Maintaining the Public Trust - The American Board of Radiology

Throughout the year, consideringall oral and computer-based examsin all locations, the ABR administers44 different types of exams.Another key effort under way in training and initialcertification is the Milestones Project, a joint effortof the Accreditation Council for Graduate MedicalEducation (ACGME) and each of the specialty boards.The goal is to determine a list of key milestones in trainingthat each resident must achieve at specified timepoints to be considered ready for independent practice.The Diagnostic Radiology Milestones Working Group,chaired by Kay Vydareny, MD, ABR associate executivedirector for diagnostic radiology and past chair ofthe Diagnostic Radiology Residency Review Committee,had two very productive meetings in March andSeptember of 2011. The committee has written draftmilestones for each of the six ACGME competencies(medical knowledge, patient care and technical skills,professionalism, interpersonal and communicationskills, systems-based practice, and practice-basedlearning and improvement) and plans to present themfor feedback at the Association of Program Directors inRadiology (APDR) meeting in March 2012.Also in March 2011, the Board introduced a tighteningof its exam security policies and communicated extensivelywith candidates, training program directors, andchairs to begin a culture change in which systematicsharing of exam content in the form of “recalls” withinand across programs will be discouraged. This effort,designed to conserve ABR resources and protect theintegrity of the examinations upon which the Boardbases the assurances it makes to the public about itsdiplomates, emphasizes the importance of the corecompetency of professionalism.As I think about the explosion in work due to the needto build the future exams, even as we prepare anddeliver the current ones and adapt to the many changesoccurring in MOC, I am impressed that a staggeringlycomplex enterprise is thriving and moving ahead, owingto our talented, hard-working staff in Board Affairs,Certification Services (Candidate and Diplomate Services,Exam Delivery, and Exam Development), Communicationsand Editorial Serivices, Digital Imaging,Finance, Information Technology, and Psychometricsand Evaluation. More about these areas, including initialcertification and MOC, can be found in other sections ofthis report.Aligning MOC with Practice LifeMOC poses a “chicken-or-egg” challenge. For MOCto be recognized as a key contributor to improvedhealthcare quality, safety, and affordability, boardsmust demonstrate that MOC participants deliver bettercare and outcomes than do nonparticipants, and thatthey do so at a lower cost. Yet many diplomates wantto see this proof as a precondition to participation. Theobvious dilemma is that participation is required inorder to produce the data that will establish the valueof MOC. Nevertheless, considering the best interests ofthe public, it defies logic for detractors to argue againsta program of lifelong learning and continuous professionaldevelopment, and in favor of the pre-MOC statusquo, with state medical licensure as the only ongoingrequirement.Throughout the debate and discussion about MOC,one thing has become very clear to the ABR: MOCcan succeed in delivering improved healthcare, basedon the standards we set, only if those standards areimplemented by our practicing diplomates. Therefore,in addition to protecting the public, MOC must deliversufficient value to the diplomates themselves.With this in mind, the ABR and ABMS have been workingto align MOC requirements with all other aspects ofpractice life, including other requirements, incentives,medical licensure, and routine workflow. Key examples(not all-inclusive) are listed below:• The Physician Quality Reporting System (PQRS) MOCProgram Incentive• Development of practice performance measures forPQRS reporting and Part IV of MOC• Alignment with Maintenance of Licensure (MOL)• Focused practice recognition within MOC• Group participation in MOC for large community andacademic practices• MOC Part IV portfolio sponsor recognition/approvalFurther details on these initiatives can be found in theMOC section of this report (see Page 12).5

