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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Losing the Track is Part of Tracking

From The Lion Tracker’s Guide To Life by Boyd Varty:

You must train yourself to see what you are looking for.

Perhaps the most concise description of radiology training.

“I don’t know where we are going but I know exactly how to get there,” he says.

Process > outcome.

I think of all the people I have spoken to who have said, “When I know exactly what the next thing is, I will make a move.” I think of all the people whom I have taught to track who froze when they lost the track, wanting to be certain of the right path forward before they would move. Trackers try things. The tracker on a lost track enters a process of rediscovery that is fluid. He relies on a process of elimination, inquiry, confirmation; a process of discovery and feedback. He enters a ritual of focused attention. As paradoxical as it sounds, going down a path and not finding a track is part of finding the track.

Uncertainty is part of life, but a search pattern helps.

On the long list for second place

It was a nice surprise to see over my busy call long weekend that I was nominated as a semifinalist for Aunt Minnie’s “most effective radiology educator” this year.

Or something like that:


As always, thanks for reading.

We’re hiring!

Well, not me/this little site.

But my organically-growing 100%-independent physician-owned radiology practice of which I am a partner/shareholder is hiring in most subspecialties including breast, body, neuro, MSK, ER, and general. Basically everything except IR at the moment.

The market is hot, as I’m sure every radiologist and resident has heard.

I’ve written before about why I believe some job healthcare models are problematic, and why not all attending jobs are created equal. I’ve also written before about how to approach getting your first job out of training. My perspective and biases about radiology practice are on full display.

Our group was/is my first job out of training. I made partner last year and recently began serving on our board of directors. It was the job I wanted–so much so that the day I got the interview invitation email (after already having job offers waiting for a response), I did an actual Street Fighter dragon punch of victory and told the others they were going to have to wait past their response deadlines. I was drawn by two things:

  1. A well-established successful privademic model combining teaching-focused academics with the no-BS of private practice (with positions leaning more in different directions based on interest including pure no-teaching PP), which gave me the chance to teach and work with trainees in a more flexible environment than a traditional big academic bureaucracy. I’m currently the associate program director for our residency, and our residents are awesome.
  2. A sustainable job model combining high-quality (as opposed to only high-volume) radiology practice with reasonable daily expectations and the goal of a standard 4-day workweek (today is my day off!). I wanted the time and mental space to also be a partner at home and have the flexibility to do the other things that are important to me (like this). My colleagues are good at what we do, and I learn from them every day.

So if you’re in the market, come work with me and check out our great team in Dallas. If you’re interested, send me your CV at and I’ll make sure it gets where it needs to go.