
● Addition or removal of any secondary site training experience. Addition of secondary
sites must be accompanied by letters of commitment from the experience providers.
At the time of annual program re-approval, PDs and RAs may be asked to verify resident
activities. Activities include, but are not limited to, satisfactory clinical training, interaction with
consultants, documentation of training in diagnostic imaging and clinical pathology, and
documentation of study and education participation.
The PD is responsible for ensuring that the resident receives directly supervised, in-person
training from board-certified specialists in at least two of these disciplines: Oncology,
Cardiology, or Neurology (see section 9.F.2 below). Telephone or electronic consultation is
not considered adequate for training purposes.
The PD ensures that signed letters of commitment for required time for secondary site training
are submitted annually with the application for program renewal. Specialists with whom the
resident has trained must provide the PD or the RA with documentation of this interaction.
The SAIM RTC can request further information or documentation from the PD, RA, and/or a
SD at any time, if such information is deemed necessary to verify that residency training is
occurring as described in the SAIM Program Description Form. Reporting inaccuracy may
result in SAIM RTP probation or termination.
9.C.3 Responsibilities of the Resident Advisor
The RA is responsible for meeting with the resident semi-annually to provide performance
evaluations, ensure satisfactory progress in the RTP, and provide general mentorship and
support for the resident (outlined in section 9.D.1). The maximum number of residents that a
RA may routinely supervise at any one time is two.
9.C.4 Responsibilities of the Supervising Diplomate
Review of the resident patient care performance is the responsibility of the SD and should be
conducted directly between the SD and the resident. Provided that one of the two SAIM
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diplomates assigned to the primary location is physically present on-site, the second SAIM
diplomate may co-participate in training via remote training when necessary.
9.C.5 Responsibilities of Residents
9.C.5.a Patient Care
Residents must actively participate in patient management, including receiving, selection,
performance, and diagnostic test interpretation; patient management and decision-making;
client communication; appropriate follow- up; and prompt professional communications
with referring veterinarians. An ACVIM or ECVIM-CA SD must directly supervise and
review case management.
Residents must maintain complete medical records for all patients in their care. The
problem-oriented veterinary medical record system is strongly encouraged. Medical
records must be retrievable and searchable.
9.C.5.b Journal Club
Residents must participate in at least 80 hours of Journal Club throughout their residency.
Participation via teleconferencing and programs having a joint Journal Club with other
programs is acceptable when necessary. At least one specialist recognized by the
American Board of Veterinary Specialties (ABVS) or a Diplomate of the ECVIM-CA must
attend each Journal Club, either in person or remotely.
Residents must keep a log of Journal Club activities that includes the date, article titles
and the identity of the specialist in attendance. The log is to be submitted as part of
credentials that are reviewed by the SAIM CC. Journal Club logs will be randomly audited
by the SAIM CC when a resident’s credentials are submitted.
9.C.5.c Clinical Case Rounds
During SAIM clinical training, residents must attend and participate in daily clinical rounds
with at least one SAIM SD present; virtual remote rounds are acceptable when necessary.
In an RTP where veterinary students are integral to and participating in hospital activities,
residents should, if possible, lead rounds discussions an average of once weekly (over the
course of the entire RTP) with a SD present until the SD deems a resident capable of
leading student rounds independently.
9.C.5.d Publication Requirement
The purpose of the publication requirement in SAIM is to ensure that residents develop adequate
skills in written scientific medical communication. In particular, the publication requirement’s goal is
to ensure that residents display an ability to organize scientific data, communicate these data in
writing accurately, and that they are capable of discussing scientific findings in a way that
promotes the generation and dissemination of knowledge that advances animal and human health.
This goal is achieved through education, discovery, and contributing to scientific medical literature.
9.C.5.d.1 Specific Requirements for Publications
1. The resident or candidate must be first author
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2. The manuscript is published in English
3. The topic is relevant to the topic of small animal internal medicine. Specifically, the
manuscript meaningfully impacts the scientific understanding of a subject relevant to small
animal internal medicine, or is relevant to the diagnosis or management of a clinical condition
by a specialist in SAIM. Candidates are encouraged to submit the topic to the credentials
committee in advance so the relevance can be assessed prior to starting the study.
Assessments of relevance may take up to 4 weeks.
4. The manuscript must be published in a journal that is MEDLINE® indexed. A list of journals
that are currently indexed by MEDLINE® can be found here.
