Organized Radiology
Article Outline
- Umbrella Organizations in Medicine
- Radiology Specialty Societies
- Subspecialty Societies
- References
- Further reading
- Copyright
Medical affairs in the United States are managed by a highly developed organizational structure within the private sector. The purpose of this article is to introduce the professional associations and other nongovernmental organizations that are key to radiology. A general overview is provided, with emphasis on organizations that directly affect training programs in radiology.
Umbrella Organizations in Medicine
Six organizations represent the general, overarching interests of medical professionals and medical enterprises in the United States: the American Medical Association (AMA) represents all physicians; the American Hospital Association (AHA), all hospitals; the Association of American Medical Colleges (AAMC), all medical schools and teaching hospitals; the Council of Medical Specialty Societies (CMSS), all specialty societies; the Accreditation Council for Graduate Medical Education (ACGME), all accrediting bodies for allopathic training programs; and the American Board of Medical Specialties (ABMS), all certifying boards. The National Residency Matching Program (NRMP), through which most medical school graduates gain access to residency positions and many radiology residents obtain subspecialty fellowships, is operated by the AAMC with oversight from other organizations (1). The Residency Review Committee for Diagnostic Radiology—one of 26 residency review committees (RRCs) operating under the aegis of the ACGME—is responsible for accrediting training programs in radiology. The Residency Review Committee for Diagnostic Radiology has 11 members, including one resident. For further details about the activities of the ACGME and the RRCs relative to resident training, see the article by Zagoria (2).
Radiology Specialty Societies
A number of radiology organizations represent all aspects of radiology, while others are devoted to the enhancement of particular subspecialties. Although this review cannot be comprehensive, it describes the major organizations in each area and summarizes their missions, their activities, and their programs for residents.
American College of Radiology
The American College of Radiology (ACR) is one of the major radiology specialty societies. It is devoted to improving radiologic service to patients, studying the socioeconomic aspects of the practice of radiology, and encouraging improved and continuing education for radiologists in their respective professional fields. Although much of its activity is concerned with the socioeconomic aspects of radiologic practice, the ACR also engages in important educational activities.
The ACR fosters and maintains close relationships with the U.S. Congress, federal and state agencies, and various medical providers, corporations, and suppliers. In the area of economics, the ACR manages coding and payment issues and maintains a liaison with the Center for Medicare and Medicaid Services (CMS). The ACR's Commission on Government and Public Relations considers and evaluates the effects of federal and state legislative and regulatory proposals and actions on the practice of radiology. The ACR has long worked to help develop standards for radiologic practice and for accreditation of radiology departments, including that of programs in mammography and radiation oncology, as well as other subspecialties. The ACR has developed appropriateness criteria in many subspecialty areas and a reporting data system in breast imaging (the Breast Imaging Reporting and Data System, or BI-RADS).
Of particular interest to residents are the educational activities of the ACR. Through its Commission on Education, the ACR develops and provides to all accredited residency training programs in radiology a yearly in-training examination for residents. Data regarding individual resident and overall program performance are provided to residents and to program directors, respectively. The ACR, together with the Association of Program Directors in Radiology (APDR), also has developed a set of video teaching modules designed to enhance residents' nonclinical skills as required by the ACGME. These videos are now available online. Topics addressed include ethics, quality assurance, and techniques for securing staff positions after residency. Lastly, the ACR makes available a large number of learning files, mostly in electronic format on CD-ROMs.
Radiological Society of North America
The Radiological Society of North America (RSNA) is a large and major specialty society. Its annual scientific assembly is the largest medical meeting in the world, attracting approximately 60,000 attendees. The mission of the RSNA is to promote and develop the highest standards of knowledge and practice in radiology and related sciences through education and research. Its educational and research efforts are directed not only to radiologists but also to allied health scientists. The RSNA provides extensive educational programs both at its annual assembly and throughout the year.
The annual meeting of the RSNA features many educational opportunities, including presentations of peer-reviewed original scientific abstracts and posters, education exhibits, special focus sessions, and multiple refresher courses dealing with each subspecialty of radiology, including radiology informatics and health policy and practice. The meeting is held jointly with the American Association of Physicists in Medicine (AAPM), and similar programs also are available in the field of radiologic physics. The RSNA meeting also features a large technical exhibit area where radiology vendors display equipment and other services for sale. A special exhibit area called infoRAD is devoted to radiology informatics.
The RSNA publishes Radiology, one of the major radiology journals and the one with the highest impact factor of any journal in the field, and RadioGraphics, an educational journal. RadioGraphics includes solicited articles based on education exhibits at the RSNA, as well as material from the archives of the Armed Forces Institute of Pathology. The educational products offered by the RSNA include enduring materials, such as the syllabi from categorical courses presented at the annual meeting and numerous CD-ROMs of refresher courses.
