Your Interaction With
The American Board of Radiology
Now and In the Future
James P. Borgstede, M.D., FACR
President-Elect
American Board of Radiology
Thanks
• Gary Becker and ABR staff
• David Laszakovits
• Jennifer Bosma
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
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)
• ABMS member boards
• support ABMS
• abide by ABMS rules
• cannot make unilateral changes
• “Rogue” boards
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can be legal entity
do not have “standing”
do not follow ABMS rules
may be used to request clinical privileges
American Board of Radiology
Mission
“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. . .”
ABR
ACR
ABMS
External forces affecting
and motivating the ABR
and other specialty
boards
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Drivers
American Board of
Medical Specialties
Payers
Licensing agencies
Public accountability
Academic radiologySociety of Chairmen of
Academic Radiology
Departments (SCARD)
and program directors
(APDR)
American Board of
Radiology
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Reactors
American Board of
Radiology
Residents
Private practice radiology
American College of
Radiology
The ABR Exam of the
(near) Future
Outline
• Exam of today
– Qualifying (aka written/physics)
– Certifying (aka oral)
• Exam of (near) future
– Core
– Certifying
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
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
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
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
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
• 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
Breast
Cardiac
GI
MSK
Neuro
Peds
Thorax
Repro /
Endo
Urinary
Vascular
Q#
CT
60
IR
60
MR
60
NM/Molecul
ar
60
Rad/Fluoro
60
US
60
Physics
90
Safety
60
Q#
60
60
60
60
60
60
60
60
60
minimum 60 questions per row/column
60
EOF, Core exam – Physics
• Practical, image-based
• More questions than other categories
• Physicist included on each of the
item-writing committees
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
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
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)
EOF, Certifying exam – Timing
• To be taken 15 months after finishing
residency
• Will be given 2x/year
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
• 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
EOF, Certifying exam – NIS
• What every physician should know
• Domain includes: ethics, governmental
regulations, systems-based practice,
etc.
EOF, Certifying exam – Essentials
• What every radiologist should know
• Includes but not limited to Emergency
Radiology, common on-call dx
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
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
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)
ABR expectations continued…
• More complete evaluation of resident’s
abilities since can’t evaluate
communication, etc. on CBE
– Milestones may help with this
ABR of the future and
you
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)
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.