5. The journal’s peer review process must meet or exceed the definition of a refereed journal.
Specifically, a refereed journal is one governed by policies and procedures established and
maintained by an active editorial board that requires critical review and approval of articles
submitted by at least one recognized authority on the article’s subject.
There is a list of acceptable journals that are both MEDLINE® indexed and are known to have
a peer review process that meets or exceeds the definition of a refereed journal.
If a candidate elects to publish a manuscript in a journal that is not currently on the Acceptable
Journals list, it is the candidate’s responsibility to submit the following to the Chair of the
Credentials Committee to request journal approval:
1. Evidence that the journal is MEDLINE® indexed.
2.
A letter from the editor outlining the review process in detail. If the letter does not adequately
document to the Credentials Committee that the peer review is acceptable, the journal will
be rejected without further review. Decisions on whether or not a journal is acceptable may
take up to 4 weeks. If a journal is deemed to be acceptable, it will be added to the
Acceptable Journals list.
9.C.5.d.2 Acceptable Types of Publications
Original research publications, retrospective studies, case reports and review articles are
examples of acceptable publications provided they meet the requirements outlined in
9.C.5.d.1. Occasionally a suitable manuscript that was originally submitted as a full paper
might be reclassified as a “brief communication” by a journal. The Credentials Committee may
accept such a manuscript if this occurs.
Book chapters, conference proceedings, clinical vignettes, and serial features (e.g., ECG of
the Month, Drug Topic of the Month) are NOT acceptable to fulfill the publication requirement.
9.C.5.d.3 Submission of the Publication to the Credentials Committee
A resident may submit their accepted publication at any time during the RTP or within five
calendar years of completing the RTP.
Provided they meet the requirements outlined in 9.C.5.d.1, manuscripts that were published
within 3 years prior to the start date of the residency may also be submitted to the CC for
consideration toward fulfillment of this requirement. The resident must meet the publication
requirement before being awarded board certification. If the resident fails to complete the
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publication requirement within the stated time, that individual’s status changes from active to
inactive. In addition, the resident is no longer eligible to become board-certified.
Whether it is submitted alone or with the other elements of the credentials application, the
resident or candidate should electronically send one of the following to the ACVIM so the
credentials committee can assess that the article is accepted (according to the ACVIM
standard definition approved by the BOR), meets with purpose outlined in 9.C.5.d. and the
requirements outlined in 9.C.5.d.1:
1. A copy of the article published in its final form (no galley proofs, word documents etc.); OR
2. A copy of the accepted article in its most advanced form (galley proof, corrected proof
etc.) AND either the final acceptance letter on letterhead from the journal or a final
acceptance email from the official email address of the journal. Any letter or email from an
editor that states there are reviewer comments to be addressed, no matter how minor the
comments, will be considered unacceptable for credentialing purposes, as it implies final
review by the reviewers has not been completed.
Candidates may proactively write a brief letter justifying how their manuscript meets the
purpose outlined in 9.C.5.d and the requirements outlined in 9.C.5.d.1. In some cases, after
submission, the Credentials Chair may request such a letter from the candidate.
9.D SAIM Residency Training Program Registration and Evaluation
Certification in the Specialty of SAIM requires completion of an RTP that is approved by the SAIM
RTC. The SAIM RTC must approve an SAIM RTP before the program starts training residents.
A resident’s RA must document that training has occurred as specified. RAs ensure that residents
submit documentation to the SAIM RTC by the date specified on the ACVIM website and upon
completion of the program.
9.D.1 Resident Evaluation
Residents should be evaluated based on the criteria listed in Clinical Milestones found later in
this section. A generic evaluation form is available on the ACVM website if an RA desires to
use it, but it is not mandatory to use this form. Evaluation of a resident should occur at least
every six (6) months.
The RA should have the resident sign the RAs copy of the written evaluation to document that
the resident received a copy of the evaluation and had the opportunity to discuss the
evaluation with the RA. If there are questions during a program’s annual review, copies of
these evaluations may be requested by the SAIM RTC.
9.D.2 Resident Case Logs
Residents are encouraged to keep a log of their cases for presentation to their RAs and to
other SDs during a progress review.
9.D.3 Resident Procedure Logs
Residents are encouraged to keep a log of all procedures they completed for presentation to
their RAs and other SDs during a progress review.
