Impact of COVID-19 on IR Training and Certification
by M. Victoria Marx, MD, ABR Trustee
The novel coronavirus (COVID-19) pandemic is having a profound effect on all aspects of undergraduate, graduate, and continuing medical education in all specialties. The new primary specialty of interventional radiology (IR) is no exception. There is likely to be variability in medical student access to IR electives/selectives in the coming months – at the time of year when many fourth-year students interested in IR typically choose to participate in an IR clerkship. The breadth and volume of patients cared for and procedures performed in IR divisions may be lower than normal, limiting the educational experience available to residents. The most dramatic effect to most residents, however, has been the necessity for the ABR to cancel the June 2020 Core Exam.
The Core Exam, normally taken in June of the PGY-4 year of residency, assesses candidate knowledge of the entire domain of diagnostic radiology (DR), including physics, safety, and radiobiology. Subsequently, the PGY-5 year of IR residency, and that of DR residents participating in an Early Specialization in IR (ESIR) curriculum, is dominated by IR and IR-related rotations. Because of the COVID pandemic, the only Core Exam now scheduled in 2020 is the fall administration on November 5-6 and 9-10. Note that it is not possible to administer the Core Exam remotely because of the inability to adequately control image quality, testing environment, and security. Administration of the Core Exam in the fall to an entire class of residents may require IR and DR program directors to reconfigure resident rotation schedules in the final quarter of the 2019/2020 academic year and in the first quarter of the 2020/2021 academic year. The process is complicated for program directors due to the need to balance the educational needs of IR integrated residents, ESIR DR residents, and other DR residents. ACGME has provided guidelines regarding the need to modify rotation schedules. Academic Radiology has also published a concise overview of information useful to managing IR residency during this time. Close collaboration between the IR and DR program directors in each department will optimize the resident experience. The ABR appreciates the efforts of all stakeholders to ensure that residents continue their education effectively and safely.
The IR/DR Certifying Exam schedule has not yet been impacted by the COVID-19 pandemic. The exam is scheduled to take place in Tucson on October 18-20, 2020. This exam consists of two computer-based modules (Essentials of Radiology and Interventional Radiology) and four oral exams covering image interpretation, image-guided procedures, and periprocedural management of patients. Graduates of a DR residency who have completed an IR fellowship are eligible to sit for the exam (either the entire exam or the oral component alone for DR certificate holders) 15 months after completion of fellowship. Graduates of an IR residency who meet all ABR qualifications (see ABR website) may take the entire IR/DR Certifying Exam three months after graduation. That means that IR residents graduating in June 2020 will be able to take the October 2020 exam. In its statement on the impact of COVID-19 on ACGME residency training, the ABR has stated that it will “continue to rely on program directors, supported by their Clinical Competency Committees, to provide attestation to the completion of individual training” (see Coronavirus Information). This statement emphasizes that programs have the flexibility and responsibility to judge the impact of COVID-19 on resident education and preparedness for independent practice and certification.
Fortunately, as a result of the implementation of the ABR’s Online Longitudinal Assessment (OLA) program in IR, the assessment of knowledge, judgment and skills component of IR MOC has not been impacted by COVID-19. Two new OLA question opportunities are available each week as scheduled.
Note that the ABR has extended the 2020 subspecialty exam application window to May 31 (see Coronavirus Information). These tests are available to DR and IR/DR certificate holders who have completed subspecialty training in neuroradiology, nuclear radiology, and/or pediatric radiology. Those exams are scheduled for October 4, 2020, in Tucson and Chicago.
The ABR is responding as quickly and thoughtfully as possible to the COVID-19 pandemic and is working closely with stakeholders in specialty education and certification to allow processes to proceed in ways that are effective and safe. It is possible that further adjustments to the testing schedule will be required. The ABR will continue to monitor the pandemic and notify stakeholders promptly of any new developments. In the meantime, we all need to continue to work hard, take care of our patients, and be mindful of our own health and safety.