ABR Seeks Stakeholder Input on DR Initial Certification Process
by Desiree E. Morgan, MD, ABR Trustee, and Brent Wagner, MD, MBA, ABR Executive Director
In response to the COVID-19 pandemic, the ABR reevaluated and changed many certification processes over the past 30 months across all disciplines (radiation oncology, medical physics, interventional radiology, and diagnostic radiology), and the radiology community has for the most part responded with satisfaction.
Armed with lessons learned relating to exam administration possibilities, in October 2021, the ABR Board began considering the effectiveness and appropriateness of DR Initial Certification. The process thus far has addressed a series of questions including: the intended purpose of the exams, the effectiveness of the current model as a testing instrument for that purpose, and whether there are potential opportunities for improvement via alternative methods of assessment.
Perceptions of the exams have understandably varied over the 10 years since the introduction of the current model, which consists of the Qualifying (Core) Exam at the end of the third year of residency and the Certifying Exam approximately 15 months after completion of the final year. Board members, most of whom are teaching faculty, recognize that thoughtful inquiry and disciplined efforts to set aside assumptions about the appropriateness of the exams as testing instruments are not only a requisite part of a critical review but also represent a responsibility of the ABR as it responds to new technology and changing practice paradigms.
The Board realized at the outset that external stakeholder input was critically important in the examination of this process. The ABR began formal communications with stakeholders in May, and thus far has established three channels: (1) meetings with leadership from radiology organizations including, but not limited to, those representing the interests of trainees and program directors; (2) invitation for public comments via our website; and (3) additional discussion forums for specific solution-based feedback as the process continues. Currently, most of these efforts pose open-ended questions about the strengths and weaknesses of existing exams, for example, “How well do the Qualifying (Core) and Certifying exams assess radiology knowledge and clinical competence?” The comprehensive list of framing questions can be viewed here.
For clarification, our responses to a few frequently asked questions about this process can be summarized as follows:
- There are no limits to the breadth of the discussion as it relates to diagnostic radiology certification. For example, although our emphasis is on the Certifying Exam, both the Qualifying (Core) and Certifying exams are the subjects of our inquiry and, potentially, modification.
- We are intentionally deferring detailed discussions of “solutions” until we, with input from our external stakeholders, establish the existence, extent, and characteristics of potential “problems” to be addressed.
- Substantive changes, if any, to the exam structure will be announced with enough advance notice that then-current trainees will not be impacted. We plan to provide approximately five years’ notice prior to implementation of any significant modifications to the exam process.
- Although interventional radiology / diagnostic radiology (IR/DR) candidates sit for the Qualifying (Core) Exam, changing the certifying exams (oral and written) for IR/DR candidates is not a subject of this analysis.
The ABR is intent on continually improving all testing paradigms. Our current focus on seeking input from stakeholders means that we spend most of the time listening. We are extremely grateful for the candid and thoughtful exchanges we have had with our colleagues, and we look forward to a robust continued dialogue.