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9.D.4 Education Logs
Residents are encouraged to keep a log of all seminars and didactic lectures they attended for
presentation to their RAs and other SDs during a progress review. Each log entry should
include the seminar or lecture date, topic, and presenter.
9.E Residency Training Interruption
Training interruptions may be unavoidable in circumstances where a resident must switch from one
RTP to another to fulfill all RTP and credentialing requirements. In such cases, the following steps
must be taken:
● A new training program must be identified;
● The SAIM RTC and the SAIM CC must approve the new RTP before the continuation of
clinical training;
● The resident must reregister with ACVIM in the new RTP;
● The resident must complete training in continuous blocks of time once training resumes.
In some circumstances, a resident may need to take a leave of absence for personal health or
profound family requirements that prevents that individual from completing the RTP in three years.
However, when actively engaged in the residency, the resident must be full time and participate in
at least 20 weeks of training in any residency year (a residency year is the 12 month period
beginning with the first day on which residency training is restarted) and that training must be
provided in at least two continuous weeks each. When a leave of absence is necessary, the
resident has a maximum of five years from the end of the RTP to achieve board certification in
SAIM (see section 4.D and 4.E).
In some cases, a resident may complete a portion of training at another approved RTP or research
unit or with a different mentor. In those cases, the second RTP or the research unit/research
mentor is a secondary training site. The SAIM RTC must approve that relationship as part of the
RTP submission, along with all appropriate supporting documents from the primary training site.
9.F Distribution of Time in Training
An approved SAIM RTP is at least 156 weeks in duration. Within a SAIM RTP, each resident must
complete sixty-eight (68 weeks) of intensive clinical training in SAIM and sixteen (16) weeks of
clinical training in other specialties, with the remaining seventy-two (72) weeks divided among
additional clinical training in SAIM and related fields, research, attendance at continuing education
or specialty meetings, preparation for the General and SAIM Specialty examinations and vacation.
Residents who complete a traditional three-year RTP without interruption have a maximum period
of eight years beginning with the first day of the residency to achieve Diplomate status.
9.F.1 Intensive Clinical Training in SAIM
At least sixty-eight (68) of those 156 weeks of a SAIM RTP must consist of intensive clinical
training in SAIM. However, additional weeks spent in SAIM are desirable and should be
scheduled as described in section 9.F.3. Partial weeks and split weeks, one-part Intensive
Clinical Training and a second part focused on another requirement will be acceptable when
necessary to meet physical distancing requirements and in order to allow a resident to
continue on their path to completion of the program. In these cases, a week in one category
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may be acquired over a 14-day span and also combined with training segments in the same
14-day span, e.g., study/research days interspersed with clinical training to equal the second
week. In these cases, remote supervision is acceptable when necessary. During the time of
Intensive Clinical Training, the resident is either under shared supervision of the equivalent of
at least two full-time onsite ACVIM SAIM Diplomates, or under shared supervision of at least
the equivalent of one full-time onsite ACVIM SAIM Diplomate and one full-time onsite ECVIM-
CA Diplomate. Training with the SDs should be balanced so that substantially more scheduled
training with one Diplomate and less scheduled training with another Diplomate does not
occur.
9.F.2 Clinical Training in Other Specialties
At least 16 additional weeks must consist of clinical training under direct supervision of one
or more SSSDs in the other specialties approved by the American Board of Veterinary
Specialties (ABVS) or by the European Board of Veterinary Specialization (EBVS). A
maximum of two secondary training site rotations is allowable for meeting clinical training in
other specialties. Certain formal rotations on a specialty service allow contact hours during the
residency rather than set blocks of time, thus, for example, a week may be completed over a
two-week time span. Residents may accrue two individual “weeks” separated by time and the
resident must have primary case responsibility.
9.F.2.a Other ACVIM Specialties
At least 8 of these 16 weeks must be in 2 of the following 3 ACVIM Specialties (Cardiology,
Neurology, and/or Oncology). Each of these rotations must consist of a minimum of 4 weeks
and must be performed in contiguous 2-week blocks (i.e., the resident may train in one
complete rotation of 4 contiguous weeks in the chosen specialty or 2 half-rotations each
consisting of 2 contiguous weeks for each elected specialty). These rotations must be under
Direct Supervision of the Supervising Secondary Diplomate. Telephone or electronic
communication is not considered adequate for training purposes.
