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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)
ABMS member boards
      • support ABMS
      • abide by ABMS rules
      • cannot make unilateral changes
  • “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. . .”





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
Study guides posted on ABR website ( January 2011
  • Exam will take two half days
  • Given in central locations – Chicago, Tucson – 2x year
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.