Executive Director’s ReportGoing GreenIn addition to serving our diplomates while protectingthe public, the ABR is committed to protecting our environmentby “going green.” A few of the changes visiblearound the office include a dishwasher, plates, glasses,and cutlery to decrease the use of plastic products formeals; recycling containers available in numerous locations;water coolers to eliminate the use of plastic waterbottles; and a timer for the office’s thermostat controlsystem to minimize the use of power for air conditioningand heating during nonworking hours. Finally, onJune 25, 2011, the 75.9-kilowatt system of 330 photovoltaiccells (solar panels) on the ABR’s roof beganproviding about 20 percent of the office’s electric powerrequirements (see Page 15).A Word on FinancesIn last year’s Annual Report (click here to view), my articleon “ABR Financial Transparency” concentrated on wherethe dollars go at the ABR. In addition, I explained thattrustees had designated more than 90 percent of theABR’s reserves for several specific purposes, including:• one year of operating expenses for emergency use;• a five-year plan for capital expenditures;• construction of exam centers to deliver the ABR’simage-rich examinations;• the dual exam development process we’re now supportingas an expanded number of committees createnot only the current qualifying, oral, and MOC exami-BuildingMOCBuilding2%ICnations for all three disciplines, but also the new Coreand Certifying examinations for diagnostic radiology;• five years of information technology initiatives;• expert consultation; and• a small amount for the ABR Foundation.This year, reserve funds are in fact being used inaccordance with several of these designated areas andare proving essential to the execution of ABR businessduring this three- to four-year transition to the Coreand Certifying examinations. Many of the expenses areeither doubled (committees) or directly related to examdelivery, e.g., building out exam centers in Chicago andTucson and completing the development of our itembankingsystem, known as ATOMS (ABR Testing Organizationand Management System). The pie charts belowprovide an overview of ABR revenues and expenses forthe 2010-11 fiscal year ending March 31, 2011.SummaryTransformational change and exponential increases inwork volume and complexity are under way at the ABR.The Board of Trustees, ABR executive leadership, andmanagement are working together to keep costs down,minimize the impact of growth on candidate and diplomatefees, and secure the rightful place of ABR-certifieddiagnostic radiologists, radiation oncologists, and medicalphysicists in the future of American healthcare.Gary J. Becker, MDExecutive Director2010-2011 ABR Financial StatisticsInitialCertification55%BOT Meetings 4%ComputerizedExams 4%ABMS3%Processing Fees 3%Depreciation 3%Building 4%Meetings5%OutsideLabor 3%Personnel53%Outside LABMSProcessinBuildingMaintenanceof Certification42%Office7%Oral Exam13%DepreciatBOT meet6RevenueExpensesComputeMeetingsOffice

New Trustees 2011The ABR welcomes the following new trustees, whoseterms of service began on July 1, 2011. ABR trusteesparticipate in leadership and decision making to carryout the ABR’s mission and set standards for Boardcertification in initial certification and Maintenance ofCertification.Vincent P. Mathews, MD,serves as president and chiefexecutive officer of NorthwestRadiology Network, Indianapolis,Indiana. He graduated fromIndiana University Schoolof Medicine with highestdistinction. He completed aresidency in diagnostic radiologyat Indiana University MedicalCenter Hospitals and a fellowship in neuroradiology atJohns Hopkins Hospital. He has received four MagnaCum Laude Awards and eight Cum Laude Awardsfor scientific exhibits from the American Society ofNeuroradiology and the Radiological Society of NorthAmerica. He also received a Gold Medal for scientificexhibits from the American Roentgen Ray Society.Dr. Mathews’ special interests include stroke,epilepsy, and physiological neuroimaging, includingfunctional MR imaging and MR spectroscopy. Heis former chief of neuroradiology and director ofthe Neuroradiology Fellowship Program at IndianaUniversity School of Medicine, where he still servesas professor of neuroradiology. From 1995 to 2003,he was a consultant and an ad hoc reviewer for theNational Institutes of Health. He is certified by the ABRin diagnostic radiology and also holds subspecialtycertification in neuroradiology.Brent J. Wagner, MD, has beena member of West ReadingRadiology Associates since1998 and is currently director ofthe Department of Radiologyand president of the medicalstaff at The Reading Hospitaland Medical Center, Reading,Pennsylvania. He also serveson West Reading RadiologyAssociates’ Board of Directors and is a former staffmember and current visiting lecturer for the AmericanInstitute for Radiologic Pathology.Dr. Wagner completed his internship at RoanokeMemorial Hospital, Roanoke, Virginia, and thenserved in the U.S. Air Force for 10 years, completinghis residency at Wilford Hall USAF Medical Center,Lackland Air Force Base, Texas. He is author or coauthorof nearly 50 publications, including Davidson’sRadiology of the Kidney and Genitourinary Tract, andhe lectures regularly on many genitourinary topics.He also is a part-time member of the teaching facultyat Hershey Medical Center, Penn State University,University Park, Pennsylvania. Dr. Wagner’s specialinterests and expertise include all areas of MRI andultrasound. He is certified by the ABR in diagnosticradiology and is also a diplomate of the National Boardof Medical Examiners.Lynn D. Wilson, MD, MPH,is vice chair and professor oftherapeutic radiology