ABR soliciting nominations for its Board of Governors

The bylaws of the American Board of Radiology are interesting. I’ve written about them here, and you should read that post. Go ahead, I’ll wait.

Relevent to an email blast the ABR sent out this week is section 4.3:

Section 4.3. Election of Governors. Nominees shall be solicited from the Board of Trustees and Board of Governors, and may be solicited from any appropriate professional organization. Professional organizations shall provide such nominations in writing. An affirmative vote of at least three-fourths (3/4ths) of the entire Board of Governors shall be necessary for the election of any nominee to the Board of Governors.

The Board of Governors is the main decision-making body of the ABR. Historically, as you might surmise, it’s been a pretty insular group. The people already in charge nominate their friends and colleagues, most of whom have already put in the time and effort to earn a place in this upper echelon through years of service to the organization.

As I wrote in that post:

If you didn’t know, there are currently 8 Governors, and they basically run the show. Lincoln’s famous “team of rivals” approach this is not. The current people in power shall nominate their replacements and other organizations may, but the key for any hopeful member is making sure that you fit in with the cool kids, essentially guaranteeing that no one with substantially differing views would ever make it to the upper echelon.

On November 7, the ABR sent an email out to all diplomates (people who are board-certified):

The American Board of Radiology (ABR) is seeking interested candidates to serve on its Board of Governors. The Board of Governors discharges the fiduciary duties of the Board through its oversight of the business and affairs of the ABR.

The ABR recognizes the benefits inherent in a diverse community and seeks individuals with varied experiences, perspectives, and backgrounds. Interested candidates must be board certified by the ABR and willing to participate in Continuing Certification (MOC). Those from nonacademic practice environments are especially encouraged to apply.

And the nomination process for those interested candidates?

Nomination Process: Interested candidates should send a curriculum vitae and a letter of interest before November 15, 2022, to Brent Wagner, MD, ABR Executive Director (bwagner@theabr.org).

How about that.

Now presumably the actually election process is still the same (as is the impressive Conflict of Interest policy), but I believe this is the first time the ABR has publicly asked for all-comers. Now that doesn’t mean they’ll actually take any of those candidates seriously or that such candidates would ever comprise more than a single spot on the board, but—nonetheless—I would encourage anyone interested to apply.

Improving my Figs

I finally broke down and bought a pair of Figs so I could try to fit in with young folk.

But I had to do a little surgery with my seam ripper:

Just because I want to pretend I can pull off squeezing into some joggers doesn’t mean I want four(!) separate branding labels on a pair of scrubs of all things.

Now they’re closer to the fantasy world where the generic hospital scrub pants have regular pockets.

Explanations for the 2022 Official Step 3 Practice Questions

Here are my explanations for the August 2022 update of the official practice materials.

The asterisks (*) signify one of the only two new questions compared with the prior set.

My explanations for the old 2020 set are here and the 2018/2019 set are here. There were 71 new questions in 2020 vs 2019, so going through that older set may still be worth your time. The one before that, which I explained here, was revised in November 2017.

You can find my thoughts on preparing for Step 3 here. Since writing that post, the main substantive change in the exam has been the ability to schedule CCS on a nonconsecutive day. In short, I think the free materials and UWorld should be enough for most folks. If you want book recs, they’re in that post. If you need another question source, I haven’t tried any of them, but you can get 10% off the popular BoardVitals if you’re interested by using code BW10.

As for this free 137-question practice exam, Blocks 1 and 2 are “Foundations of Independent Practice” (FIP). These should take up to 1 hour each. Blocks 3 and 4 are “Advanced Clinical Medicine” (ACM). These should take up to 45 minutes each. Total practice time should be no more than 3:30 if taken under test-day conditions.

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Perceptions of Radiology MOC

In August, the results of a large ACR survey about radiologists’ opinions concerning MOC were released. The summary:

Similar proportions judged the existing program as excellent or very good (36%), or fair or poor (35%), with 27% neutral. MOC–CC was perceived more often as excellent or very good by those who were grandfathered yet still participating in MOC, were in academic practice, were in an urban setting, were older, or had a role with the ABR. In contrast, MOC–CC was more often judged as fair or poor by those who were not grandfathered, were in private practice, were in a rural setting, or were younger.

It’s a pretty sharp divide. Perhaps it is no great surprise that ABR volunteers and grandfathered academics are among those who view the ABR’s offering most favorably. The whole paper is worth a read, and the survey construction itself was very involved.

I’m not personally involved in any of this work, but the story behind why the survey even occurred (which I’m relaying secondhand) is perhaps the most interesting part.

If you recall, there was an ACR Taskforce on Certification in Radiology that was initially authorized in 2019 and concluded in 2020. You can read my highlights and analysis of their work here.

You also might not recall said task force, because their work apparently marks the only time in history that the ACR Board of Chancellors voted against authorizing a task force to submit their findings as a paper to the JACR. What could have been a paper shared with the broader radiology community was instead buried in a lonely random corner of the ACR website.

This is politics at work, of course.

Behind the scenes, the executive committee asked the task force to water down their language and conclusions, remove certain points, and generally “be nice.” The ACR, trying to repair some historically sour relationships with other radiology societies, didn’t want to be mean to the ABR. It probably doesn’t help when inbred leadership positions across multiple societies read like a game of musical chairs. It was apparently after multiple rounds of softening edits that the task force report was eventually buried anyway.

As a consolation, the board did permit a next-step survey in order to ascertain the true feelings of the radiology community (and not just the task force’s presumably squeaky wheels). The ACR used an outside consultant to help generate a fair survey, and then at the subsequent request of leadership, all “irrelevant” questions concerning the ongoing lawsuit, handling of COVID-19/testing delays, and the kerfuffle over the MOC agreement, etc were excised.

The survey results paper was initially submitted to JACR in 2021 and was–as you may have surmised–also rejected (though please note that the JACR is editorially independent). Much back and forth ensued–largely in order to limit perceived “bias against the ABR”–and the paper you see was finally published a year later.

In the end, thanks to editorial assistance, the limitations section is longer than the neutered discussion.

Joining and Leaving Private Equity: A Radiologist’s Story

Previously in the PE series, we spoke with someone who joined a practice that had previously been purchased (before eventually leaving). In this entry, we’re hearing from someone who joined an independent practice and was an associate in the work-up when the group sold.

Just like last time, I’ve sanitized names and some details. This case study is food for thought, not an indictment of a specific group or corporate entity.

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