Your Interaction With The American Board of Radiology Now and In the Future James P. Borgstede, M.D., FACR President-El

1. Your Interaction With The American Board of RadiologyNow and In the FutureJames P. Borgstede, M.D., FACRPresident-Elect American Board of Radiology

2. Thanks • Gary Becker and ABR staff • David Laszakovits • Jennifer Bosma

3. Goals and Objectives • Background on ABR • Analyze external forces affecting and motivating the ABR and other specialty boards • Understand the ABR exam of the future • ABR of the future and you

4. Background on the ABR • Established 1934 • Currently has 3 disciplines: • Diagnostic Radiology (DR) • Radiation Oncology (RO) • Medical Physics (MP) • May have a 4th discipline of combined DR/VIR • Is one of the 24 member boards of the American Board of Medical Specialties (ABMS)

5. ABMS member boards • support ABMS • abide by ABMS rules • cannot make unilateral changes • “Rogue” boards • can be legal entity • do not have “standing” • do not follow ABMS rules • may be used to request clinical privileges

6. American Board of RadiologyMission “To serve patients, the public, and the medical profession. . .” “By certifying that its diplomates have acquired, demonstrated, and maintained a requisite standard of knowledge, skill, and understanding. . .”

7. ABMS ABR ACR

9. External forces affecting and motivating the ABR and other specialty boards

10. Drivers American Board of Medical Specialties Payers Licensing agencies Public accountability Academic radiology-Society of Chairmen of Academic Radiology Departments (SCARD) and program directors (APDR) American Board of Radiology Reactors American Board of Radiology Residents Private practice radiology American College of Radiology

11. The ABR Exam of the (near) Future

12. Outline • Exam of today • Qualifying (aka written/physics) • Certifying (aka oral) • Exam of (near) future • Core • Certifying

13. At this year’s oral exam 6 modules will be piloted in May (MSK , Breast, Peds, Cardiac, IR, Neuro) Candidate can choose to take one module before or after exam Passing score can raise conditioned score but will not allow a failing candidate to pass Doing poorly on module does not affect oral score Will allow evaluation of time, software interface, questions, etc. Will not represent actual modules to be given during core exam Will be a second pilot May 2012 to include all modules

14. EOF Core exam – Purpose To validate that a diagnostic radiology candidate has acquired knowledge, skill, and understanding of the entire field of diagnostic radiology, including physics

15. EOF, Core exam – Timing • Residents expected to take at 36 months • Exception – research residents with >9 months research in first 3 years can delay • Would be few other exceptions granted • First exam September 30 – October 4, 2013 • Subsequent exams – third week of June

16. EOF, Core exam – Structure Image-rich Will assess knowledge and comprehension (40%) and application, analysis, synthesis, and evaluation (60%) Level of expertise expected for the exam is basic to intermediate Will contain embedded RadioIsotope Safety Exam (RISE) exam

17. EOF, Core exam – Timing • 18 categories, each must be passed • Organ system: MSK, Cardiac, Thoracic, Gastrointestinal, Urinary, Repro/Endo, Neuro, Pediatric, Breast, Vascular • Modality: Ultrasound, Interventional, Nuclear Radiology/Molecular Imaging, CT, MRI, Rad/Fluoro • Fundamental concepts: Patient safety, physics • Items presented in random order

18. Study guides posted on ABR website (www.theabr.org) January 2011 • Exam will take two half days • Given in central locations – Chicago, Tucson – 2x year

19. minimum 60 questions per row/column

20. EOF, Core exam – Physics • Practical, image-based • More questions than other categories • Physicist included on each of the item-writing committees

21. EOF, Core exam – Scoring • Criterion-referenced exam (not graded on a curve) • Must pass each row/column • Condition exam = fail 1-5 categories (including physics) • RISE will not count as one of these categories, but will be scored separately

22. EOF, Core exam – Transition • If fail last attempt (3rd time) at clinical exam- go to core • If fail last attempt (3rd time) at oral – go to core

23. EOF, Certifying exam – Purpose • To validate that the candidate has acquired and is able to apply the requisite knowledge, skill, and understanding that: • every practicing physician should possess. (20%) ( NIS) • every practicing radiologist should possess. (20%) (Essentials) • this particular practicing radiologist should possess to begin independent practice in chosen clinical practice area(s). (60%) (CPAs)

24. EOF, Certifying exam – Timing • To be taken 15 months after finishing residency • Will be given 2x/year

25. EOF, Certifying exam – Structure Image-rich exam Emulate practice Focus assessment on application, analysis, synthesis, and evaluation Level of expertise expected for the exam is intermediate to advanced Will include normals, normal variants, artifacts

26. Each module at least 60 scorable units • Exam will be ~ 5 hours long • Administered 2 X / year • Is both the first MOC exam and the certifying exam for the residency

27. EOF, Certifying exam – NIS • What every physician should know • Domain includes: ethics, governmental regulations, systems-based practice, etc.

28. EOF, Certifying exam – Essentials • What every radiologist should know • Includes but not limited to Emergency Radiology, common on-call dx

29. EOF, Certifying exam– CPA • Candidate chooses 3 modules • If more than 1 in an area, will contain more advanced content • CPAs: Breast, Cardiac ,GI ,MSK, Neuro, Pediatric, Thoracic, Reproductive/Endocrine, Urinary, Vascular-Interventional, Nuclear Medicine, Ultrasound, and General Radiology. • Each will include relevant Peds, Physics

30. EOF, Certifying exam – Scoring • Criterion referenced i.e. no curve • Will be pass/fail only • Must pass NIS, Essentials and CPAs (as a group) • If fail, must keep CPAs the same for next administration of the exam

31. EOF, Certifying, Transition from present • If condition oral on last (3rd) attempt – take one module in each conditioned section + NIS + Essentials • If fail, take entire Certifying exam (5 modules)

32. ABR expectations continued… • More complete evaluation of resident’s abilities since can’t evaluate communication, etc. on CBE • Milestones may help with this

33. ABR of the future and you

34. Age of Transparency and Accountability

35. The ABR of the Future • Increased demands to demonstrate relevance of certification • Increasing expectations of accountability to our diplomates • ABR has established advisory committees • Relevant exams (our EOF) • Maintenance of Certification • Increased demands from a more robust American Board of Medical Specialties (ABMS)

36. The ABR asks you to assist the ABR in demonstrating to our patients, the public, and the medical profession that our diplomates have acquired, demonstrated, and maintained a requisite standard of knowledge, skill, and understanding. It’s the mission of the ABR and it’s your future.