9.F.2.b Non-ACVIM Specialties
For ABVS or EBVS recognized specialty training in non-ACVIM specialties, each rotation must
consist of a minimum of 2 contiguous weeks of training.
9.F.3 Additional Clinical Training in SAIM or Related Fields, Research/Scholarly Activity,
Exam Preparation and Vacation
The remaining 72 weeks of training should consist predominantly of clinical training in SAIM or
related fields, research/scholarly activity, preparing for the General and SAIM Specialty
examinations, and vacation. Clinical training during this period is not necessarily under direct
supervision of an ACVIM or ECVIM Diplomate. Clinical training during this 72-week period
should occur with the resident actively participating in assigned clinical rotations in the ABVS
or EBVS recognized specialties. A maximum of 16 weeks of this time may be spent in any one
specialty other than SAIM. There is no maximum number of weeks a resident can spend on
SAIM provided that the resident meets the minimum requirements for SAIM and related fields
of study. This training time may be under direct or indirect supervision of a specialist in fields
related to SAIM. Direct participation in and responsibility for patient care by SAIM residents in
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these rotations is required. This training should not take place during time scheduled for
research, examination preparation, or vacation.
Within these 72 weeks, the resident must spend the equivalent of at least 80 hours (two full
training weeks) in direct contact time with a board-certified veterinary radiologist. One of these
full training weeks of 40 hours should be spent interpreting radiographs, learning and
evaluating the results of special imaging techniques (other than ultrasonography), and
attending radiology rounds or seminars. The didactic portions of this training may include one-
on-one remote didactic experiences with the SD. The second full training week of forty 40
hours of training in ultrasonography must entail direct contact time with a board- certified
radiologist. This training should emphasize abdominal ultrasonography; it must include hands
on performance of abdominal ultrasonography on clinical cases, and theoretical training in the
principles and application of ultrasonography. The theoretical training may include one-on-one
remote didactic experiences. This is the minimum requirement for training in ultrasonography.
It is recognized that true proficiency in this diagnostic technique requires more than this
minimum training standard. Non-continuous training is permitted with radiologists, the 40
required hours may be accumulated over a two-week span.
During the RTP and within these 72 weeks, the resident must have at least 40 hours (one
training week) of direct contact time with a board-certified veterinary clinical pathologist or
anatomic pathologist (ACVP or ECVP) evaluating clinical-pathologic findings, and reviewing
cytologic and/or histologic specimens. This may include one-on-one remote review of teaching
materials. Non-continuous training is permitted with pathologists, the 40 required hours may
be accumulated over a two-week span.
9.F.4 Research and Scholarly Activity
Time allocated to research or to attend/participate in scientific meetings should be taken
during the 72-week period, not during the initial 68 weeks allocated to SAIM or during the 16
weeks allocated to intensive study in related fields.
At least 12 weeks over the three-year residency must be allocated for research and scholarly
activity ideally in the pursuit of a publication.
A week may be acquired over a 14-day span and may also be combined with other training
segments in a 7-day span, e.g., study/research days interspersed with clinical training with
remote supervision is acceptable when necessary.
Successful completion of any one of the options listed below will satisfy the requirements for
research by SAIM residents (see section 4.F.7):
● Successful completion of at least six hours of seminars or classes offered at the
ACVIM Forum, as on-line courses, or at other facilities and recognized by the ACVIM
and covering the following subjects:
o Critical evaluation of the veterinary medical/biomedical literature;
o Grant-writing;
o Study design and participation in clinical trials;
● Documented (by a letter from the RA) submission of a grant proposal;
● Acceptance and presentation at a scientific meeting of an abstract (either oral or
poster) of original work;
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● Documented completion (by a letter from the RA) of a prospective research project
pertinent to SAIM;
● Documented completion (by a letter from the RA) of a retrospective research project
pertinent to SAIM;
● Documented completion (by a letter from the RA) of graduate coursework in
biostatistics, research methods, and/or research ethics.
9.F.5 Protected Study Time for the General and SAIM Specialty Examinations
In addition to the 12 weeks of research and scholarly time, an additional minimum period of at
least four continuous weeks of protected and uninterrupted study time must be allocated to the
candidate to prepare for the ACVIM General Examination. If the resident does not take the
General Examination during their second year of their residency, some or all of this study time
may be “banked” and transferred to the third year. That banked time does not have to be
scheduled in continuous weeks, rather may be provided as individual week-long blocks of
time.