andprofessor of dermatology for YaleUniversity School of Medicine. Hejoined the faculty in 1994 and isa member of Yale Cancer Centerand the Yale Cancer CenterThoracic Oncology Program.In addition, he serves as clinicaldirector and residency training program director for theDepartment of Therapeutic Radiology.Dr. Wilson received the Francis Gilman Blake Award,designated by the senior class and presented to a YaleSchool of Medicine faculty member for exceptionalteaching of the medical sciences. Yale Medical Groupalso honored him with the first David J. Leffell Prizefor Clinical Excellence, bestowed on a faculty memberwho best exemplifies clinical expertise, a commitmentto teaching, and the highest standards of care andcompassion for patients.Dr. Wilson earned a medical degree from GeorgeWashington University and a master’s degree in publichealth from Yale University School of Medicine. Healso completed a residency and internship at Yale-New Haven Hospital and was chief resident in theDepartment of Therapeutic Radiology. Dr. Wilson’sclinical research interests include cutaneous lymphoma,lung cancer, benign and malignant tumors of the skin,breast cancer, and total skin electron beam therapy. Heis certified by the ABR in radiation oncology.7

Retiring Trustees 2011The ABR thanks the following trustees, whose termsended in June 2011. We greatly appreciate their manyyears of faithful and dedicated volunteer service.N. Reed Dunnick, MD, served asan ABR trustee for nine years andwas president of the Board from2008 to 2010. During his tenure,he served on 13 Board committeesand subcommittees, includingAudit, Budget & Finance,Maintenance of Certification,Investment, and Policy. He wasan Executive Committee memberfor five years. He is the FredJenner Hodges professor and chair of the Departmentof Radiology at the University of Michigan. Dr. Dunnickis also Board Liaison for Science for the RadiologicalSociety of North America.Beth A. Erickson, MD, was anABR trustee for eight years, duringwhich she served on 13 Boardcommittees and subcommittees,including Professionalism Licensure,Investment, and the ExecutiveCommittee. In 2010-11, shewas chair of the Policy, RadiationOncology (RO) Breakout, and ROFocused Practice committees.Dr. Erickson continues to volunteer her assistance indeveloping the ABR’s new demonstration pilot programon focused practice recognition in brachytherapy. She isprofessor of radiation oncology at the Medical Collegeof Wisconsin, Milwaukee.Glenn S. Forbes, MD, was anABR trustee for eight years,during which he served on nineBoard committees and subcommittees,including Bylaws,Subspecialty, Diagnostic RadiologyBreakout, and the ExecutiveCommittee. He was chair of theAudit Committee in 2010-11. Dr.Forbes began serving as chair ofthe ABR Foundation in July 2011. He is currently a professorof radiology at Mayo Medical School and medicaldirector for Mayo Clinic Imaging Solutions, the businessunit within Mayo Clinic’s diversified activities.8ABR Staff ReorganizationIn June 2010, a staff reorganization began at theAmerican Board of Radiology’s Tucson office. Theplan was based on a variety of needs: improvingprocesses, gaining efficiencies, eliminating “singlepoints of failure,” enhancing communications andteamwork, and increasing transparency. The reorganizationprimarily impacted three areas: InitialCertification (IC) Services, Maintenance of Certification(MOC) Services, and Administration/VolunteerServices.IC and MOC Services were combined into two divisions:Certification Services and Standards. Thedivisions not only cut across IC and MOC, but alsoacross diagnostic radiology, radiation oncology, andmedical physics.Certification Services, directed by David Laszakovits,MBA, has three subdivisions: 1) Exam Development,Joe Kamell, MBA, assistant director; 2) ExamDelivery, Lydia Warg, MS, assistant director; and 3)Candidate and Diplomate Services, Christina Slater,MBA, assistant director.Three areas of core competency are the basis for theStandards Division: 1) Psychometrics, directed byAnthony Gerdeman, PhD (June Yang, PhD, assistantdirector); (2) Digital Imaging, directed by MichaelEvanoff, PhD (Aaron Gudenkauf, assistant director);and (3) Communications and Editorial Services,directed by Donna Breckenridge, MA.The Administration Division was reorganized as aBoard Affairs Division to strengthen the focus ontrustee and volunteer services. Jennifer Hutson,MBA, directs this area and is the point person fortrustee requests and the need for general information.There is close coordination with the ExamDevelopment subdivision to ensure seamless managementof volunteer services.The remaining two ABR divisions are InformationTechnology (IT), directed by John Adams, and FinancialServices, directed by Vicki Franz, CPA. Assistantdirectors for IT include Chris Mazzarella, MBA, testingservices, and Keith Scollick, software/data development.Gail Ugstad, MBA, MSA, serves as assistantdirector for Financial Services.

