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IR ResidencyIR/DR Certificate

Matt Mauro MD ABR Trustee

APDR 2014

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What does an ABMS specialty have to have? Approval of ABMS and ACGME Program requirements Accredited programs Certifying examinations MOC program

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Background

SIR proposed primary IR certification to ABR 2007 IR fundamentally different than DR Need different way of training with

additional clinical skills Reworked proposal - dual

certification in IR/DR

First step to developing a certificate ABMS approved concept of IR as

separate specialty, Sept 2012 Rarionale: domain of IR has expanded

and can’t gain technical expertise in 1 year. Also includes clinical care

5 + years of work Process originated from SIR; ABR

approved and presented plan to ABMS Required phase-out of SS certification

(only one pathway to certification)4

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How Did This Happen?

What is the IR/DR Certificate? Specialty status to IR recognizes IR/DR as a

unique specialty in medicine. ABMS acknowledged the role of IRs as imagers, proceduralists and clinicians.

ABR will issue a new certificate – certifying that an IR practitioner is competent in these areas of expertise. Transition 2017.

IR training programs will change. ACGME is in the process of establishing a new IR Residency – distinct from DR. Timeline for transition - 2022.

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What is the status now?

ACGME approved IR as a new specialty – 2013 Program Requirements

Written by sub-committee of R-RRC COMPLETED Placed in appropriate format NOW 45 Day comment period Reviewed by Committee on Requirements

Hope to have PR accepted by ACGME by 3rd quarter 2014

Then programs can apply –need site visit ?begin 2015-6

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Some Specifics Regarding the IR residency Integrated (5 year) and Independent

(2 year) options

Match from medical school, transfer from DR

More IR training: 2 years (minimum 1

year, 9 rotations) - More emphasis on clinical care

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Some specifics regarding the IR certificate Eventually there will be only one

certificate – IR/DR Certificate 2017 seamless transition to IR/DR

certificate thru MOC process. Those with IR CAQ will be

grandfathered in.

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Key aspects of proposed PR 6 year program: Integrated

Program 1 year clinical 3 years DR (including some IR) – same

as DR residents 2 years IR (including critical care, in-

patient consults/followup clinics + up to 4 mo DR)

Institution can have independent (2 years) and/or integrated (5 years) programs.

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General scheme of program requirements: Integrated Program

Year CURRENT IR residencyPGY 1 Internship InternshipPGY 2 DR DRPGY 3 DR DRPGY 4 DR DRPGY 5 DR IRPGY 6 IR IR

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Integrated Program

IR= IR or IR relatedMust participate in OP clinicsDR months in PGY5 as necessary (Nuc Med, breast imaging) Required ICU/critical careCompletion of training - need 1000 IR procedures

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Independent Program

Two Year Program 1st year 12 IR Rotations; 1 ICU Rotation 2nd year 13 IR Rotations

Candidates enter AFTER completing full DR Residency

Candidate may receive credit for 1st year IR if they had 12 rotations of IR and > 500 cases in residency

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Flexibility

Can transfer within same institution anytime

Can transfer to program outside of institution only after finishing DR residency

Fellowships will have to phase out 5-7 years after IR residency begins in an institution

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What about certification? Would attain IR/DR certification Likely plan

Core exam at 36 months of DR with peers Essentials/NIS modules of Certifying exam +

Oral exam 3 months after finishing residency (ie with peers)

Grandfathering for those with VIR SS certificates

VIR SS certification to phase out after 5-7 years

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Important to remember

PR’s not yet approved---but CLOSE

Don’t know exact timeline for implementation

For now, if interested in IR, should take IR fellowship

PR’s will give programs flexibility Multiple entry points, R2-R5

PGY 5 call not specified – up to program (ie could be DR or IR)

Separate PD for program – but DR PD could be Associate for first three years

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Summary: Timeline (maybe…) 2014 – program requirements

approved by ACGME Includes approval by DR RRC (DONE), 45

day public comment period, approval by Committee on Requirements and BOD

2015 – First residency applications Must have site visit since new core

program

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Summary: Timeline (cont) 2016 – First program approvals

First graduates could be 2017 2022 – end of 1 year fellowships

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Summary: IR/DR certification Core exam

Same exam as DR residents Same time period (ie in 36th month)

Certification exam: 2 Computer Modules: Essentials, NIS Oral exam

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Summary: Time line (maybe…) First exams likely given 2017

IR SS certificates will be given IR/DR certificates if MOC requirements up to date Likely require PQI project in IR

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ABR governance changes Now have three IR trustees

Jeanne LaBerge Matt Mauro John Kaufman, trustee designate

IR is one of 4 disciplines in ABR DR RO MP IR

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