Has the American Board of Radiology (ABR) finally thrown up its hands and said it can no longer do its job? That was the take home message from my recent excursion to the AUR meeting. The explicit role of the American Board of Radiology is to standardize the quality of trained radiologists throughout the country. In fact, if you read the mission statement of the ABR website you will read verbatim- “Our mission- to certify that our diplomates demonstrate the requisite knowledge, skill, and understanding of their disciplines to the benefit of patients.” What are the most crucial skills in order to become a radiologist? Well, two of the most important pillars for creation of a competent radiologist is medical knowledge and communication. For the first time at this meeting, the ABR explicitly stated that they will abandon the role of testing radiology resident communication skills and will leave this responsibility for maintaining minimum standards to the individual programs while continuing to standardize testing of medical knowledge. What???????
If you leave the responsibility of testing and maintaining communication skills to individual programs, you are certainly not ensuring the baseline quality of our future radiologists. There are no accrediting bodies out there that can ensure the outcome of training as well as a governing/testing body such as the ABR. Without the lead of an accrediting board such as the ABR, I can see wide variability among different programs in the ability of residents to dictate and communicate results to their fellow clinicians. Some residencies will shine and produce a resident product that will competently communicate results to clinicians and others will no longer create residents with the minimum level of communications skills since there is no impetus to do so. We no longer have an oral board exam that can assess some basic communication competencies. How can the ABR accrediting body support such a position?
Government funding for medical education is at an all time low and hampers the ability of regulating bodies to do their job. Now we are leaving the responsibility of the ACGME/RRC with less teeth and funding to regulate these competencies? On the other hand, the ABR is funded by private radiology resident and radiologist dollars. Each of us spends thousands of dollars on getting and maintaining board accreditation during our lifetimes. And with all this money being spent, the ABR is saying that they cannot ensure a minimum communication competency. This is absurd.
Other licensing boards are actually moving in the opposite direction because they know it is the right thing to do for patient care. For instance, the USMLE has added on a clinical skills section to their test because creating doctors that can’t assess and communicate results to patients makes no sense. Why should testing by the ABR in the field of radiology be any different?
Please ABR… Step back and think about your position on testing communication skills. If you want to stay relevant in today’s day and age, there are other accrediting bodies out their that may take on the role of maintaining standards if you can’t do so yourself. Rethink your position statement and honestly reassess if it is in the best interest of the radiology community to forgo testing of minimum competency in communication skills. I don’t think so.
