IC Policies

INITIAL CERTIFICATION POLICIES

The following policies are pertinent to Initial Certification :

 Appeals
CAMPEP - Physics only
Professional Standing
 Policy Regarding Brachytherapy Requirements - RO only
 Medical degree information
 Board Eligibility policy
 

  APPEALS POLICY

The American Board of Radiology has established the Appeals Policy to resolve concerns with decisions made by the Board relative to the following five areas:

1. Training requirements
2. Admissibility to examinations
3. Examination process
4. Requests for examination accommodations under the Americans with Disabilities Act (ADA) (see ADA policy)
5. Non-renewal of MOC certificates

The policy provides for three avenues of resolution for concerns:

1. Inquiries and requests as to status or requirements
2. Requests for reconsideration by the Board
3. Appeals hearings (informal and formal)

All appeals MUST be made in writing, submitted via email or certified letter, and received at the ABR office no more than 45 days from the date of the initial written notification of the Board decision. Appeals must be addressed to the Executive Director, and appropriate documentation should accompany written concerns.

CATEGORIES OF CONCERNS

Training Requirements

• Concerns regarding denial of approval of training.

Admissibility to Examination

• Concerns regarding the denial of admissibility to an examination for any other reason.

Examination Process

• Concerns regarding the process (including form or administration, e.g., computer malfunction) of the Initial Certifying or Maintenance of Certification examinations
• Examination results may not be appealed.*; written feedback on oral exams and hand scoring of computer-based exams are available by request on our website.

• Appropriate documentation should accompany written concerns.

Requests under the Americans with Disabilities Act (ADA)

• Concerns regarding the denial of a request for examination accommodations under the ADA

Non-renewal of MOC Certificates

• Concerns regarding notice of non-renewal of an ABR time-limited certificate (based on failure to meet MOC requirements)

* All examination results are subject to extensive quality assurance procedures before release. In the case of the oral examinations, scores are reviewed on-site at the oral exams by multi-category panels, senior staff, and trustees.

This policy is subject to amendment. Candidates and diplomates are advised to check the ABR website periodically for the most current version.

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  ABR MEDICAL PHYSICS EXAMINATION FUTURE REQUIREMENTS (CAMPEP)

Two new requirements address eligibility to take the ABR initial certification examination in medical physics with linkage to CAMPEP-accredited education programs starting in 2012. This policy statement was developed by the Medical Physics Trustees as a follow-up to the August 17, 2007, ABR/CAMPEP Summit in Dallas, Texas. The policy as recommended was approved by the full ABR Board of Trustees on October 13, 2007.

2010 Initiative:

Candidates taking the American Board of Radiology Part 1 examination in medical physics for the first time in 2012 or later must be enrolled in or have graduated from a CAMPEP-accredited education program (e.g., MS, PhD, or residency). A candidate who has graduated from the CAMPEP-accredited education program at the time of application must be working as a medical physicist as specified here.

Note: This policy was updated in August 2012. For more information, please visit www.theabr.org/ic-rp-newcampep.

2014 Initiative:

Candidates who file new applications for Part 1 in the year 2013 for the 2014 exam cycle must be enrolled in a CAMPEP-accredited education program, certificate program or residency.  They must have completed a CAMPEP accredited residency to become eligible for Parts 2 and 3.  Their CAMPEP residency director must attest that the candidate has had appropriate didactic and clinical training take the Part 2 and Part 3 examinations.  The program director must also designate a field (Diagnostic Medical Physics, Nuclear Medical Physics, or Therapeutic Medical Physics) in which the candidate is prepared to take the examination.

ABR procedures require application submission by October 31 of the year before the examination.

This policy is subject to amendment.

Candidates and diplomates are advised to check the ABR website periodically for the most current version.

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  PROFESSIONAL STANDING POLICY FOR APPLICANTS/CANDIDATES

September 23, 2011

POLICY:

A. Required Licensure. At the time of certification by the ABR and throughout the certification and maintenance of certification processes, the physician must hold a current, full and unrestricted license to practice medicine in at least one jurisdiction in the United States, its territories or Canada, including the state(s) in which he/she currently practices, or if practicing abroad, in the country of practice (see Policy for International Licensure). Restrictions placed on a medical license must be reported to the ABR by the physician within 60 days of their imposition.

B. Potential Certificate Sanctions. The Board may at its discretion revoke or suspend a certificate for due case as provided in the ABR bylaws:

“Any license of the person to practice is not, or ceases to be, a valid and unrestricted license to practice within the meaning set forth in the Rules and Regulations of the American Board of Radiology.  In the event that a diplomate’s license to practice is suspended, revoked or restricted in any state in which the diplomate practices, holds a license or has held a license, the diplomate’s board certification may be revoked or suspended.”

