American Board of RadiologyAmerican Board of Radiology

November 29, 2009November 29, 2009

RSNA - RC 102RSNA - RC 102

ABR - Part of the quality ABR - Part of the quality

movement, and how it will help movement, and how it will help

you.you.

Dennis Balfe, M.D.Dennis Balfe, M.D.

Gary Becker, M.D.Gary Becker, M.D.

Jim Borgstede, M.D.Jim Borgstede, M.D.

N. Reed Dunnick, M.D.N. Reed Dunnick, M.D.

AgendaAgendaTransition to EOF Dunnick

Primary Certification Balfe

Maintenance of Certification Borgstede

External Environment BeckerIncluding ABMS

QuestionsQuestions

American Board of Medical American Board of Medical Specialties (ABMS)Specialties (ABMS)

Established 1933

• ABR established 1934

24 member boards

Overarching governing body

Among the 24 Member BoardsAmong the 24 Member Boards

Radiology is “medium large.”

Working to reduce expenses.

Playing an increasingly influential

role.

ABMS Member BoardsABMS Member Boards2007 Certificates2007 Certificates

ABIM 13,062

Pediatrics 3,221

Family Medicine 2,872

Psych & Neuro 2,570

Radiology 1,842

Radiology ranks 6th by revenue.

Time-Limited CertificationTime-Limited Certification

Field evolves

Practice changes

Remote certification obsolete

Must “recertify”

ABMS MandatesABMS Mandates Time Limited CertificationTime Limited Certification

• All 24 member boards

• Maintenance of Certification

• Continue to lead quality

• Attain “deemed status”

ABRABR

Last lifetime certificate 2001Last lifetime certificate 2001

• 8,412 time limited in DR

• 1,129 time limited in RO

• 1,885 time limited in RP

Current Exam StructureCurrent Exam Structure

Physics 2, 3 or 4th year

General Content 3 or 4th year

Oral 4th year

Maintenance of Certification

Current Exam DeficienciesCurrent Exam Deficiencies

Requires candidates to be Requires candidates to be

“competent” in entire field.“competent” in entire field.

• Radiology has grown dramatically

• No one can master it all

• “Binge and purge” approach

• Not durable learning

Emphasis on fact retention and Emphasis on fact retention and pattern recognitionpattern recognition

• Unrealistic exam format

• Poor face validity

• Intimidating exam setting

Physics Scores FallingPhysics Scores Falling

• Can take exam 3 years» not studying first time?

• Considered a hurdle, not necessary knowledge

• Physics teaching inconsistent

Exam of the Future (EOF)Exam of the Future (EOF)

• Residents entering July 2010

• Computer based

• Practical

• Image rich

• Core and certifying exams

PhysicsPhysicsImprove teaching

• Learning modules» Bill Hendee, Ph.D.» RSNA supported

Include physics in exams• Core• Certifying

Make items more clinical• Ph.D. / M.D. teams write items

EOFEOF

Comprehensive core exam will cover entire field.

Certifying exam will include basic radiology but focus on intended area(s) of practice.

Culture of life-long-learning.

International Medical Graduates International Medical Graduates (IMG’s)(IMG’s)

Physicians whose radiology training was outside U.S. and Canada.

Significant minority of practicing physicians.

Need pathway to board certification and maintenance of certification.

International Medical GraduatesInternational Medical Graduates

243,457 IMG physicians

25.8% of practicing physicians

28.5% of physicians in training

Pathway for IMGs

MOC

No MOC

Years

Qu

alit

y

Must have alternate pathwayMust have alternate pathway

State Medical Licensure

Healthcare organization

Quality

Reimbursement

ABR Alternate PathwayABR Alternate Pathway

Four (4) continuous years in a radiology department with residency training program.

• any combination of faculty or trainee

Access to educational materials.• Department Chair is “program director”

Must pass all examinations.• physics• written• orals