Initial Certification ReportOnline Examination ResultsSince the 2010 oral exam administration, the ABRhas published results of its exams online for candidates,training program directors, and program chairs.The ABR is committed to providing accurate results ina timely manner, and a team effort among staff andtrustees has resulted in a refined process that increasesthe quality and accuracy of reporting. The ABR hascompleted one year of online results reporting, and theradiation oncology and medical physics initial qualifyingexam results were made available to candidates on theirPersonal Databases (PDBs) for the first time in 2011.Training programs now receive exam results for their individualresidents, as well as cumulative program examresults, online via their program databases. Future improvementsto online results reporting include addinginformation related to Authorized User (AU) eligibilityand providing an exam results letter that a candidatewill be able to print directly from the ABR website.Core Pilot ExaminationAt its May 2011 oral exam, the ABR offered all diagnosticradiology candidates an opportunity to improvetheir oral exam scores in a single category by taking thecomputer-based diagnostic radiology initial qualifying(Core) pilot examination. Information obtained from thepilot was helpful to the ABR and its volunteers as progresscontinues on this new exam, which will replace thecurrent “written” physics and clinical exam in diagnosticradiology. The feedback received from the candidatesurvey has proved invaluable to the refinement of theexam and its delivery. Exam content was available in 6of the 10 oral exam categories during the 2011 pilot. TheABR anticipates conducting another pilot exam in 2012,which will include all diagnostic radiology areas.Advisory CommitteesThe ABR trustees created the Diagnostic Radiology InitialCertification Advisory Committee (ICAC) to suggestways to improve communications between the ABRand radiology trainees through the following:• identifying and evaluating methods of contemporarycommunication such as social media,• investigating methods for facilitating exchangesbetween the ABR and trainees,• developing methods to assess the effectiveness ofproposed modifications in communications, and• suggesting modification of approaches as needed.The ICAC has been guided by Trustee Donald Frush,MD, and supported by Kay Vydareny, MD, associateexecutive director (AED) for diagnostic radiology.An ICAC survey, developed by resident and fellow committeemembers and launched in February 2011, providedvaluable suggestions for improving communicationabout initial certification examinations and MOC requirements.The ICAC also provided important feedbackabout the Core pilot exam, mentioned above. Based onthe committee’s recommendation, residents who tookthe pilot chose one of six categories AFTER they took theoral exam, rather than before. This encouraged greaterparticipation; a passing score on a pilot module had thepotential to enhance a candidate’s performance in thesame category on the oral exam. According to the rules,failure of the Core pilot examination could not adverselyimpact a candidate’s oral exam results.Similarly, an advisory committee on the initial certificationprocess for radiation oncology has been establishedunder the guidance of Trustee Dennis Shrieve,MD, PhD, supported by Paul Wallner, DO, AED for radiationoncology.Exam Registration EnhancementCandidates taking ABR exams at Pearson VUE centersnow have greater advance notice of the opening ofexam registration. Based on candidate feedback, theABR now offers more time between the mailing of examinvitations and the beginning of registration. To ensurethat all candidates have equal opportunity to register foran exam at a convenient location, the ABR has also standardizedthe registration start time as 12:01 a.m. CST onthe first day of registration for all initial exams.Pathways to CertificationA three-year effort to establish primary certification forinterventional radiologists is coming to fruition underthe leadership of Trustees Matt Mauro, MD, and JeanneLaBerge, MD, working collaboratively with John Kaufman,MD, ABR examiner and leader in the Society of InterventionalRadiology. The concept of a dual interventionalradiology/diagnostic radiology primary certificatehas gained the support of numerous radiological societiesand is currently in preparation as a formal proposalto the ABMS. A decision is expected in 2012.The ABR Holman Research Pathway is designed forindividuals to simultaneously train in diagnostic radiologyor radiation oncology and in basic science, clinical9