The RSNA Web site (www.rsna.org) contains an education center called “InteractEd,” offering 227 peer-reviewed programs, including refresher courses, plenary and focus sessions, education exhibits and cases of the day from the annual meeting, and a cardiovascular imaging program.
The RSNA offers many benefits to residents in approved radiology training programs, including free RSNA membership (member-in-training status). Although there is an $80.00 charge for subscriptions to the printed editions of Radiology and RadioGraphics, the RSNA provides residents free online access to these journals. The “Residents' Lounge,” reachable via the education portal at the RSNA Web site, offers membership information, virtual monographs, video of the Sunday image interpretation session at the annual meeting, and a course on radiation biology essentials. A virtual journal club is under construction.
American Roentgen Ray Society
The American Roentgen Ray Society (ARRS), the first and oldest radiology society in the United States, was founded in 1900. It is dedicated to the goal of advancing medicine through radiology and allied sciences. These goals are accomplished through an annual scientific meeting, usually held in the last week of April or the first week in May, and through the publication of a major journal in radiology, the American Journal of Roentgenology, or AJR, a highly respected, peer-reviewed journal with a worldwide circulation of more than 25,000. The annual meeting of the ARRS includes instructional courses, scientific presentations, a symposium, a new-issues forum, scientific and commercial exhibits, and a categorical course. Also at the annual meeting, three awards—the President's Award and two Executive Council awards—are given to residents and fellows in radiology and radiologic sciences for excellence in submitted scientific abstracts.
Other benefits for residents include membership-in-training, offered free of charge to radiology, radiation oncology, and nuclear medicine residents or fellows and to postgraduate students in allied sciences in the United States and Canada. A subscription to the printed edition of AJR costs $85.00, but the online journal is available without charge to member trainees.
Association of University Radiologists
The Association of University Radiologists (AUR) consists of over 3,000 radiologists, residents, and fellows. Its purpose is to represent academic radiology at a national level, and it encourages excellence in radiologic laboratory and clinical investigation, teaching, and clinical practice. The AUR also serves as an umbrella organization for a number of affiliated societies. These include the APDR, the American Association of Academic Chief Residents in Radiology (A3CR2), the Society of Chairmen of Academic Radiology Departments (SCARD), and the Alliance of Medical Student Educators in Radiology (AMSER). The AUR holds an annual meeting, usually in the spring, at which original scientific abstracts and individual sessions are presented by members of the affiliated societies. There is also a film interpretation competition. The AUR publishes Academic Radiology, the official journal of the AUR and affiliated societies. Its content includes original peer-reviewed articles in radiology and the radiologic sciences, usually devoted to basic research, as well as articles on radiologic education.
Of particular interest to program directors is the APDR, a unique alliance of those who share the task of resident training in radiology. The APDR sponsors meetings, forums, seminars, and other educational activities designed to advance the art and science of radiology. It holds its annual meeting in conjunction with that of the AUR. Members include program directors and associate and assistant program directors of residencies and fellowships in radiology and nuclear medicine in North America. The APDR Web site (www.apdr.org) provides an education portal with links to Web sites of other organizations in radiology offering teaching materials, radiology tutorials, and teaching files. The APDR has been instrumental in developing training curricula for the 10 major subspecialty areas in radiology. Each curriculum includes goals and clinical objectives for resident rotations. The annual meeting provides reviews and symposia for program directors on topics related to resident training, including new RRC and ACGME requirements, teaching and educational methods, and social issues (eg, management of conflicts and problems among residents).
A3CR2 is another affiliate of the AUR. Its annual meeting, which also takes place in conjunction with that of the AUR, includes a number of symposia on topics of interest to residents. The society also conducts a yearly survey of chief residents (2).
SCARD is dedicated to the advancement of the art and science of radiology through the promotion of medical education, research, and patient care; the development of methods of undergraduate and graduate teaching in radiology; and the provision of a forum for radiology department chairpersons to discuss problems of mutual interest. Two meetings of SCARD are held each year, one of them in conjunction with the AUR meeting.
AMSER is a group of radiologists actively involved in the education of medical students. Its annual meeting is held in conjunction with that of the AUR, and several symposia are held during this meeting, some conducted jointly with the APDR. Topics of interest to medical student educators are discussed.
American Board of Radiology
The American Board of Radiology (ABR) is the certifying organization for radiology. It arranges, controls, and conducts investigations and examinations of specialists in radiology, evaluating their qualifications for certification or recertification. The ABR grants and issues certificates in the medical specialty of radiology to voluntary candidates who have been found qualified. Since 2002, the ABR has issued time-limited certificates for a period of 10 years, after which recertification will be required. The ABR also determines the competence of specialists in radiologic physics and conducts examinations and issues certificates in that field.
The ABR was incorporated and organized in 1934. It is a member of the ABMS and is approved by the Council on Medical Education of the AMA. Its organization includes a board of trustees composed of individuals nominated by a number of sponsoring organizations in radiology. The ABR provides certification for both diagnostic radiology and radiation oncology. This summary deals with the activities of the ABR in diagnostic radiology.
