Initial Certification for Interventional Radiology

Certificate Conversion FAQs

Last verified on July 22, 2019
 
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The IR/DR Certificate

 
 

Why did the ABR create a single IR/DR certificate? How was the decision made, and what process did you follow?

The IR specialty and the IR/DR certificate are the results of almost 20 years of work by the SIR and ABR on IR and IR education. The SIR was the primary driving force behind ACGME approval of VIR fellowships in 1991. Subsequently, the SIR and ABR achieved ABMS approval of VIR as a subspecialty of radiology in 1994. Beginning in 2006, as first an SIR initiative and then a combined SIR/ABR effort, work began on an IR primary (specialty) certificate. The fundamental motivation has always been the recognition that non-procedural care was a unique aspect of IR that, in combination with imaging and procedural competence, required dedicated training and warranted recognition as a primary specialty.
This effort resulted in a single certificate that includes competency in both interventional radiology and diagnostic radiology (IR/DR) for two major reasons:
  • First, SIR members and all diagnostic radiology stakeholders overwhelming favored a combined specialty certificate that would support practice in both interventional radiology and diagnostic radiology. This was ascertained through SIR member polls; discussions and presentations at SIR meetings; and formal discussions (leading to modifications of the proposal and endorsements) with key radiology organizations such as the American College of Radiology, the Radiological Society of North America, the American Roentgen Ray Society, the Association of Program Directors in Diagnostic Radiology, the Society of Chairs of Academic Radiology Departments, and nine other radiology specialty organizations.
  • Second, the American Board of Medical Specialties (ABMS), the governing body of the 24 specialty boards, does not allow any of its Member Boards to issue two certificates covering the same specialty. Therefore, the ABR cannot issue both a VIR subspecialty certificate and an IR/DR specialty certificate, nor can we issue both a DR certificate and an IR/DR certificate to the same individual.
 
 

Did you have an open comment period to obtain feedback about this change? If so, when was it held? If not, why?

There has been significant support for the development of a defined IR specialty and training. Implementing the specialty of interventional radiology, the IR training path, and the IR/DR certificate was a multiyear process that began in 2006. It was widely discussed and debated throughout the development period, during which feedback from all IR and DR stakeholders, including those from the SIR, ACR, and ABR, was obtained and incorporated into the final proposal. Through this FAQ, the ABR is attempting to address the concerns of current and future certificate holders.  
 

Does conversion to the IR/DR certificate mean I am not considered a diagnostic radiologist with a subspecialty in IR?

  The IR/DR certificate indicates competency in both specialties. The IR portion of the certificate elevates the current subspecialty certificate to a primary specialty level, and the DR portion of the certificate is equivalent to a DR-only certificate. This provides diplomates with flexibility in the future to revert an IR/DR certificate back to a DR certificate.
 
 

If I chose to convert my DR and VIR certificate to an IR/DR certificate, will my old DR certificate be shown as “inactive” on the ABR and ABMS websites?

No. The DR certificate will no longer be visible on the ABR website. ABMS CertiFACTS will show a diplomate’s entire certification history, so credentialers will see that both the DR and VIR certificates were “converted” on October 15, 2017.  
 

If IR is truly its own specialty, why am I not being offered a new and separate IR board certification?

The initial thought was to have an IR certificate that would be completely separate from diagnostic radiology. However, after significant discussions, focus groups, surveys, etc., it became clear that this would be detrimental to practicing interventional radiologists because it would not allow them to practice diagnostic radiology if they were injured, changed jobs and needed to practice diagnostic radiology, or wanted to practice only diagnostic radiology. Thus, the IR/DR certificate was created. This certificate does several things, including the following:
  • It recognizes that interventional radiologists have trained in the same manner as diagnostic radiologists. Both are required to take three years of core radiology residency training. Following their core training, those in a DR residency may take up to 12 months of training in a single subspecialty (for a total of 15 months during the four years of residency), while those in an IR/DR residency are required to take two years of interventional radiology training. Therefore, there is no question that diplomates with the IR/DR certificate are also qualified to practice diagnostic radiology. This means that IR/DR diplomates cannot be disadvantaged in a radiology practice or told that they can’t practice diagnostic radiology.
  • The IR/DR certificate allows diplomates to drop the IR portion of the certificate if they decide they are not going to practice interventional radiology. They would simply notify the ABR that they are dropping the IR part of their certificate, and assuming they are continuing to practice radiology, they would change their MOC activities to focus on their new practice pattern. (See discussion about lifetime certificates below.)
 