Definitions of Sanctions:

1. Revocation: Diplomate ceases to be certified. Re-entry is under provisions of re-entry policy, with a new time-limited certificate requiring participation in MOC for its maintenance. 
2. Suspension: Diplomate is not certified for at least the specified period of time (possibly concurrent with the licensure action). Conditions may be stipulated by the board; when met, the suspended certificate is reinstated (as a lifetime certificate, if it was originally lifetime)

An alternative to certificate sanctions is “probation” in which the diplomate continues to be certified; monitoring is done, there may be restrictions on practice, periodic contacts and other requirements may be stipulated.

C. Regaining or Reinstatement of Certification

1. Once a valid, unrestricted license is held in the state of current practice, a physician may contact the Board to initiate a request to regain board certification, or have his/her original certificate reinstated.
2. After suspension: When the Board reinstates a physician’s board certification after it has been subject to suspension by the Board, he or she is entitled to resume use of his/her original board certification with the appropriate expiration date of that certificate. If the original board certification was not time-limited, after reinstatement the physician will continue to have a non-time-limited certificate. The Board may, however, in its sole discretion, set other conditions and terms for reinstatement that it deems appropriate considering, among other things, the underlying facts that led to the restriction,  the period of time the physician has not been able to engage in the unrestricted practice of medicine, and her/his specialty.
3. After revocation: When the Board has revoked a physician’s board certification, the physician is not eligible to have the original certificate reinstated. In addition to other terms and conditions, the Board may require that a physician first pass the examination(s) required for ABR certification or maintenance of certification in the specialty or subspecialty.  Upon satisfactory completion of all steps required by the Board, the physician whose certificate previously was revoked shall be issued a new certificate that is time-limited, and the physician shall be required to participate in MOC for its maintenance.  

Professional Standing Policy for Applicants/Candidates

Policy history:   Approved by MOC Coordinating Committee at the March 2006 meeting of the Board of Trustees.  Modified by Policy Committee October 2006. Modifications proposed February 2007 by attorney with Policy & Bylaws Committee chairs, further amended May 2007 on advice of attorney, including separate policies for diplomates and applicants/candidates.

A. Required Licensure

For certification by the ABR, the physician must hold either:

• a current, full and unrestricted license to practice medicine in at least one jurisdiction in the United States, its territories or Canada,  or
   
• in jurisdictions which provide for a “training license” under the supervision of the institution’s training program, the physician must hold such license continuously and without restriction.

Any restrictions placed on any medical license or training license must be reported to the ABR by the physician within 60 days of their imposition.

   POLICY REGARDING BRACHYTHERAPY REQUIREMENTS

February 21, 2011

Purpose: To clarify classification of brachytherapy and radioactive unsealed sources for completion of residency training and registration for the ABR certifying examination.

Program directors and candidates for ABR certification have frequently raised questions regarding the appropriate category for logs in brachytherapy cases because of differing terminology employed by the ACGME, FDA, and NRC, and the periodic introduction of new agents and delivery systems that seem not to permit simple categorization. This policy has been developed to reduce that confusion and to better enable staff to deal with numerous candidate inquiries.

Current requirements: (from the ACGME Program Essentials in Radiation Oncology, adopted 1/2009)

IV.A.5.a).(2)….... must perform no fewer than 5 interstitial implants and 15 intracavitary implants. Resident involvement should include planning, review of dosimetry, and hands-on participation in a significant portion of the implantation procedure. Separate applications of an implant in a given patient (such as two separate intracavitary applications) may be counted as two separate procedures. However, multiple fractions of a single application (such as multiple fractions of an interstitial implant) may be counted only once. Only one resident may count a specific application.

IV.A.5.a).(3)……. must participate in the administration of no fewer than six procedures using radioimmunotherapy, other targeted therapeutic radiopharmaceuticals, or unsealed radioactive sources;

Note: NRC requirements for Authorized User eligibility require a minimum of 3 oral I-131 cases and 3 cases employing unsealed sources.

Acceptable case material:

Interstitial implants

• Any application of radioactive needles, wires, or seeds directly into a tumor volume or into catheters placed in a tumor volume (e.g. prostate brachytherapy, etc)
• Any application of sealed or unsealed sources into a catheter pre-placed directly into tissue (non-natural body cavity or non-natural lumen) (e.g. breast balloons, GliaSite® applications, etc.)
• Surface molds

Intracavitary implants

• Any LDR or HDR application into a natural body cavity or lumen, whether direct or into a pre-placed applicator (e.g. endobronchial, billiary, cervix, endometrial, etc.)

