Radiology trainees decry moving Core Exam to 2021

By Theresa Pablos, AuntMinnie.com staff writer

June 10, 2020 -- The decision by the American Board of Radiology (ABR) to postpone its 2020 Core Exam to next year has led to an outcry by representatives from 17 major radiology groups. The groups have signed a letter asking the ABR for alternative testing options.

On June 3, the ABR announced it would postpone in-person certifying and specialty exams scheduled through November of this year, including the Core Exam that residents must pass to become board-certified radiologists. The ABR had previously rescheduled the 2020 Core Exam for November due to global disruption related to the novel coronavirus pandemic.

In response, more than a dozen radiology committees, organizations, and sections wrote a letter to ABR leadership outlining the potential personal and professional costs of postponing exams until 2021 and asking for alternative solutions. The signees included the RSNA Resident and Fellow Committee, the executive committees of both the American College of Radiology (ACR) Resident and Fellow Section and Young and Early Career Professional Section, and the Society of Imaging Informatics in Medicine executive committee and Member-in Training Committee.

The letter, addressed to the ABR executive director, incoming executive director, and president, outlined a number of concerns regarding the delay of exams. Signatories to the letter expressed concern that delaying the exam would result in the most senior radiology residents not being available to cover essential radiology services, including overnight services, with third- and fourth-year residents taking the exam in the same calendar year.

The exam changes and delays could also affect residents' and early career physicians' family planning, including if travel restrictions prevent women who are pregnant or wish to become pregnant from traveling in 2021. The signees specifically expressed concern the decision would disproportionately impact female physicians at a time when radiology has expressed interest in diversifying the workforce.

Other issues documented in the letter included the following:

  • Potential effect on employment opportunities and significant salary losses
  • A negative effect on performance-based grading due to unequal delays between rotations and exam time
  • Increased care burden on other radiologists in practices

"Delaying these important steps toward board certification has a number of far-reaching consequences on individual physicians and on practices," Dr. Monica Wood, a member of the ACR Resident and Fellow Section executive committee and fifth-year diagnostic radiology resident at Massachusetts General Hospital, told AuntMinnie.com.

Dr. Monica Wood
Dr. Monica Wood.

In lieu of in-person exams in Chicago and Tuscon, Arizona, the signees proposed virtual remote testing, which some other medical certifying agencies have adopted for the 2020 year. The letter also pointed out that the ABR provided a remote module with breast imaging in 2017 after the Core Exam did not include breast imaging questions for all candidates.

While the ABR declined to respond specifically to the letter, a June 5 statement from ABR President Dr. Vincent Matthews noted that there are no current, virtual solutions available to meet radiology's needs.

"No board has developed a secure initial certification written exam virtual platform that would be needed to deliver our Diagnostic Radiology and Interventional Radiology Core and Certifying Exams," Matthews wrote in the letter.

Should the ABR not have a virtual or other testing solution this fall, Matthews stated the association hopes to administer the Core Exam in February 2021.

But radiology residents fear the delay won't be an adequate solution.

"The limitations related to the COVID-19 pandemic will likely be ongoing, and we believe adaptation to this new normal by offering novel solutions is critical to the success of our trainees and practices," Wood said. "The concerns voiced by our radiology community and listed in the joint letter to the ABR underscore the importance of avoiding further delays."


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