 

I have been board certified for 20 years. If someone looks up my certifications, will the record reflect my years of board certification? Will the date of certification be the date of conversion to the IR/DR certificate?

No. The ABR system does not show the initial date of certification for any ABR diplomate’s certificates.  
 
 
 

Lifetime DR Certificates

 
 

How does conversion to the IR/DR certificate affect my lifetime DR certificate?

Your lifetime DR certificate gets removed from the public listing on the ABR and ABMS websites, but it will be stored in the ABR systems. If you decide to drop the IR portion of your IR/DR certificate in the future, your lifetime DR certificate will be re-issued.  
 

Can the ABR issue an IR/DR certificate and leave my DR certificate active as well?

No. The ABMS does not allow any of its Member Boards to issue two certificates covering the same specialty. Therefore, the ABR cannot issue both a VIR subspecialty certificate and an IR/DR specialty certificate, nor can we issue both a DR certificate and an IR/DR certificate to the same individual.  
 

If I had a lifetime DR certificate and I chose to convert to an IR/DR certificate, did I give up my ability to regain my lifetime DR certificate in the future if something changes?

Absolutely not. If you converted your DR and VIR certificates to an IR/DR certificate and for any reason decide you would like to drop the IR component of your IR/DR certificate at a later time, your lifetime DR certificate will be re-issued. No new requirements will be attached to the re-issued lifetime certificate.
 
 

If I converted to the new IR/DR certificate, am I still able to bill for DR activities?

Yes. The ABR specifically named this certificate Interventional Radiology/Diagnostic Radiology so interventional radiologists could practice in both specialties.
 
 

If the new certificate “does not negate the lifetime DR certificate,” why is it no longer acknowledged on the ABR’s website?

The ABR policy is to show only the current certificate(s) on its website.  
 

Will my lifetime DR certificate be converted to a time-limited certificate via the new combined certificate?

The new IR/DR certificate will be a continuous certificate, requiring participation in Maintenance of Certification. Your lifetime DR certificate will be removed from the public listing on the ABR and ABMS websites, but it will be stored in the ABR systems so that if you decide to drop the IR portion of your IR/DR certificate in the future, your lifetime DR certificate will be re-issued.  
 

Do I have to give up my DR certification to maintain my IR certification? Why?

No. The new IR/DR certificate covers your current DR certification. However, the DR-only certificate cannot be left active for those holding an IR/DR certificate because the ABMS does not allow any of its Member Boards to issue two certificates covering the same specialty. If you decide not to practice IR, then you would simply notify the Board that you want to drop the IR portion of your certificate. Your former DR certificate – lifetime, time-limited, or continuous – then would be reissued.  
 

If I chose the IR/DR option but drop the IR portion of my practice at a later date for any reason, can I reactivate my DR certification? How will this work?

Yes. Simply notify the ABR at (520) 790-2900 or by email at information@theabr.org, and we will make the requested change to your certification.  
 

If it is not being revoked, then why do I have to “reactivate” my “lifetime” DR certificate?

Since ABMS does not allow any of its member boards to issue two certificates covering the same specialty, your lifetime DR certificate must be held in a “converted” state and is covered by the IR/DR certificate. If you decide not to practice IR in the future, then the ABR will reactivate your lifetime DR certificate upon your request.  
 

Will reactivation of my lifetime DR certificate happen regardless of the reason I dropped my IR practice?

Yes, unless any disciplinary actions negate the validity of any certificate.  
 

