SPR Education Session Radiology Review Committee American Board of Radiology Update

1. SPR Education SessionRadiology Review CommitteeAmerican Board of Radiology Update RRC/ ACGME Update: Janet L. Strife, MD

2. Jason Itri, MD University of Pennsylvania University of Michigan

3. Composition of RRC 3 members nominated by ACR 3 members nominated by ABR 3 members nominated by AMA 1 resident member Executive Director of ABR (ex officio) Seeking a pediatric radiologists for RRC

4. ACGME data: Peds fellowshipsABR data: Fellows performance on CAQ exams

5. ACGME Update: Changes to training • Program requirements for Pediatric Radiology approved March 2010 (last done in 1998) • Highlights of changes: • 3 month elective at discretion of program director • 360 evaluations including self evaluations • Evaluations of communication/reports • Safety/quality/systems based practice; increased emphasis • Evaluation of teaching/conference skills • Portfolios…continue from residency • Case logs will represent aggregate data, similar to residency • Measurement of competencies/outcomes based • Teaching and testing of “normal's and normal variants”

6. RRC Frequent citations: • Program director should meet four times/yr, review performance issues/feedback (case logs, portfolio, identify issues) • Fellow evaluations must be confidential of faculty and program • Process for program evaluation • Survey of residents/5 years from graduation • Education Meeting dedicated to making changes based on review of program • Conferences dedicated to the fellow

7. Supervision of trainee Can fellows perform invasive procedures without direct supervision? One facet of “graded responsibility” is performing procedures independently Faculty must be aware procedure is being performed and available Must be documentation that competence has been demonstrated in performing the procedure

8. On APDR web site

9. Faculty: Board Certification The physician faculty must have current certification in the specialty by the American Board of Radiology, or possess qualifications judged to be acceptable by the RRC (not a NEW requirement) RRC concerned about the increasing numbers of noncertified faculty members in some programs

10. “How do I know that my doctor is trained and maintained his certification?” • RRC Eligibility for fellowship; Fellows “should”have completed either an ACGME-accredited or Royal College of Physicians and Surgeons of Canada (RCPSC)-accredited core program in diagnostic radiology. • RRC Eligibility for faculty; ACGME citation when faculty does not have subspecialty boards unless they are eligible or in the process. • ABR Requirements: Board certification for subspecialty (CAQ) • In order to take subspecialty exam, must have Diagnostic radiology certifications

11. Review of Pathways • NORMAL PATHWAY: Clinical year, Diagnostic Radiology ACGME or non ACGME fellowship • INTERNATIONAL MEDICAL GRADUATE: (IMG) • Four consecutive years at ACGME site • Must take ABR DR exams • Fellowship prior to DR certification does not “count” toward fellowship year • ALTERNATIVE PATHWAY; Anyone with DR certification (IMG or other faculty) • Stay two years employed at an ACGME site with fellowship program.

12. Revision of Core Radiology Program Requirements;Could affect rotations/fellowship programs Effective July 1, 2010

13. Restructure Of Radiology/Changing The Timing Of ABR Exams

14. Re-structuring of Radiology Residency/ Effective 2010 • Much discussion at the recent ACGME/APDR meeting • Likely, each rotation will be two or three months in first three years; CORE EXAM • Fourth year is more elective time, more on call, coverage, conference • Need to work with university • Most will take fellowship after DR residency

15. Impetus for Revisions New ABR Test Structure and Sequencing Core Exam Will cover all subspecialties of radiology plus core curriculum and physics 18 categories; condition up to five Certifying Exam given 15 months after completion of radiology residency training Computer-based interactive exam focused on scope of candidate’s practice Select clinical modules Pediatric cases in all the modules

16. Core; Revisions Duration and Scope of Education B.5 relief from callresponsibilities for short periods before the oral board exam and before the “Core” board exam . Overlap year 2013 (Oral exam in June, Core exam in Sept)

17. Mission: “Improve healthcare by accessing and advancing the quality of resident physicians' education through exemplary accreditation”

18. Competencies: Where do we need to be? ACGME timetable: Full integration of the competencies and their assessment into learning and clinical care Current: “The goals and objectives must be specific for each rotation and incorporate the core competencies” Future: Development of specialty-specific milestones that, when met, will foster proficiency in each of the competency domains (work has already begun in some specialties and radiology likely to be next in line)

19. Goals and Objectives Competency-based Specific for each subspecialty rotation Specific for each level of rotation Reviewed and revised as needed annually Distributed to faculty and residents Discussed with residents before each rotation

20. Overview of Changes • Program requirements on line • New Program information form • New CPT codes for case logs • Thank you friends and colleagues • Thank you for helping on the revisions • Thank you for your interest in education and feedback.