From the Board of Trustees: Upcoming Volunteer Agreement Will Address Potential Conflicts of Interest
By ABR Board of Trustees Chair Matthew B. Podgorsak, PhD; ABR Executive Director Brent Wagner, MD, MBA; and ABR President Cheri L. Canon, MD
February 2026;19(1):4
The ABR bases its certification decisions on assessment of the knowledge and skill of candidates and diplomates. The materials that we use to make those determinations are the product of the volunteer efforts of more than 1,000 subject matter experts who generously contribute their time and expertise to the process.
The ABR is committed to providing exams1 that are fair and reliable, and part of this duty includes an obligation to maintain the confidentiality and integrity of the process by avoiding conflicts of interest that might apply to volunteer activities. However, the ABR also recognizes that the expertise and willingness that lead individuals to volunteer with the ABR are manifest in research and teaching activities that characterize their role in their institution and health system; as a result, we seek to provide reasonable flexibility for diplomates to be both educators and ABR volunteers.
The most obvious potential conflict is the submission of recognizable case material for an ABR exam that has been or will be shared as part of another work, including (but not limited to) a presentation, paper, or textbook. This does not mean that the same diagnosis, teaching point, or concept cannot be part of both activities (ABR and “other”), but it must be sufficiently distinct that it would not be recognizable as the same case. ABR volunteers who wish to publish a case as part of a journal article, for example, cannot submit that case for an exam. Similarly, cases or specific materials used to teach residents may not also be part of submitted ABR exam content.
An indirect but potentially more significant conflict of interest is the participation by an ABR volunteer in “board prep” as part of any educational activity (a presentation, case conference, textbook, webinar, etc.). One could reasonably perceive such participation as representing “insider information,” where the volunteer activity relates directly to “success on the exam” rather than the indirect goal of accumulation and application of knowledge by the certification candidate. Although volunteers are encouraged to teach clinical concepts that directly relate to the knowledge domain expected of well-trained and hard-working candidates for certification, we ask that they refrain from discussing scoring models or specific exam performance rubrics.
Formerly referred to as the “Conflict of Interest and Commitment Disclosure Statement,” the updated ABR “Volunteer Agreement” will, when released, again include the change implemented in 2025 that removed the distinction between what is permitted for volunteers in their own department versus what they might do in another institution. This was specifically intended to address “shared faculty” who often deliver remote educational conferences across a broader platform of loosely affiliated facilities. It also incorporates a reminder of confidentiality (“I will not disclose information I come to know and understand as a result of being a volunteer”) and an acknowledgement of an ABR practice that prohibits the use of generative AI when creating exam content. Acknowledging the absence of a consistent bright line delineation between acceptable and prohibited behavior, the ABR has posted examples that address selected use cases.
The ABR recognizes and is grateful for the invaluable contributions of its volunteers and encourages participation in reasonable related research and teaching activities. The mutual understanding of the limits described in the Volunteer Agreement is intended to remind us of the organizational obligation to maintain a fair, defensible, and transparent process.
1. For the purposes of this article, “exams” refer to qualifying exams, certifying exams, and online longitudinal assessment (OLA).