What happens if the ABR eventually decides that lifelong DR certificates cannot be reactivated? What recourse will we have if this happens?

When the ABR began issuing time-limited certificates in diagnostic radiology in 2002, we promised lifetime certificate holders that they would not lose their certification, even if they chose not to participate in MOC. We will continue to honor our commitment to lifetime certificate holders.
 
 

VIR Subspecialty (CAQ)

 
 

If I chose to maintain only my DR certification, what happens to my VIR CAQ? Can I reactivate it at a later date?

The VIR subspecialty certificate became a legacy certificate on October 15, 2017, as this is the date that the first IR/DR certificate was issued. If you opted out of the IR/DR certificate and subsequently decide you would like to have the IR/DR certificate, you will need to follow a re-entry process.  
 

Can I opt out of the IR/DR certificate now but opt in to the combined certificate at a later date?

The VIR subspecialty certificate became a legacy certificate on October 15, 2017, as this is the date that the first IR/DR certificate was issued. If you opted out of the IR/DR certificate and subsequently decide you would like to have the IR/DR certificate, you would need to follow a re-entry process.  
 

If I chose not to convert to the new IR/DR certificate, can I still bill for IR activities?

That would depend on the insurance company/payer requirements. If they require IR certification for billing procedures, then you would not meet their requirement.  
 

If someone looks up my certifications, will they see my VIR CAQ as lapsed?

If you chose to convert to an IR/DR certificate, your VIR certificate will not show at all. Your new IR/DR certificate is shown as “Valid” on the ABR website. If you have a continuous VIR subspecialty certificate and chose not to convert, it showed as “inactive, not maintained” on October 15, 2017. If you have a time-limited VIR subspecialty certificate with a “valid-through” date and chose not to convert, it shows as “valid, not maintained” until the expiration date, at which point it will show as “expired.”  
 

What happens to my continuous VIR certificate (with no end date) if I chose not to convert to an IR/DR certificate?

The ABR policy is to show only the current certificate(s) on its website.  
 

What happens to my time-limited VIR certificate (with an end date) if I choose not to convert to an IR/DR certificate?

A time-limited VIR subspecialty certificate that is not converted to an IR/DR certificate remains valid until its expiration date. However, you can no longer maintain this certificate through MOC, as the ABR cannot support both the VIR subspecialty certificate and the IR/DR specialty certificate. This VIR certificate will be listed on the ABR website as valid until the end date, and not maintained.  
 

I am MORE than 10 years out from my fellowship and never obtained my VIR CAQ. Now it appears there is no way to convert to an IR/DR certificate without it. How can I become a board-certified IR? Can I take the boards without redoing my fellowship?

Yes. The ABR created a Transition Pathway to subspecialty certification in VIR (now IR/DR). The deadline to apply under this pathway expires February 28, 2020. Details are available here.  
 

I am FEWER than 10 years out from my fellowship and never obtained my VIR CAQ. Now it appears there is no way to convert to an IR/DR certificate without it. How can I become a board-certified IR?

If you are FEWER than ten years out from completing your fellowship, you are still eligible to sit for the IR oral exam and become IR/DR certified. Please contact the ABR office at (520) 790-2900 or by email at information@theabr.org for information on the application process.  
 

MOC Process and Costs

 
 

If I converted to an IR/DR certificate, do I have to participate in MOC?

Yes. MOC participation is required to maintain IR/DR certification. (See IR/DR MOC requirements.) However, you ONLY need to meet MOC requirements associated with IR. You do NOT have separate MOC requirements for a DR certificate. The MOC requirements are the same as those for maintaining the VIR subspecialty certificate.  
 

If I changed to the new IR/DR certificate, how will my current MOC process change? Do I have to take a test?

The MOC process for IR/DR is the same as the MOC process you’ve participated in for your VIR subspecialty certificate. However, the ABR recently made a decision to move away from the traditional 10-year MOC exam for all ABR specialties in favor of a continuous model with more feedback. You will be able to answer practice-profiled questions from your own personal computer or smart device. Check out this Beam article for more information on Online Longitudinal Assessment (OLA).  
 

