IR/DR certification

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Matt Mauro MD
ABR Trustee
APDR 2014
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Approval of ABMS and ACGME
Program requirements
Accredited programs
Certifying examinations
MOC program
2
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SIR proposed primary IR certification to ABR
2007
 IR fundamentally different than DR
 Need different way of training with additional
clinical skills
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Reworked proposal - dual certification in
IR/DR
3
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ABMS approved concept of IR as separate
specialty, Sept 2012
 Rarionale: domain of IR has expanded and can’t
gain technical expertise in 1 year. Also includes
clinical care
 5 + years of work
 Process originated from SIR; ABR approved and
presented plan to ABMS
 Required phase-out of SS certification (only one
pathway to certification)
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What is the IR/DR Certificate?
Specialty status to IR recognizes IR/DR as a unique
specialty in medicine. ABMS acknowledged the role
of IRs as imagers, proceduralists and clinicians.
 ABR will issue a new certificate – certifying that an
IR practitioner is competent in these areas of
expertise. Transition 2017.
 IR training programs will change. ACGME is in the
process of establishing a new IR Residency – distinct
from DR. Timeline for transition - 2022.
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ACGME approved IR as a new specialty – 2013
Program Requirements
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Written by sub-committee of R-RRC COMPLETED
Placed in appropriate format NOW
45 Day comment period
Reviewed by Committee on Requirements
Hope to have PR accepted by ACGME by 3rd quarter
2014
 Then programs can apply –need site visit
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 ?begin 2015-6
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Integrated (5 year) and Independent (2 year)
options
.
 Match from medical
- school, transfer from DR
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More IR training: 2 years (minimum 1 year, 9
rotations) - More emphasis on clinical care
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Eventually there will be only one certificate –
IR/DR Certificate
2017 seamless transition to IR/DR certificate
thru MOC process.
Those with IR CAQ will be grandfathered in.
8
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6 year program: Integrated Program
 1 year clinical
 3 years DR (including some IR) – same as DR
residents
 2 years IR (including critical care, in-patient
consults/followup clinics + up to 4 mo DR)
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Institution can have independent (2 years)
and/or integrated (5 years) programs.
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Year
CURRENT
IR residency
PGY 1
Internship
Internship
PGY 2
DR
DR
PGY 3
DR
DR
PGY 4
DR
DR
PGY 5
DR
IR
PGY 6
IR
IR
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IR= IR or IR related
Must participate in OP
clinics
DR months in PGY5 as
necessary (Nuc Med,
breast imaging)
Required ICU/critical
care
Completion of training need 1000 IR procedures
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Two Year Program
 1st year 12 IR Rotations; 1 ICU Rotation
 2nd year
13 IR Rotations
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Candidates enter AFTER completing full DR
Residency
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Candidate may receive credit for 1st year IR if
they had 12 rotations of IR and > 500 cases in
residency
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Can transfer within same institution anytime
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Can transfer to program outside of institution
only after finishing DR residency
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Fellowships will have to phase out 5-7 years
after IR residency begins in an institution
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Would attain IR/DR certification
Likely plan
 Core exam at 36 months of DR with peers
 Essentials/NIS modules of Certifying exam + Oral
exam 3 months after finishing residency (ie with
peers)
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Grandfathering for those with VIR SS
certificates
VIR SS certification to phase out after 5-7
years
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PR’s not yet approved---but CLOSE
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Don’t know exact timeline for
implementation
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For now, if interested in IR, should take IR
fellowship
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Multiple entry points, R2-R5
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PGY 5 call not specified – up to program (ie
could be DR or IR)
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Separate PD for program – but DR PD could
be Associate for first three years
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2014 – program requirements approved by
ACGME
 Includes approval by DR RRC (DONE), 45 day
public comment period, approval by Committee
on Requirements and BOD
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2015 – First residency applications
 Must have site visit since new core program
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2016 – First program approvals
 First graduates could be 2017
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2022 – end of 1 year fellowships
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Core exam
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Same exam as DR residents
Same time period (ie in 36th month)
Certification exam:
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2 Computer Modules: Essentials, NIS
 Oral exam
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First exams likely given 2017
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IR SS certificates will be given IR/DR
certificates if MOC requirements up to date
 Likely require PQI project in IR
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Now have three IR trustees
 Jeanne LaBerge
 Matt Mauro
 John Kaufman, trustee designate
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IR is one of 4 disciplines in ABR
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DR
RO
MP
IR
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