A further additional minimum of four continuous weeks of protected and uninterrupted study
time (e.g., time where the resident is relieved of all clinic responsibilities, including
responsibility for client communications) must be allocated to prepare for the SAIM Specialty
Examination. Protected and uninterrupted study time should be scheduled to precede the
respective examination date as much as is practical. During study time, residents should still
attend Journal Club, seminars and didactic learning opportunities as they arise. Time allocated
for exam preparation should be taken during the 72-week period, not during the initial 68
weeks allocated to SAIM or during the 16 weeks allocated to intensive study in related fields.
9.F.6 Vacation and Personal Time
A resident should take vacation over the three-year residency that is totally separate from
other activities and requirements. Vacation time should be scheduled within the 72 weeks of
additional clinical training. Total vacation time is at least six weeks over three years that is best
allocated at two continuous weeks each year. However, at the request of a resident, vacation
time may be arranged differently. Vacation must never be required to be used as a release
from clinical obligations in order to prepare for the ACVIM General Examination or the SAIM
Specialty Examination. An RTP is expected to provide reasonable accommodation for a
resident’s medical needs, e.g., doctor’s appointments, etc.
9.G Clinical Milestones for First Year SAIM Residents
9.G.1 Expectations Regarding Patient Care
● Residents must provide patient care that is compassionate, appropriate, and effective;
● Residents must develop comprehensive history taking and physical exam skills;
● Residents must demonstrate the ability to evaluate and prioritize data into a problem list
and formulate a diagnostic plan with some supervision;
● Residents must be able to assess daily patient progress accurately and perform
appropriate and timely follow-up of diagnostics tests and interventions;
● Residents must have daily communication with the SD including attending daily service
and house officer rounds;
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● Residents must develop effective communication skills accompanied by respectful and
professional behavior in all interactions with owners, referring veterinarians, staff, and
colleagues.
9.G.2 Expectation Regarding Medical Knowledge
● Residents must demonstrate acceptable knowledge about established and evolving
biomedical and clinical sciences and be able to apply this knowledge to patient care;
● Residents must have a basic knowledge of pathophysiology, pharmacology, and clinical
disease states;
● Residents must demonstrate a compassionate and analytical approach to clinical
situations;
● Residents must demonstrate self-directed learning and reading of the pertinent medical
literature;
● Residents must participate in organized educational activities designed to develop or
expand their medical knowledge base and to learn analytical thinking and problem solving
skills such as:
o Attending daily clinical service and house officer rounds when on SAIM
clinical service;
o Attending scheduled Journal Club and structured learning activities such as
departmental seminars, morbidity and mortality rounds, and other related
sessions;
o Participating in clinical service and house officer rounds when rotating
through SAIM or other specialty services (e.g., Cardiology, Neurology,
Oncology, Critical Care, etc.);
o Participating in rounds specific to any service or specialty rotation in which
the resident participates in (e.g., diagnostic imaging, clinical pathology, or
other activities related to the SAIM training program).
9.G.3 Expectations Regarding Learning and Improvement
● Residents must be able to assess and evaluate their patient care practices, appraise, and
assimilate scientific evidence, and improve their patient care practices because of these
activities;
● Residents should demonstrate a willingness to acknowledge and to learn from errors;
● Residents must participate in didactic lectures, daily house officer rounds, Journal Club,
and other performance improvement activities (see expectations regarding medical
knowledge), including presentation of ACVIM review topics and in Journal Club at least
five (5) times per year;
● Residents must use available medical data bases or evidence-based medicine resources
to support clinical decision making;
● Residents must demonstrate an interest in and ability to participate in a variety of didactic
learning opportunities;
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● Residents must assist in clinical teaching of veterinary students, externs, interns (if
applicable), and other house officers including providing feedback to these individuals
regarding performance, knowledge, medical record keeping, and patient care as
applicable.
9.G.4 Expectations Regarding Interpersonal and Communication Skills
● Residents should demonstrate strong interpersonal and communication skills that result in
effective information exchange and engagement with owners and professional associates;
● Residents should develop stronger language and documentation skills (e.g., succinct and
comprehensive case presentations, progress notes, and comprehensive patient care
plans as they progress in training);
● Residents should provide efficient, but comprehensive information exchange with
colleagues, health care professionals, and owners;
● Residents should develop effective listening skills;
● Residents should establish professional and ethically sound relationships with owners and
referring veterinarians.
