Winter 2016 � Volume 9, Issue 1
 
From the Editor
by ABR Trustee Lane F. Donnelly, MD
 
2016;9[1]:1
 
All the best to you in 2016! We present to you the first edition of The BEAM for this new year. As always, our purpose for The BEAM is to effectively communicate activities of the ABR and any changes in the credentialing landscape. To that end, we have included a number of articles that we hope you will find informative and helpful. We have also redesigned our layout to make it easier to read, especially for those of you who are using mobile devices.

This issue contains a personal perspective on MOC from Dr. Milton Guiberteau, ABR president; an article on the first full MOC look-back and the new simplified attestation process for MOC by Dr. Vincent Mathews; an article on the first diplomate to use simplified attestation; and a "Focus on Quality and Safety" article regarding changes in the ABR approach to quality and safety that I have written. Other features include articles focused on residents (Dr. Donald Flemming), interventional radiology (Dr. James Spies), diagnostic radiology (Dr. Kay Vydareny), radiation oncology (Drs. Paul Wallner, Dennis Shrieve, and Anthony Zietman), and medical physics (Drs. Geoffrey Ibbott and Donald Frey). 

Additional information concerns the schedule for ABR booths at societal meetings, an update on the ABR Connections Center, and a "Spotlight on an MOC Participant." Your feedback on the content of The BEAM is always appreciated; send an email to [email protected]
From the President
Merriment Meets MOC
by Milton J. Guiberteau, MD
 
2016;9[1]:2-3
 
It's nearing the end of 2015 as I write this, and I am grumpy. I am scrunched in the back of a very large black vehicle (the kind I imagine would be driven by the Secret Service or maybe a drug lord). My fellow passengers are four children under 10 and four other adults, all related to me, or so I hope. Our destination is the proverbial "grandmother's house," and we know there will be pie, lots of pie, when we get there, which usually makes me happy with anticipation. But at this moment, I am trying to write a message to you for the January issue of The BEAM, and in a car full of "Jingle Bells" singers and excited, hyperkinetic kids, nothing profound comes to mind. So, I am grumpy. Truthfully, that is only half the story, since the night before I concocted a list of things I have to do before the end of the year or in early 2016, and it is long. It includes taking an accounting of some of my personal ABR MOC responsibilities. A partial list reads as follows:
 
1.  ATTESTATION. As I think about attesting on myABR to meeting my MOC requirements before the end of the year, it occurs to me that I now have until March 1, 2016, to do it. I like this, so I take this off my EOY list and move it to February.

 

Focus on Maintenance of Certification
Important: Don't Forget March 1 Deadline for myABR Attestations
by Vincent P. Mathews, MD, ABR Board of Governors
 
2016;9[1]:4-5
 
All diplomates participating in Maintenance of Certification (MOC)--except those initially certified in 2013, 2014, and 2015--will have their first "full" annual look-back on March 2, 2016. To ensure that they maintain their certification, these diplomates must attest to meeting their MOC requirements for Parts 1, 2, and 4 no later than March 1, 2016. Since the ABR has records of those who have taken and passed the MOC Exam, attestation for Part 3 is not necessary. Other diplomates, initially certified in 2013 or later, must attest only to Part 1--licensure.  

Simplified Attestation: First User Comments on New Process
Daniel Gurell, MD

2016;9[1]:6
 
On January 4, 2016, after months of diligent  work by our IT Department, we were pleased to  launch our new "Simplified Attestation" process  in myABR. Now diplomates need only to log in to myABR and affirm that they have met  requirements for Parts 1, 2, and 4 of MOC. Entering detailed data is no longer necessary, but diplomates need to retain this information so they can document that they have met MOC requirements in case of an audit.

The first physician to take advantage of the new process--a mere 30 seconds after its launch!--was Daniel Gurell, MD, a diagnostic radiologist from University Diagnostic Medical Imaging, PC in Bronx, New York. We reached out to Dr. Gurell to ask him a few questions about the new process.

He told us that he had used myABR in the past to attest to his MOC activities, but he immediately noticed the changes, and that he completed his online attestation in a matter of seconds. He said that it was much easier, quicker, and more intuitive than in the past. Dr. Gurell had not been aware that the new process was in place. He goes on the site each year to attest and update his information, and this time he just "happened" on the new, better system, which gave him no problems whatsoever.

Dr. Gurell was so pleased with the new website, he did not have any immediate suggestions for improvement. One thing he asked us to reiterate was that the new attestation system does not require updating or uploading of CME credits, which in the past was a bit tedious. Thanks for your input, Dr. Gurell!

