During the annual meeting of the American College of Radiology in May, several radiologists peppered the group's leadership with concerns over controversial plans for a sweeping overhaul of the certification examination process.
Dr. Steve Koller, chief of radiology for Middlebury's Porter Medical Center and president of the Vermont Radiological Society, was one of many practicing members of the ACR who spoke up during an open-microphone segment to register misgivings about the revisions.
Asserting the changes could "destroy the heart of radiology," Koller, a generalist, said he has observed almost an active campaign to stamp out the concept of general radiology.
"Which would be a terrible loss for the profession," he said.
The new exam has two major modifications: Residents will be able to choose subspecialty areas in which they will be tested, and it will be given a full 15 months after training is completed instead of during the final year of residency.
Interviews with academics, practicing radiologists, and residents reveal a range of concerns and opinions. Some criticized the exam's delay, saying it simply transfers the problem of cramming from residency into the workplace, while others think the revisions will produce better trained radiologists.
An ACR task force, in a white paper published in the November issue of the Journal of the American College of Radiology (2008;5[11]:1112-1117), claimed that the decision to revise the oral board examination "raises more questions than it answers."
Koller asserts the changes unnecessarily pressure radiologists into specialized fields, insisting this does not reflect real-world practices that either don't need or can't support widespread specialization except in large, urban hospitals.
The revised focus of the exam will only hasten the commoditization of radiology, effectively mandating subspecialization, he said.