Initial Certification Reportinvestigation, or translational investigation. Trustee KianAng, MD, PhD, and Paul Wallner, DO, AED for radiationoncology, asked diplomates who had completedthe Holman Pathway to evaluate the program. Theirresearch results will be used to strengthen the programand to prepare an article to be submitted for publicationin an appropriate journal.The Diagnostic and Interventional Radiology EnhancedClinical Training (DIRECT) Pathway is currently a provisionalABR program. Surveys of DIRECT participants,both residents and program directors, were conductedthis year and will provide data to be considered in theprogram evaluation being conducted by a committeeunder the leadership of Trustee Matt Mauro, MD. TheAlternate Pathway for International Medical Graduates,under the direction of a committee headed by TrusteeDennis Balfe, MD, and Kay Vydareny, MD, AED fordiagnostic radiology, has refined its policies related toprerequisites for entering the pathway for radiologiststrained in India. The committee is gathering statisticsto compare the effectiveness of this pathway with theusual ACGME-accredited residency training pathway.Finally, a special time-limited program to reinstate eligibilityfor subspecialty certification for diplomates withfellowship training ending more than ten years ago hasbeen crafted by the Subspecialty Committee under theleadership of Trustee Milton Guiberteau, MD, chair.What Is the Exam of the Future?For diagnostic radiology (DR), the Exam of the Future consists of theCore Exam, which will replace the current “written” computer-basedexam, and the Certifying Exam, which will replace the current oralexam. The first Core Exam will be given in October 2013. It will include 18categories, and physics questions will be integrated into each category;the exam will take 1 1/2 days.The first Certifying Exam, to be administered in October 2015, willemphasize synthesis of information, differential diagnosis, and patientmanagement. Aspects of physics and basic sciences important in imagingwill be included. The exam will take 1/2 day and will include five modules:noninterpretive skills, essentials of DR, and three clinical practice areasselected by the individual based on training, experience, and practiceemphasis. Both exams will be computer based, image rich, and offeredtwice yearly at the ABR’s new Chicago Exam Center and in Tucson.Ella A. Kazerooni, MDJohn K. Crowe, MDDennis M. Balfe, MDKay H. Vydareny, MDAll efforts in working toward the ABR’s DR Exam of the Future wereguided by the DR trustees, with specific leadership provided by Ella Kazerooni, MD, for the Core Exam; JackCrowe, MD, for the Certifying Exam; and Dennis Balfe, MD, who is also assistant executive director for DRinitial certification. Kay Vydareny, MD, associate executive director for DR, has also provided a great deal ofleadership. They have devoted countless hours to conference calls, emails, meetings, and presentations, inorder to provide the strategic and policy oversight that will ensure both exams meet the quality, security,timeliness, and service standards rightfully expected of examinations for certification in a medical specialty.For more information, visit the ABR website at www.theabr.org.10

Initial Certification Examination ResultsInitial certification examination results in diagnosticradiology, radiation oncology, and medical physics areshown here. All figures represent the percentage of candidateswho passed the exam. For more information,visit the ABR website at www.theabr.org. Under theInitial Certification red box, click on a specialty and thenclick on “Scoring and Results” in the red Exam Informationbox to the right.YearDiagnostic Radiology Clinical ResultsThird-yearresidentsFourth-yearresidents2006 93% 95%2007 93% 96%2008 96% 98%2009 92% 97%2010 94% 91%Medical Physics Part I ResultsYearDiagnostic Radiology Physics ResultsSecond-yearresidentsThird-yearresidents2006 90% 90%2007 87% 87%2008 90% 88%2009 90% 90%2010 94% 88%YearDiagnostic Radiology Oral Exam ResultsResidents taking exam for first time2006 85%2007 90%2008 88%2009 90%2010 92%Medical Physics Part II ResultsYear General Clinical2006 77% 82%2007 86% 79%2008 78% 86%2009 77% 85%2010 77% 85%Year Diagnostic Nuclear Therapy2006 60% 56% 69%2007 70% 56% 70%2008 71% 31% 71%2009 70% 58% 70%2010 69% 62% 72%Medical Physics Oral Exam ResultsRadiation Oncology Oral Exam ResultsYearResidents taking exam for first timeYearResidents taking exam for first time2006 53%2007 47%2008 57%2009 55%2010 53%2006 90%2007 86%2008 80%2009 89%2010 85%Radiation Oncology Computer-Based Exam ResultsYear Clinical Physics Biology2006 92% 95% 98%2007 95% 85% 95%2008 98% 95% 96%2009 98% 89% 96%2010 96% 90% 91%11

