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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

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


  • Gary Becker and ABR staff

  • David Laszakovits

  • Jennifer Bosma

Goals and objectives
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)

  • “Rogue” boards

    • 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
    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. . .”




    External forces affecting and motivating the abr and other specialty boards

    External forces affecting and motivating the ABR and other specialty boards


    American Board of Medical Specialties


    Licensing agencies

    Public accountability

    Academic radiology-Society of Chairmen of Academic Radiology Departments (SCARD) and program directors (APDR)

    American Board of Radiology


    American Board of Radiology


    Private practice radiology

    American College of Radiology


    • Exam of today

      • Qualifying (aka written/physics)

      • Certifying (aka oral)

    • Exam of (near) future

      • Core

      • Certifying

    At this year s oral exam
    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
    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
    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
    EOF, Core exam – Structure


    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 timing1
    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

  • Eof core exam physics
    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
    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
    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
    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
    EOF, Certifying exam – Timing

    • To be taken 15 months after finishing residency

    • Will be given 2x/year

    Eof certifying exam structure
    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
    EOF, Certifying exam – NIS

    • What every physician should know

    • Domain includes: ethics, governmental regulations, systems-based practice, etc.

    Eof certifying exam essentials
    EOF, Certifying exam – Essentials

    • What every radiologist should know

    • Includes but not limited to Emergency Radiology, common on-call dx

    Eof certifying exam cpa
    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
    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
    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
    ABR expectations continued…

    • More complete evaluation of resident’s abilities since can’t evaluate communication, etc. on CBE

      • Milestones may help with this

    The abr of the future
    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)

    It s the mission of the abr and it s your future

    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.