Focus on Residents
Frequently Asked Questions
by Donald J. Flemming, MD, ABR Trustee, Diagnostic Radiology
 
2016;9[1]:7-8
 
The new ABR call center, known as "ABR Connections," receives many queries from candidates. In this article, I would like to discuss some of the more common questions that pertain to initial certification.
 
1.  I am interested in subspecializing in vascular and interventional radiology (VIR). How does the new interventional radiology (IR) training pathway affect me if I am currently in my residency program?
 
The new IR residency will affect any person who starts IR training after July 1, 2020. This includes nearly all diagnostic radiology (DR) residents whose radiology (post-internship) start date is on or after July 1, 2016. All VIR certificates offered by the ABR will change to the new IR/DR certificate after July 1, 2020. In addition, the ACGME will no longer accredit one-year fellowships after July 1, 2020. At that point, training in IR for DR residents will have to be in either a one- or two-year independent IR residency. For DR trainees to be in a one-year independent IR program, their PGY-5 year of DR training must be in an ACGME-approved Early Start in Interventional Radiology (ESIR) curriculum. For more information on IR training pathways, see the "Focus on Interventional Radiology" article in this issue of The BEAM.

Focus on Quality and Safety
The Approach to Quality and Safety as Pertains to ABR Certification in Diagnostic Radiology
by Lane F. Donnelly, MD, ABR Diagnostic Radiology Trustee for Quality and Safety
 
2016;9[1]:9-10
 
During the past 15 years, a great deal of attention in American medicine has focused on quality and safety (Q&S) and how we can ensure the reliable delivery of safe, effective, efficient, and patient-centered care. Within the radiology community, great progress has been made regarding these aspects of care, although we continue to have room for improvement.  
 
From a certification standpoint, over the past decade the emphasis on leveraging the board certification process to foster a culture of Q&S among the member boards of the American Board of Medical Specialties (ABMS), including the ABR, has increased. There is evidence that board certification is in itself associated with improved quality [1-3] and that members of the public see board certification as important to their confidence in their physicians [4, 5]. Although the process is still relatively new, there is also growing evidence that Maintenance of Certification (MOC) is associated with increased quality [6-10].  

Focus on Diagnostic Radiology
A Short History of Certifying Examinations in Diagnostic Radiology
by Kay H. Vydareny, MD, Associate Executive Director for Diagnostic Radiology and the Subspecialties
 
2016;9[1]:11-13
 
Now that the transition to our new examination paradigm is complete, and the "Examination of the Future" is now the "Examination of Today," it is a good time to look back at the history of ABR certifying examinations in diagnostic radiology. 
 
The ABR was incorporated in January 1934, and the first examination--an oral examination covering musculoskeletal, thoracic, gastrointestinal, and genitourinary radiology--was given later that year. No two examiners used the same material, and thus no two examinations were the same. Applicants for the first exam were separated into three groups: The members of one group, who were considered outstanding radiologists, were given their certificates without an exam; the second group, which consisted of lesser-known but still important radiologists, took four-category exams; and the third group, everyone else, took six-category exams. Residents had to wait a year after finishing a training program to qualify for the examination.

Focus on Interventional Radiology
The New IR Training Pathways
by James B. Spies, MD, MPH, ABR Trustee
 
2016;9[1]:14-16

In November 2015, the ACGME approved the first eight interventional radiology (IR) residencies, the vanguard of a new training paradigm for the specialty. In the months ahead, more programs will complete the application process and will be approved, and it is anticipated that more than 30 programs will be able to participate in the match for the new IR residency in March 2017.
 
In reflecting on this milestone moment, it is useful to consider the dynamics within medicine that have led to the creation of this new program. It is the culmination of more than a decade of efforts by leaders in radiology, working to create a stronger training program--one designed to meet the challenges of today's practice. This effort has been driven by the desire to improve training in interventional procedures and patient care, particularly in the increasingly complex environment of current medical practice. 

Focus on Radiation Oncology
Past, Present, and Future of the Radiation Oncology Specialty
by Paul E. Wallner, DO; Dennis C. Shrieve, MD, PhD; and Anthony L. Zietman, MD
 
2016;9[1]:17-19

In anticipation of the October 2015 meeting of the ABR Board of Governors (BOG) and Board of Trustees (BOT), we were asked to prepare an overview of the state of radiation oncology, including challenges and opportunities that face the specialty in the coming decade as they might relate to initial certification (IC) and Maintenance of Certification (MOC) development and programming. The request provided an opportunity for a review of the dramatic changes in the specialty over the past 100-plus years, and how those changes have impacted IC and, more recently, MOC.

