Focus on IR/DR

Focus on IR/DR

Change in the Timing of the IR/DR Oral Certifying Exam

By James B. Spies, MD, MPH, ABR Associate Executive Director for Interventional Radiology


James Spies, MD

Board certification is a central goal of graduating residents in interventional radiology. Many employers and health systems require certification within a specified interval after board eligibility is established and therefore the timing of the exams is important. For IR residents, the computer-based Qualifying (Core) Exam is the same as for diagnostic radiology residents and occurs after 36 months of training. Upon graduation, there are two components of the certifying exam to consider – computer-based and oral. Both need to be passed to become IR/DR certified.

The computer-based component is given once a year, usually in the early fall, coordinated with administration of the Diagnostic Radiology Certifying Exam. Graduating IR residents qualify to take this exam upon successful completion of their training, and they may register for the exam the same year as their graduation.

When interventional radiology was a subspecialty of diagnostic radiology, IR fellowship graduates were required to have a full year in practice prior to taking the oral component of the certifying exam, and thus certification was delayed until the following calendar year. Mindful of the burden this might have on candidates trying to meet certification requirements in their practice, this requirement was changed with the new IR residencies in 2020, and those graduates qualified for the oral exam immediately after completion of training. The last group of fellowship graduates completed training in June 2020, and all subsequent graduates have been qualified to sit for the exam at the fall administration that same year.

While this may have aided a small number of graduates in their desire to become certified as soon as possible, somewhat surprisingly, we have found that a majority of candidates have not chosen to register for the oral exam in the fall after graduation. This might be due to the many transitions newly graduated interventional radiologists face in the first few months after completing training. Most will have a new job, often in a different city or state, and settling themselves and their families into a community is time consuming. They are beginning a new practice, with unfamiliar rules, administrative burdens and the stress of adapting to practice as an IR attending. With all these burdens, setting aside the time to prepare for both the computer-based and oral components of the certifying exam might be a challenge. Perhaps for this reason, many take the computer-based component in the fall of their graduation year but choose to defer the oral component until the following spring or even later.

Regardless of the reasons why new grads choose to defer the oral component of the exam, it has made it challenging for ABR staff to predict the number of registrants for the fall and spring oral exams. This, in turn, makes it difficult to plan the number of exam days needed and the number of examiners necessary for each exam. This has a significant impact on the examiners, who need to plan the time they must set aside for each exam well ahead of exam days.

Two of the other ABR disciplines (radiation oncology and medical physics) have a longstanding requirement that the oral certifying exam may not be taken until the calendar year after graduation, and their primary exams are in the spring. The new Diagnostic Radiology Oral Exam, scheduled to begin for those graduating in 2027, will also require that the exam be taken no sooner than the calendar year after graduation.

With both these factors in mind, the ABR Board of Governors decided in February 2023 that for IR trainees graduating in 2024 or later, the first opportunity to sit for the oral exam will be spring of the following calendar year. This will result in the spring IR oral exam becoming the primary oral exam for the year, anticipating that a majority of eligible candidates will choose that administration. IR (and the other disciplines) will continue to offer a fall oral exam, but with a much smaller group of candidates.

The goal of this change is to meet the anticipated needs of the candidates for a more stepwise approach to certification and for the ABR to plan more accurately for its exam events. We hope that with graduates taking the computer-based component in the fall of their graduating year and the oral component the following spring, certification will be a less of a burden on the candidates and provide a more stress-free exam experience.

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