Accreditation Council for Graduate Medical Education What s New from the Radiology Residency Review Committee January 7, 2017 Duane Mezwa, MD Member RC Diagnostic Radiology
Topics Today The Committee Single Accreditation System Committee Discussions Diagnostic Radiology Requirement Revisions
Radiology RC Composition Appointing Organizations: ABR, AMA, ACR, AOA 12 voting members including: One public member One resident member 2 nominations each from ACR and APDR RRC then selects from nominated resident candidates ABR and AMA Ex Officio non-voting
Distribution of RC Members
Review Committee Members 2015-2016 James Anderson - Chair (Neuro) Susan John - Vice Chair (Peds) Kristen DeStigter (US) Janet Bailey (Breast Imaging) Donald Flemming (Musculoskeletal) Jeanne LaBerge (Interventional) Elizabeth Oates (Nuclear) Gautham Reddy (Cardiothoracic) Duane Mezwa (Abdomen) Karl Soderlund(Resident) George Erbacher (Osteopathic) Jennifer Bosma (Public) Kay Vydareny (ABR ex officio)
Upcoming RC Meeting Dates January 26-28, 2017 April 24-26, 2017 Please contact staff for agenda closing dates Felicia Davis Kate Hatlak Executive Dir. Assoc. Executive Dir. 312.755.5006 312.755.7416 fdavis@acgme.org khatlak@acgme.org
Single Accreditation System (SAS) 14 Original AOA Radiology programs All AOA Radiology program applications require a site visit prior to review by the Committee Current AOA Application Status Pre-Accredited 2 Continued Pre-Accredited 3 Initial Accreditation 4
SAS Pre-Accreditation Status Granted upon receipt of completed application Created for and to be applied only during the transition to ACGME accreditation of currently AOA-approved programs Graduates from pre-accredited programs are not eligible for ABR certification, per the ABR Graduates from pre-accredited programs are eligible to enter radiology fellowship programs check with ABR for certification eligibility.
ACGME Eligibility Requirements ACGME 2016 Eligibility Requirements (III.A.1.a) All pre-requisite training must be ACGME-accredited. All transfer residents must be from ACGMEaccredited programs. All prerequisite post-graduate clinical education required for initial entry or transfer into ACGME-accredited residency programs must be completed in ACGME-accredited residency programs, or in Royal College of Physicians and Surgeons of Canada (RCPSC)-accredited or College of Family Physicians of Canada (CFPC)-accredited residency programs located in Canada. Residency programs must receive verification of each applicant s level of competency in the required clinical field using ACGME or CanMEDS Milestones assessments from the prior training program. (Core)
Review Committee Discussions
Ongoing Discussions Can a clinical year obtained abroad count for the required preliminary year for entry into a Diagnostic Radiology residency? No, for all residents entering the PGY2 in July 2017 for Diagnostic Radiology and Interventional Radiology residencies, the preliminary year must be in ACGME (or RCPSC/CFPC) accredited programs. The only exceptions will be for AOA clinical years. No exceptions will be made for IMGs without clinical training as by the above organizations.
Ongoing Discussions Can we have some of our residents fulfill their PET/CT minimum case log requirements by attending the ACR-Dartmouth PET/CT course? No, the Committee feels strongly that procedures done during a conference/course do not provide the same experience. Conferences and courses are no substitute for independent interpretation of cases. The case log minimums are set such that if a resident in a program experiences problems meeting the minimum case log numbers, this deficiency may be indicative of a resource issue in the department.
Ongoing Discussions Courses and/or education outside of a residency program This doesn t mean that all education must be internally produced or provided. On-line, remote, or conference based education has a valuable role in educating residents. We expect that some educational experiences may need to occur through means that are not produced internally by an individual program. However, programs must oversee and coordinate these educational experiences as well as assure they are meeting the individual program needs. Interpretation of cases is felt to be best provided with direct faculty interaction.
Program Requirement Revisions
Timeline Reviewed internally by ACGME Posted for public comment Review public comments Final Draft Submission to Committee on Requirements (CoR) Address CoR concerns if any Submission to ACGME Board for approval
Timeline Reviewed internally by ACGME Posted for public comment Review public comments Final Draft Submission to Committee on Requirements (CoR) Address CoR concerns if any Submission to ACGME Board for approval
Program Requirements» Probable effective date July 2018» Focused review of IR requirements to keep the 2 in alignment
Program Requirements Purpose» Establish what is needed to start a program» Set minimum standards for resident training in the specialty» Set expectations for resident outcomes» Provide guidelines for oversight, monitoring, and improvement
Program Requirements Revision Highlights» 66% of the Radiology Program Requirements are Common Program Requirements (not Radiology specific)
Program Requirements Revision Highlights» Number of key faculty» Alignment with ABR and Core Exam» 8 Practice Domains» Minimum of 8 faculty to oversee those areas» 9 additional Educational Content areas» Individuals that oversee these areas do NOT need to be unique individuals
Practice Domains» Abdominal Imaging (includes gastrointestinal and urinary)» Breast Imaging» Cardiothoracic Imaging (includes cardiac and thoracic)» Musculoskeletal Imaging» Neuroradiology» Nuclear Radiology and Molecular Imaging» Pediatric Radiology» Interventional Radiology
Educational Content Areas» CT» MRI» U/S» Radiography/fluoro» Reproductive/endocrine» Vascular imaging» Physics» Quality and Safety» Radiology informatics
Key Points» Programs must designate individuals to oversee Practice Domains and educational areas» Minimum of 8 individuals» Allows more flexibility for assigning faculty to educational areas» Stresses importance of organ based education as well as education of the modalities and physics» Aligns with current ABR testing paradigm
Protected Time / Support» Sliding scale based on program size» Recognition that there are more demands on PD time» Scaled back a bit from original draft» Smallest programs need 0.3 FTE» Allows the protected time to be divided between PD and APDs If a large program has 0.7 FTE support required, the PD can be 0.4 and an APD could be 0.3. etc.
Protected Time / Support» Program Coordinators» Finally required support» Recognition of importance» Dedicated:» wholly committed to something, as to an ideal, political cause, or personal goal:» set apart or reserved for a specific use or purpose:
Program Director» Set at 3 years experience as faculty member» Prior vagueness in this area led to a decision that a certain amount of experience as a faculty member is valuable prior to being a program director» In reality, some training either with a current PD or through national organizations should be done to prepare people for the position.» The days of you re it are in the past.
Board Pass Rate» First» This is a whole new concept from the previous program requirements» Based on Core exam, not oral or certifying» No longer first time pass rate, now by end of residency» Reviewed on a year by year basis (not 5 year intervals of PIFS and site reviews)
Board Pass Rate» At least 90 percent of the program s graduates from the preceding three-year period who take the ABR Core Examination must pass by the end of the PGY-5 year
Board Pass Rate» Careful analysis of ABR data from programs» Reviewed yearly with a 3 year rolling average» One component of each years review» Isolated individuals that fail will not put your program at risk
Physics» Establishment of expected outcomes and support for the training in Physics» Balance of training needed at various programs
Physics» Expectations:» In-person educational content delivery should be provided. Again, a remote course taught in-person is not the intent. Personnel at your institution or affiliated with your institution is the expectation. On-line module content alone is not acceptable. Remote physics courses and on-line content can supplement your curriculum.