Maintenance of Certification ReportWith healthcare reformcrashing down like atsunami wave, ABR trusteesand staff continue striving tomake Maintenance of Certification(MOC) participationa meaningful and reasonableendeavor. American Board ofMedical Specialties (ABMS)board certification and MOCcontinue to draw attention from a variety of externalhealthcare stakeholders interested in physician qualityand performance in practice. The result is numerous opportunitiesto use MOC participation to fulfill regulatoryrequirements and other incentive programs.PQRS MOC IncentiveAs a result of the Affordable Care Act, 2011 marks thefirst year that ABR diplomates participating in the Centersfor Medicare and Medicaid Services’ (CMS’) PQRS(formerly PQRI) program—through claims-based orregistry-based reporting—will be eligible for an additional0.5% incentive bonus. To qualify, they must meetthe ABR’s criteria for “more frequent” participation inMOC. Lifetime certificate holders participating in thePQRS program are also eligible for the 0.5% incentiveif they enroll in MOC and meet the “more frequent”requirements applicable to them. For more informationon PQRS MOC incentive requirements, go to www.theabr.org and in the Announcements section, clickon the appropriate link under “Important MOC PQRSIncentive Updates.”The ABR realizes that from now on, it will be importantfor us to work with CMS. Therefore, along with a handfulof other boards and ABMS, ABR representatives metwith CMS Administrator Don Berwick, MD, in March2011 to discuss the development of a collaborativerelationship. The ABR will self-nominate yearly so it canattest on behalf of its diplomates that they have metthe requirements for the MOC incentive in the final rule.Measures DevelopmentIt has been said that too few practice performancemeasures exist for radiologists in the PQRS program,and as a result, it is difficult for many—if not most—radiologists to participate. The ABR recognizes that aspayment reform advances, a robust set of measures willbe required as an underpinning of value-based healthcarepurchasing. Specifically, measures will be used to12inform the development of value modifiers. Therefore,from late 2009 until this year, the ABR teamed with theAmerican College of Radiology (ACR), the ABMS, andthe American Medical Association/Physician’s Consortiumfor Performance Improvement (AMA/PCPI) toproduce a measures set on the very high clinical priorityof radiation dose optimization.This pilot effort was under an agreement betweenABMS and AMA/PCPI, and the ABR was the first boardto complete a set of measures. The Radiation DoseMeasures Development Committee was co-chairedby Trustee Milton Guiberteau, MD, and David Seidenwurm,MD, chair of ACR’s Metrics Committee. Primarystaffing was by Paul Wallner, DO, ABR associate executivedirector (AED) for radiation oncology, and JudyBurleson, director of metrics for the ACR.The ABR anticipates that several of the measures developedin this first-ever pilot program will be available foruse in Part IV of ABR MOC (PQI) in 2012, and followingNational Quality Forum (NQF) endorsement, for theThe ABR will self-nominate yearlyso it can attest on behalf of itsdiplomates that they have met therequirements for the MOC incentivein the final rule.PQRS program in 2013. Of note, 2013 is a key year formeasures in all specialties because it will be the baselineyear that underpins the development of value modifiersfor CMS payments beyond 2015.The ABR’s MOC Committee on PQI, chaired by TrusteeMilton Guiberteau, MD, has been working to elucidatehow diplomates can most effectively and efficientlyengage in PQI projects. This committee is working toensure that several of these measures will be readiedto provide MOC Part IV credit to diplomates who usethem. The ABR will also work to provide those who usethe measures with direct linkage to online MOC Part IIself-assessment and continuing education products andservices that will fill in identified practice/knowledgegaps and satisfy still more MOC requirements.So, the complete vision is that in the process of routineworkflow, a diplomate will accomplish all of these tasks:

