American College of Radiology blog

How Will the ABR’s Changes to Diagnostic Radiology Boards’ Structure and Timing Affect You?

We are all well aware that the American Board of Radiology (ABR) has planned changes to future certification exams in radiology. This will affect residents beginning in 2010, and will not alter the training of those already in residency. The last time this topic was discussed on the blog, many of you voiced your concerns over the decision to delay the certifying exam to 15 months out of residency, and how the changes may create too strong an emphasis on subspecialization.

These changes have been in deliberation for years — those who agree with the changes believe fourth-year residents should concentrate on their responsibilities, and not have to balance studying at the same time; those on the other side believe that residents in their fourth year are best suited to handle the core competency-based format and therefore the exam should remain static.

In response to the many questions ACR members had regarding these changes — rather than deliberate the pros and cons to each side of the debate — the College created a task force to consider the potential impact of changes in the diagnostic radiology boards’ structure and timing. I served as chair, and my fellow members included a mix resident physicians, and private and academic practice members.

So, what will these changes mean for those of us at present — those already in practice?

We realized that there would be no easy solution to this question, and we immediately determined a need to create two subcommittees — one to examine the impact of the ABR’s decision on the future practice of radiology and the ACR, and the other to focus on how the change might affect residency training programs and trainees. Our discussions are summarized at length in a white paper in the November issue of the Journal of the American College of Radiology (JACR). To read the paper in its entirety, login to the ACR Web site and then click on the JACR links on the bottom left-hand side of the page.

Was the task force successful at addressing your questions and concerns about this major change in radiology?

How do you think the number of individuals choosing to complete fellowships immediately after residency will change?

And, what other issues, if any, do you foresee?

I look forward to your thoughts.

How Can Academic and Private Practice Radiologists Work Together to Protect the Future of Radiology

A recent survey of SCARD (Society of Chairmen in Academic Radiology Departments) members revealed that up to 50 percent of academic radiology departments are underfunded, understaffed and are receiving declining support from state governments and medical schools.

Nearly one quarter of academic departments in the country are on the brink of insolvency. According to the survey, academic radiology departments spend nearly $400,000 on average annually to support lectures and educational programming alone. 

Due to a number of factors, many residents who may have sought positions in academic radiology as educators or researchers are opting to pursue their calling in private practices.

While fulfilling the need for radiology teaching and research positions is critical to the ongoing success and future of the profession, it is less clear how the profession will support these efforts in the future. 

Thomas Fletcher, M.D, FACR and Gerald Dodd, III, M.D., FACR have formed a task force to explore alternative ways for private and academic practices to form partnerships or alliances to alleviate the current strains on academic radiology.

Ideas put forward to date include:

Private practice doctors:

• Performing clinical work pro bono for academic departments to relieve staff shortages in the academic setting and preserve department revenue
• Establishing endowed chairs in academic departments
• Funding fellowship slots
• Investing in radiology research organizations like the ACRIN Fund for Imaging Innovation

Academic departments:

• Providing free CME
• Appointing private doctors to academic appointments
• Recognizing support from private doctors with publication bylines

We would like to hear what ideas you may have for the task force. Is there a problem in academic radiology funding? If so, what are some solutions? 

What partnerships or alliance efforts have you formed or would consider forming in your area? Are there national solutions to consider? 

I look forward to your thoughts.

How Do We Attract More Medical Students to Radiology?

More radiologists are (and will increasingly be) needed as advancing technology allows imaging exams to replace more invasive procedures. An aging population, which will require more medical services, can only add to the need to attract medical students and recent graduates to the field of radiology.

One area of particular concern is women in radiology. An Association of American Medical Colleges survey released in October 2005 showed that nearly half (48.5 percent) of medical students are women, but only about one-quarter (24 percent) of diagnostic radiology trainees, residents and fellows are female and only 18 percent of all post-training, professionally active radiologists are women. The report cited the following as reasons for this trend:

• Lack of direct patient contact
• Lack of exposure to radiology as medical students
• Lack of female radiologist role models

To counter a slight shortage of radiologists, both male and female, the ACR has taken several steps including:

• Working to increase the residency slots for radiology annually by 300
• Arranging events for female medical students to interact with women radiologists as role models
• Organizing a focus group including several young and more experienced female radiologists to explore ways in which radiology can attract/retain more women to/in the specialty

There is no doubt that residents and fellows are the future of our specialty. What other steps do you think that the ACR can take to attract more medical students to pursue a career in radiology?

Should the Oral Boards Be Delayed?

At the ACR Annual Meeting and Chapter Leadership Conference (AMCLC) this past May, the Oral Boards, or more specifically, their timing, were a lively topic of conversation.

In their meeting, the members of the Society of Chairmen in Academic Radiology Departments (SCARD) had recommended the boards be delayed for two years after residency, so that residents would be able to spend the entire fourth year of their training concentrating on their rotations, rather than in the library, studying, and so forth.

The Residents and Fellows Section of the Council disagreed and suggested such a change would make it difficult to obtain and concentrate on new jobs or fellowships, and that it would be more difficult to study for and pass the boards.

Add to this the concern of private practices — that the new recruits would be less available, would not have Board Certification, plus the issues surrounding Maintenance of Certification and Time Limited certificates — and you have quite a brew (and brouhaha).

Accordingly, the Council decided to empower a task force to study these issues. Chairman of the Board Dr. Arl Van Moore has asked me to chair that task force, and we will be preparing a report for the next annual meeting (May 2008).

Please give us your thoughts, and be sure to include your basic demographic data. Your voice will be important in clarifying the many attendant issues.

Barry D. Pressman, M.D., FACR
President
American College of Radiology