Matt Mauro MD ABR Trustee APDR

 Approval of ABMS and ACGME  Program requirements  Accredited programs  Certifying examinations  MOC program 2

 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 3

 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

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

 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 3 rd quarter 2014  Then programs can apply –need site visit  ?begin

 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.-.- 7

 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. 8

 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. 9

10 General scheme of program requirements: Integrated Program YearCURRENT IR residency PGY 1 InternshipInternship PGY 2 DRDR PGY 3 DRDR PGY 4 DRDR PGY 5 DRIR PGY 6 IRIR

IR= IR or IR related Must participate in OP clinics DR months in PGY5 as necessary (Nuc Med, breast imaging) Required ICU/critical care Completion of training - need 1000 IR procedures 11

 Two Year Program  1 st year 12 IR Rotations; 1 ICU Rotation  2 nd year13 IR Rotations  Candidates enter AFTER completing full DR Residency  Candidate may receive credit for 1 st year IR if they had 12 rotations of IR and > 500 cases in residency 12

 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 13

 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 14

 PR’s not yet approved---but CLOSE  Don’t know exact timeline for implementation  For now, if interested in IR, should take IR fellowship 15

 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 16

 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 17

 2016 – First program approvals  First graduates could be 2017  2022 – end of 1 year fellowships 18

 Core exam  Same exam as DR residents  Same time period (ie in 36 th month)  Certification exam:  2 Computer Modules: Essentials, NIS  Oral exam 19

 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 20

 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 21