What is the definition of continuous certification? What does it entail?

Continuous certification means that ongoing certification is contingent upon participating in and meeting requirements of MOC. Check out the IR/DR MOC requirements.  
 

How much does the new IR/DR certificate cost to maintain? What is the cost increase of maintaining the new certificate vs. the current DR certificate and VIR CAQ?

There are no changes in your MOC fees. The cost for maintaining an IR/DR certificate is the same as it has been for the VIR subspecialty certificate.  
 

I recently took and passed an MOC exam for DR and/or VIR. Does that exam earn me another 10 years of certification without MOC participation?

No. Passing an MOC exam doesn’t prospectively count for future MOC requirements. The 10-year examination has always been the culmination of the previous 10 years of certification. MOC requires continuous participation, including annual attestation. However, IR/DR diplomates will no longer have to take a traditional 10-year MOC exam if they were meeting their exam requirement by March 1, 2017. The ABR is working hard to improve the MOC process and is currently developing an Online Longitudinal Assessment (OLA) program. Questions in IR, along with immediate feedback, will be provided on your personal computer or smart device. The OLA process will be a means for continual assessment and learning. We anticipate this process to start in 2019-2020.
 
 

I have a current lifetime certificate in DR with no need for MOC. If there is a need for MOC, is it purely for IR or is it DR as well? Will we need to take ongoing exams for DR? At what price? At what time commitment?

Since the IR/DR certificate is continuous, MOC participation is required in order to maintain it. Your MOC content is exactly the same as for your current VIR subspecialty certificate. You are not required to take additional material or perform additional tasks to maintain the DR component of the IR/DR certificate. The only change was that we are no longer requiring a traditional MOC exam every 10 years if you passed the exam before March 1, 2017. The ABR is working hard to improve the MOC process and is currently developing an Online Longitudinal Assessment (OLA) program. Questions in IR will be provided, along with immediate feedback on your personal computer or smart device. The OLA process will be a means for continual assessment and learning. We anticipate that this process will start in 2019-2020. There will be no changes in your MOC fees, and the cost for maintaining an IR/DR certificate will be the same as it has been for maintaining the VIR subspecialty certificate. You will not be required to participate in a second MOC process for the IR portion of your certificate.  
 

AU Designations

 
 

I am an Authorized User (AU). Does the IR/DR certificate conversion affect my AU designation?

No. The IR/DR certificate conversion does not affect your AU status from the NRC. If you have already received AU status from the NRC, this does not impact that status.  
 

I have the Authorized User-Eligible (AU-E) designation on my diagnostic radiology certificate, but have not yet been granted Authorized User (AU) status by the NRC. Does the IR/DR certificate conversion affect my Authorized User eligibility?

Yes. The NRC has not yet approved the new IR/DR certificate as an Authorized User-Eligible (AU-E) certificate. Therefore, you will need to apply to the NRC for Authorized User status based on the credentials on your DR certificate before the IR/DR certificate conversion on October 15, 2017.  
 

For Those in Training

 
 

What will happen to the DIRECT Pathway?

No new applications for the Diagnostic and Interventional Radiology Enhanced Clinical Training (DIRECT) pathway will be accepted.  
 

How does this certificate impact current training programs and fellowships?

The ACGME has approved the IR program requirements, and institutions began applying in 2015. Each training institution needs to review the requirements and determine whether and when to offer interventional radiologic training though an IR residency program. The impact of new IR residencies on DR residencies is determined by the course of action taken by each training institution. Trainees currently enrolled in VIR fellowships will be able to complete their training through June 30, 2020.  
 

How will these changes impact me if I’m currently in training?

The ABR recommends that you continue your training and seek certification according to the current processes already in place. If you are interested in practicing interventional radiology, you can seek certification in IR/DR by completing an ACGME-accredited VIR fellowship and then taking the IR/DR Certifying Exam. Those who have begun DR training may be able to earn IR/DR certification by transferring to an Integrated IR Residency in their current institution.