Focus on Medical Physics
Medical Physics and ABR Certification
by Geoffrey S. Ibbott, PhD, Secretary-Treasurer, ABR Board of Governors, and G. Donald Frey, PhD,
Associate Executive Director for Medical Physics
 
2016;9[1]:20-25

The American Association of Physicists in Medicine (AAPM) estimates that there are 6,800 practicing medical physicists in the U.S. Membership in the AAPM is open to scientists and others who have an interest in the field, and who practice in settings that involve medical physics work. Membership is not restricted to those with degrees or certification in medical physics, and as a result, there is a wide variation in educational background, clinical experience, qualifications, and career goals among AAPM members. There are others who identify themselves as medical physicists but who are not members of the AAPM. All this makes it somewhat difficult to characterize the profession, but this article is an attempt to do so.
 
According to the AAPM, the majority (75 percent) of medical physicists work fully or primarily in radiation therapy. (See Figure 1.  Source, AAPM Annual Professional Survey). Only 70 percent report that they are certified by the ABR, the American Board of Medical Physics, the Canadian College of Physicists in Medicine, or another board. Approximately the same number (69 percent) say that they work primarily in clinical activities, with 22 percent working in research and 9 percent who are primarily administrators.
Spotlight on an ABR MOC Participant
2016;9[1]:26-27

For this issue's "Spotlight on MOC" article, we interviewed Dr. Mario E. Torres-Le�n, a diagnostic radiologist with numerous interests and entrepreneurial projects. We asked him to describe his experience with MOC, and he recounted the following story:
 
"In October 2015, I flew to Chicago for my 10-year MOC recertification examination. I must confess that I was quite intimidated by the process. I could only think about all the anecdotes that attendings, residents, and fellows had told about the Executive West (for those who had the pleasure of taking the Boards there). For months, it was as though I was reliving the spring of 2004 all over again! Could this really be happening? Well, I guess it could. Fortunately, the ABR's extremely kind and supportive staff was there to make the process easy and to guide me literally to the door of the hotel.

"Having gone through the process of initial board certification and Maintenance of Certification has been invaluable. We have chosen what, in my opinion, is the most intellectually challenging specialty in medicine. By virtue of this, the amount of material we must know is substantial and continues to increase. The MOC process allows us to get reacquainted with much of what we had to study and intimately know to initially pass the boards. While studying for the MOC exam, I was surprised by how much information I was able to recall, even though I had not seen it in years. That was reassuring! I chose to define the preparation process as a way to recommit to patients and an important opportunity to polish my skills. Having practiced for 10 years gave me a unique perspective for the exam and a degree of appreciation for my specialty that I did not have in 2004.  
Reminder: Diagnostic Radiology Exam Fees
2016;9[1]:28
 
Beginning in 2016, registrants in Diagnostic Radiology (DR) programs will be required to pay their registration fees as part of the application process. Registration will open on July 1 and end on September 30. Late registration will be accepted from October 1 through October 31 with an additional late registration fee of $400.
Connections Center Staff Respond Quickly to Queries
2016;9[1]:29
   
Left to right: Connections Center Supervisor Kelly Trapp, and Specialists Jessica Smith and Breann Stevens
A little over a year after implementing the Connections Center, the American Board of Radiology (ABR) has cut its turnaround time for resolution of issues from days or weeks to minutes and hours. This team of trained, customer-focused individuals is charged with providing timely, accurate, and consistent responses to inquiries. The team serves as the first tier of response to telephone calls and email messages from 7 a.m. to 5 p.m. (Arizona time) weekdays.

"They are able to answer most questions immediately, or forward the call or message to the appropriate ABR staff expert," said ABR Executive Director Valerie P. Jackson, MD. Each inquiry is tracked from initiation to resolution to ensure that nothing falls through the cracks, and responses are timely, that is, completed within one business day in most cases. Feedback from candidates and diplomates has been overwhelmingly positive, as reflected in the many compliments received by Connections Center staff. 

List of Society Attendance
2016;9[1]:30

 

The ABR sponsors a booth at numerous society meetings throughout the year. Printed materials are available, and ABR representatives are in attendance to answer your questions. To see a list of society meetings at which the ABR plans to have a booth in 2016, please click here

Thank you. . .

 

for reading this issue of The BEAM. If you have any comments, suggestions, or questions, please email [email protected].

 

View or download all articles in one Adobe PDF file. Adobe PDF Icon

Copyright 2016. The American Board of Radiology. All rights reserved.