The ABR certifies physicians to practice radiology in North America. Certificates are issued to candidates who demonstrate their knowledge and proficiency by successfully completing comprehensive written and oral examinations. Nine primary certificates are offered in three fields of radiology: one certificate each for diagnostic radiology and radiation oncology and seven separate certificates covering radiologic physics with three subfields. In addition to the primary certificates, four subspecialty certificates are offered. In 1994, certificates of added qualification, or CAQs, were introduced. At present, these certificates are available in pediatric radiology, vascular/interventional radiology, and neuroradiology. Candidates must meet the training requirements determined by the ABR and must have successfully passed their oral examinations in radiology.
In diagnostic radiology, 10-year certificates are issued to candidates who have finished the prescribed period of training and study and have passed written and oral examinations demonstrating an adequate level of knowledge and ability in diagnostic radiology. The written examination consists of two parts: the physics of radiology, and diagnostic radiology. The written examination is usually given early in September. The examination is held at selected sites on 2 successive days. The content includes two parts: the physics of medical imaging, biologic effects, and safety (part I), and diagnostic imaging (part II). Part II includes a category for each subspecialty in radiology. Candidates may take the physics portion of the written examination after completing 12 months of diagnostic radiology training, and they may sit for the clinical portion after completing 24 months.
The oral examination occurs at the end of residency, in June of the 4th or final year. Candidates must have successfully completed the written examination before seeking admission to the oral examination. The oral examination consists of problems of image interpretation and of clinical application and patient care. Electronic displays of images are used. There are 10 categories of examination, each concerning a different subspecialty of radiology. If the candidate successfully passes all portions of the examination, he or she will be certified a diplomate of the ABR. Candidates may fail (ie, condition) up to three of the 10 categories on the June examination and return for reexamination in these areas in the fall. However, a candidate who receives a failing grade in more than three categories must wait 1 year and then retake the entire oral examination.
For more information about the ABR and the certification process, see the article by Capp and Hattery (3). Residents also are encouraged to consult the ABR Web site at www.theabr.org for complete details about current examination policies. This Web site provided the following examination statistics in 2002: More than 90% of candidates had passed the physics examination in the previous 3 years, and the passing rate for the clinical written examination in the same period ranged between 82% and 93%. Among those who took the oral examination for the first time in 2001, 76% passed it completely, 16.6% conditioned one or more sections, and 7% failed.
Subspecialty Societies
There are numerous subspecialty societies in radiology. It is not possible to describe all of them here, but most of these organizations conduct an annual meeting that features presentations of peer-reviewed scientific abstracts, as well as refresher courses. Most have Web sites that provide information of interest to residents. Some of the larger organizations also publish journals. Information on all of these societies can be obtained through the RSNA Web site at www.rsna.org. The larger organizations include the American Institute of Ultrasound and Medicine (AIUM), the American Society of Emergency Radiology (ASER), the American Society of Head and Neck Radiology (ASHNR), the American Society of Neuroradiology (ASNR), the Fleischner Society (FS) (a multidisciplinary society with a limited membership devoted to chest diseases), the International Society for Magnetic Resonance in Medicine (ISMRM), the International Skeletal Society (ISS), the North American Society for Cardiac Imaging (NASCI), the Society of Breast Imaging (SBI), the Society for Computer Applications in Radiology (SCAR), the Society of Computed Body Tomography and Magnetic Resonance (SCBT/MR), the Society of Gastrointestinal Radiologists (SGR), the Society of Interventional Radiology (SIR, previously known as SCVIR, the Society for Cardiovascular and Interventional Radiology), the Society of Nuclear Medicine (SNM), the Society of Radiologists in Ultrasound (SRU), the Society of Skeletal Radiology (SSR), the Society of Thoracic Radiology (STR), and the Society of Uroradiology (SUR).
The primary organization in radiation oncology is the American Society for Therapeutic Radiology and Oncology (ASTRO). The American Association of Women Radiologists (AAWR) provides a forum for issues of particular concern to women in radiology, radiation oncology, and related professions. It holds luncheon seminars at the annual meetings of both the ARRS and the RSNA. It publishes a newsletter, and offers various activities and awards for women in radiology.
Glossary of radiology organizations
The Figure lists the major radiology organizations surveyed here. Additional information can be obtained from the organizational headquarters and their Web sites.
References
- References
- . Resident recruitment. Acad Radiol. 2003;10(suppl 1):S4–S9
- . The ACGME and the residency review committee: external program review. Acad Radiol. 2003;10(suppl 1):s10–s15
- . Chief residency. Acad Radiol. 2003;10(suppl 1):s54–s59
Further reading
PII: S1076-6332(03)80157-5
doi:10.1016/S1076-6332(03)80157-5
© 2003 Acad Radiol. Published by Elsevier Inc. All rights reserved.
