American Board of Radiology Certifying Examination – Why 15 months after residency completion?

I am currently studying for the American Board of Radiology Certifying Examination. By far this is the one standardized examination that I have studied the least for. How the board thinks newly minted radiologists can study for an exam and practice in a new job still baffles me.

A few years ago the American Board of Radiology (ABR) axed the oral boards which were traditionally taken a few weeks before a fourth year radiology resident (post-graduate year 5) would finish residency. This way it was a clean and neat way to finish training board certified, granted said resident actually passed the oral boards. In this model, most programs would allow their fourth year residents ample time for boards prep, which most likely would include extensive case conferences where residents would “take” cases orally in practice for the real deal. To accommodate the studying senior residents, most programs would give these residents light rotations, and the super cushy programs would schedule dedicated studying time for these residents. Eventually someone or a group of academic radiologists up in their towers decided to change this system. The argument against the oral boards at the end of fourth year was that they didn’t want their best trained residents to not be taking any of the call for essentially 6 months out of every year.

And so the ABR moved the initial board certification examination to 15 months after residency! Why 15 months? Because at that time approximately 95% of radiology residents were doing fellowships in radiology, and this way the initial certification exam would be 3 months after completing fellowship. If this isn’t flat on its face shifting the burden of a studying radiologist from the academic programs to the private practices then I don’t know what is. Now the academic residency and fellowship programs don’t have to accommodate their trainees need to study, and the burden rests solely on the newly minted radiologist and their practice to prepare for this exam. The timeline is below.

Exam timeline for becoming a board certified radiologist.

Do I sound like I’m complaining? Its because I am. I once heard from one of my mentors that a physician is the most dangerous when he or she is new somewhere. And if you’re a physician you know this to be true by experience. Besides having to actually master the complex task of being a good physician, you have to learn a new schedule, a new commute, where to park, how to login to all of the different applications, how to use the PACS, where to take a shit, whom to give a shit about, and so on and so forth. Its hard enough just being a good radiologist. And to on top of all of this study for the new ABR certifying examination?! I still don’t understand why the ABR thinks this is okay.