ABR-APDR Update: Present and Future (EOF) Exams

1. Kay Vydareny, M.D. April 2011 ABR-APDR Update: Present and Future (EOF) Exams

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

3. Qualifying exams: Physics and Clinical • Registering for exam – will be notified via website when able to register at Pearson Vue • Erroneous reporting of results – • Affected those who checked physics results before receiving email from ABR • Have changed processes and are certain will not happen again

4. Electronic payment for initial certification • Top priority for ABR • Process will be complete by end of 2011

5. Certifying exam: oral • Core pilot exam - 2011 • 6 modules will be piloted in May (MSK , Breast, Peds, Cardiac, IR, Neuro,) • Candidate can choose to take before or after exam • Passing score can raise conditioned score but will not allow a failing candidate to pass • Will allow evaluation of time, software interface, questions, etc • Will not represent actual modules to be given during core exam

6. Will be a second pilot May 2012 to include all modules • Appointments for oral and for core pilot were sent at end of last week

7. Certifying exam - oral • Results • To be posted electronically Friday May 27 • Letters will be mailed in late June • Candidates must make sure we have up-to-date contact information.

8. 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

9. 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

10. 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

11. EOF – Core exam, structure • 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

12. RISE (RadioIsotopeSafety Exam) • Will be embedded in Core exam • Rationale: radioisotope safety is important for all DR not just for AU’s • 50-60 scorable units • 25-30 already contained in NM, Safety, Physics • 25-30 additional radioisotope safety items

13. If fail RISE, can re-take if desire AU-E status; don’t need to retake if don’t qualify/want AU-E • Must pass this virtual exam + NRC requirements before end of residency to have AU-E on certificate • Must pass Core exam before RISE counts towards AU-E status

14. Core exam, general • 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

15. minimum 60 questions per row/column

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

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

18. EOF, Core exam – transition • If fail last attempt at clinical exam- go to core • If fail last attempt at oral – go to core

19. 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%) (CPA’s)

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

21. 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

22. 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

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

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

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

26. EOF, Certifying exam, Scoring • Criterion referenced • Will be pass/fail only • Must pass NIS, Essentials and CPA’s (as a group) • If fail, must keep CPA’s the same for next administration of the exam

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

28. How can the APDR help? • Help establish a culture shift from “how many questions can I remember?” to “I am honor bound not to share reminiscences” • Much time and effort to write new exams • Want certificate to be worth something • Avoid analysis/management items becoming recall only • Public would expect no less • Should be part of professionalism competency

29. How can APDR help? (2) • More complete evaluation of resident’s abilities since can’t evaluate communication, etc on CBE • Milestones may help with this