9.G.5 Expectations Regarding Professionalism
● Residents must demonstrate a commitment to carrying out professional responsibilities,
adhering to ethical principles, and possessing a sensitivity to cultural differences and
preferences;
● Residents must demonstrate respect, compassion, and integrity in all interactions with
patients, owners, colleagues, and other health care professionals;
● Residents must maintain a professional appearance;
● Residents must demonstrate a commitment to ethical principles pertaining to
confidentiality of patient information and informed consent;
● Residents must demonstrate commitment to professional responsibility in completing all
medical records in a timely fashion;
● Residents must begin to develop skills in conflict resolution.
9.G.6 Expectations Regarding Clinical Research and Publication Productivity
● Residents must demonstrate an initiative to identify, participate, and complete a clinical
research study for publication under the supervision of their RA or SD;
● Residents should select a clinical research project of interest (preferably a prospective
project) in collaboration with at least one SAIM mentor. Project selection should be made
during the first six months of the residency program. Preparation of a detailed research
proposal (written in grant format if applicable) is expected by the end of that time;
● Residents should assist in study design, literature review, and grant preparation and
submission (if applicable) of the selected clinical research project in collaboration with a
research mentor;
● Residents must comply with the ethical principles of research and actively participate in
writing an animal care and use protocol (if applicable).
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9.H Clinical Milestones for Second and Third Year SAIM Residents
9.H.1 Expectations Regarding Patient Care
● Second and third year residents must continue to fulfill all requirements expected of first
year residents;
● Second and third year residents must formulate independent diagnostic and therapeutic
plans with the supervision of an attending veterinarian;
● Second and third year residents must coordinate patient care among all members of the
healthcare team;
● Second and third year residents must counsel and educate owners and referring
veterinarians;
● Second and third year residents must develop competence in performing the core
procedural skills essential to the practice of SAIM.
9.H.2 Expectations Regarding Medical Knowledge
● Second and third year residents must continue to fulfill all requirements expected of first
year residents;
● Second and third year residents must develop a deeper understanding of disease states
and their management;
● Second and third year residents must further develop skills in critical assessment, reading,
and interpretation of the medical literature with application to patient care;
● Second and third year residents must apply knowledge of study design and statistical
methods to the appraisal of clinical studies (i.e., skills emphasized in clinical rotations and
rounds discussions).
9.H.3 Expectations Regarding Practice-Based Learning and Improvement
● Second and third year residents must continue to fulfill all requirements expected of first
year residents;
● Second and third year residents must continue developing competence in educating
owners;
● Second and third year residents must facilitate the learning of students and interns (if
present), other residents, and other health care professionals.
9.H.4 Expectations Regarding Interpersonal and Communication Skills
● Second and third year residents should continue interpersonal and communication skills
developed as first year residents;
● Second and third year residents should develop effective negotiation and leadership skills
that facilitate conflict avoidance and resolution.
9.H.5 Expectations Regarding Professionalism
● Second and third year residents should continue to refine and demonstrate
professionalism skills developed as first year residents.
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9.H.6 Expectations Regarding Clinical Research and Publication
● Second and third year residents must fulfill all requirements expected of first year
residents;
● Second and third year residents should initiate study implementation, including active
participation in patient recruitment and sample collection, data analysis, and manuscript
preparation;
● Second and third year residents should maintain focus on study completion and
troubleshoot any problems that may arise with their mentor(s);
● Second and third year residents should demonstrate their research productivity by having
a published abstract, conference presentation, and accepted peer-reviewed publication.
9.I Procedures for Submitting Credentials for the SAIM Specialty Examination
***Always check the ACVIM website prior to submission, as this process is subject to change.***
Candidates may submit the completed credentials packet and the credentialing fee online to the
ACVIM office following completion of 22 months of the three-year residency. If an individual is
ACVIM board-certified in a different specialty and is participating in a SAIM RTP, that individual
may submit credentials within the final 12 months of the SAIM training program. The SAIM CC
evaluates submitted credentials packets for completeness and accuracy.
The information listed in this section provides an overview of the procedures for submitting
credentials. Specific guidelines are in the SAIM Credentials Information Packet online including
examples of correctly completed forms and a video covering the correct way to submit credentials.
Because application requirements change periodically, candidates must be certain that they are
using the most current application and credentials packet. If a candidate has any questions
regarding the application process, that individual should request clarification in writing from the
chair of the SAIM CC before the submission deadline.