Parenteral procedures (to be considered as unsealed sources for NRC Authorized User eligibility a minimum of 3 are required)

• Therapeutic microspheres for treatment of disease in any anatomic site (e.g. TheraSpheres®, SIR Spheres®, etc.)
• Unsealed sources for treatment of bone metastasis (e.g. strontium-89, samarium-153, radium-223
• Unsealed sources for treatment of hematologic malignancies (e.g. P-32)
• Unsealed source administration directly into a body cavity (e.g. P-32)

Oral 131-Iodine procedures (for NRC Authorized User (or Agreement State) eligibility a minimum of 3 cases with administered activity equal to or in excess of 1.22 Gigabecquerels (33 mCi) are required)

• Conditions may be either benign or malignant but the counted administration must be for therapeutic intent.

Case logs and case counting

Program Directors and/or clinical supervisors will be required to attest on candidate case logs to the candidate’s meaningful participation in reported/counted cases.

 

   MEDICAL DEGREE INFORMATION PRINTED ON CERTIFICATES

September 23, 2011

POLICY:

ABR diplomates, who have been awarded a certificate from the American Board of Radiology, shall have their medical degree information printed on the certificate.  Additionally:

• The ABR shall print the doctorate level degrees that qualified the diplomate to enter the certification process. 
• An MD degree will not be substituted for a variety of international degrees if the diplomate has not earned it.
• If a diplomate requests that a degree not be included on the certificate, that request will be accommodated.
• A diplomate holding an earned PhD who requests its inclusion on the certificate will be accommodated, even if it is not the degree that qualified him/her for certification.
• Requests to change the certificate to add degrees earned post-certification will not be accommodated.

 BOARD ELIGIBILITY POLICY 

During the past several years, the American Board of Medical Specialties (ABMS) and its Member Boards have engaged in significant dialogue regarding the concept of “board eligibility.” The discussion has concerned what that term precisely means, how Member Boards and candidates should use it, and how it should be reported to the public. In September 2011, the ABMS Board of Directors determined that all Member Boards must develop consistent policies for the length of “board eligibility.” Under the new policy, each ABMS Member Board must determine the “board eligibility” interval, which must begin at the completion of accredited residency training and extend for no less than three years and no more than seven years.

On October 22, 2011, the ABR Board of Trustees adopted a policy for all ABR diagnostic radiology (DR) and radiation oncology (RO) initial certification candidates that became effective January 1, 2012. The medical physics (MP) trustees added MP requirements in March 2012. Candidates will have specific, pre- determined time limits for remaining eligible to be initially certified by the ABR and to maintain their status as “board eligible.”

Because a number of current candidates have completed training and continue in the examination process, the new policy will have a transitional phase-in period. For DR and RO, the phase-in timing will begin at the completion of residency training. For MP, “end of training” is defined as completion of a Commission on Accreditation of Medical Physics Education Programs (CAMPEP)-approved residency program or approval for Part 2 of the initial certification examination, whichever is earlier. For international medical graduates, “end of training” is defined as the end of the four-year period outlined in the Sponsoring Department Agreement.

For DR and RO, the termination dates for board eligibility status are listed in the table below:

End of Training	Termination of board eligibility
2004 or before	December 31, 2014
2005	December 31, 2015
2006-2010	December 31, 2016
2011 and afterward	6 full calendar years from end of training

 

For MP, the termination dates for board eligibility status are listed in the table below:

End of Training or Part 2 Approval	Termination of board eligibility
Prior to Jan. 1, 2011	December 31, 2016
Jan. 1, 2011, or later	6 full calendar years from end of training or Part 2 approval, whichever comes first

 

After the period of board eligibility, candidates failing to successfully complete the initial certification process will no longer be considered by the ABR as “board eligible,” will no longer be permitted to designate themselves as such for communications or credentialing purposes, and will no longer be reported as such on the ABMS website (www.certificationmatters.org) or in verification letters.

To return to “board eligible” status, DR or RO candidates must take an additional year of training in a department with an Accreditation Council for Graduate Medical Education (ACGME)-accredited or Royal

College of Physicians and Surgeons of Canada (RCPSC)-accredited DR or RO residency program. For MP candidates, the additional year of training must be at a CAMPEP-accredited program. At the end of the additional year, the department chair (or the program director for medical physics) must attest to satisfactory completion of the experience. After that documentation is provided to the ABR, the candidate may re-enter the certification process and will again be required to pass both the qualifying (Part 2 for medical physics) and certifying (Part 3-Oral for medical physics) examinations within a six-year interval.

Questions related to these or other Board certification issues can be addressed to icnotification@theabr.org, or by calling (520) 790-2900.

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These policies are subject to amendment. Candidates and diplomates are advised to check the ABR website periodically for the most current version.