A candidate who intends to take the SAIM Specialty Examination must submit credentials for the
SAIM Specialty Examination no later than the date specified on the ACVIM website of the year
preceding that examination date. Each candidate is notified no later than 60 days after the
submission deadline regarding the acceptability of the submitted credentials packet for the SAIM
Specialty Examination. All candidates must submit online the current standard SAIM application
form along with the other required documents. They must carefully follow the instructions provided
in the credentials packet. Inadequate attention to detail will cause the entire application to be
rejected. A resident/candidate with rejected credentials is not eligible to take the SAIM Specialty
Examination. A resident/candidate may correct the identified deficiencies and resubmit credentials
prior to the date specified on the ACVIM Website for that examination cycle or wait and resubmit
credentials the following year. Resubmitted credentials are subject to an additional fee.
Although acceptance of an article for publication is not required before taking the SAIM Specialty
Examination, the candidate is strongly encouraged to meet this requirement for certification before
taking the examination. The candidate will not be eligible to receive board certification until all
requirements have been completed, even if that individual successfully passed the SAIM Specialty
Examination.
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9.J SAIM Specialty Examination
Candidates must include the following credential items in their SAIM Specialty Credentials
Application (***always check the ACVIM website, as this list is subject to change***):
● The completed credentials SAIM Specialty Examination application packet as described in
the SAIM Information Packet;
● The letter of understanding (which documents awareness of the publication requirement),
or a copy of an approved publication with a copy of the acceptance email from the SAIM
CC;
● A letter from the RA verifying satisfactory progress in the training program;
● Payment of the examination and credentials fees online.
9.J.1 SAIM Specialty Examination Registration and Fee
Once credentials are approved, candidates may register for the SAIM Specialty
Examination and pay the fee online by the date specified on the ACVIM website. Deadlines
are typically the year before the year in which the candidate intends to take the examination,
so they must check the website on a regular basis to ensure that they meet their deadlines.
Eligible Candidates taking or retaking all or part of the SAIM Specialty Examination must pay
fees online by the date specified on the ACVIM website of the year they plan to take the
examination. The ACVIM office verifies eligibility to sit the exam. Candidates can expect
confirmation of payment/registration within 30 days of registration.
9.J.2 SAIM Specialty Examination Content and Format
***Always check the ACVIM website; the examination format is subject to change. Any changes will be
reflected in the current examination blueprint.***
ACVIM SAIM Diplomates use subject matter experts and statistical equating to maintain the
standard of the specialty examination and cut-off score determination.
The SAIM Specialty Examination consists of three sections that cover all aspects of small
animal internal medicine:
Section One: Small Animal Written
● Essay/short answer questions related to SAIM
● Graded independently
Section Two: Medical Literature
● Multiple choice questions on the current literature pertaining to the practice of
SAIM
● Graded independently
Section Three: Case Materials (consists of two parts)
Parts A and B are each graded as independent sections
● Part A –
Patient Management: This part covers patient management related to the practice
of small animal internal medicine. The patient management section is designed to
test the candidate's clinical judgment, diagnostic acumen, and therapeutic
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decision- making skills in a multiple-choice format. Radiographs and other
diagnostic images, photographs, ECGs, echocardiograms, etc. may be
incorporated into the case materials.
● Part B –
Knowledge and Problem-Solving: This part consist of case-based multiple choice
questions designed to test knowledge and problem-solving skills related to SAIM.
A resident or candidate must pass each section of the examination to become-certified.
Candidates that do not pass all sections on the first attempt only need retake failed sections.
In this examination format, the scores of Parts A and B in Section 3 are graded with an
individual grade for each Part. If a resident or candidate fails either part of Section 3, the
individual only needs to retake that failed portion.
A blueprint of the SAIM Specialty Examination is posted on the ACVIM website at least 60
days before the examination date. More specific information on grading the examination is
provided in the instructions distributed to candidates taking the examination at least 60 days
before the examination date.
9.K Maintenance of Credentials
The SAIM MOC Committee maintains a list of acceptable continuing education experiences and
their associated points that count toward renewal of SAIM credentials by ACVIM. The MOC
requirements are posted on the ACVIM’s website.
9.L Online Exit Interview Survey
After completing the RTP, a candidate is strongly encouraged to fill out an online survey regarding
the quality of the training experience. New Diplomates are contacted and asked to participate after
becoming board-certified.