• use a measure,• satisfy the PQRS reportingrequirement and the PQRSMOC incentive requirement,• satisfy the MOC Part IV requirement,• identify and complete the MOCPart II self-assessment and educationalproducts/services towhich he/she has been directed,• meet local institutional/departmentalquality improvementand credentialing requirements,including The Joint Commission’sOngoing ProfessionalPractice Evaluation (OPPE)requirements, and• ultimately satisfy requirementsfor maintenance of state medicallicensure (see below).James P. Borgstede, MDPresident-elect and AssistantExecutive Director,MOCThomas A. Berquist, MDChair of MOC Subcommitteefor Lifelong Learningand ExamsMaintenance of LicensureThe ABMS has been working with the Federation ofState Medical Boards (FSMB) and the National Board ofMedical Examiners (NBME) on a plan for Maintenanceof Licensure (MOL). The initiative is considered necessaryto increase the robustness of state medical licensureby linking license renewal to ongoing professionaldevelopment. FSMB has crafted implementation plans,and 11 states in the Midwest are planning to launch variouspilot projects.In all proposals so far, FSMB has indicated its intent to“count” those who are meeting MOC requirements oftheir respective boards as having met the requirementsfor maintenance of state medical licensure. Thougheach state is a sovereign entity, and changes in statecode and/or medical board policy can take a long time,the ABR is seeing movement toward MOL. This is yetanother important way in which participation in MOCwill eventually satisfy other requirements simultaneously.Focused Practice Recognition in MOCOver the past two years, two trustee committees haveworked diligently to create programs and proposals toboth recognize and develop the expertise of ABR diplomatesin two specific areas of practice: brachytherapy(radiation oncology diplomates) and cardiac CT (diagnosticradiology diplomates). At its January and March2011 board meetings, the ABMS approved these twoMilton J. Guiberteau, MDAssistant Executive Director,Initial Certificationand MOC SubspecialtiesDavid J. Laszakovits,MBA, ABR Director of CertificationServices (InitialCertification and MOC)proposals as five-year innovationpilot programs in MOC.The brachytherapy effort is led byBeth Erickson, MD, immediate pasttrustee, and supported by PaulWallner, DO, AED for radiation oncology.The cardiac CT effort is ledby Trustee Ella Kazerooni, MD, andsupported by Kay Vydareny, MD,AED for diagnostic radiology. Eachof the pilot programs, currently inthe pre-implementation year, willbe available in 2012 to diplomateswho have a practice emphasis inthe specified area and meet theminimum qualifications.The goals of focused practice recognitionare as follows:• formally acknowledge areas ofpractice concentration in whichpractitioners develop proficiency and expertise postresidencyand—unlike subspecialties—outside thecontext of ACGME-accredited training,• create specialized MOC programs that foster continuousprofessional development in these areas,• demonstrate the proficiencies of participating diplomates,and• gather data from patients, referring physicians, credentialers,and other stakeholders concerning thevalue of these specialized programs.Only three such innovation pilots have been approvedby the ABMS, and the ABR has two of them. The onlyother one is Focused Practice Recognition in HospitalMedicine, an innovation pilot program of the AmericanBoard of Internal Medicine (the American Board ofFamily Medicine is now participating in this one as well).Group MOCMany large group practices have several diplomatesparticipating in MOC, and some community and academicpractices have now decided that all of their diplomateswill participate in MOC. Leaders of these groupshave asked the ABR to render participation easier forthe diplomates and the practices by providing a GroupMOC option. The idea is for the Board to provide anadministratively streamlined option, so that designatedpractice administrators can sign on and manage the13

Maintenance of Certification ReportABR personal databases (PDBs) of each diplomate in agroup practice. The ABR has worked both internally andwith several of the practice groups to identify the keyrequirements for programming this option. As of thiswriting, the ABR is only approximately three monthsaway from having a beta version of Group MOC availablefor testing.MOC Part IV Portfolio Sponsor Recognition/ApprovalSeveral leading healthcare institutions across the nationwith established track records in quality improvementwant to continue pursuing quality improvementpriorities of their institutions while obtaining MOC PartIV credit for each of the participating diplomates. TheABR is working to establish a set of principles accordingto which each institution (portfolio sponsor) wouldThe ABR continues to strive forgreater understanding of the MOCprogram and its requirementsamong the diplomates. . .conceive, develop, implement, oversee, and report onits projects in a sort of “deemed status” relationshipwith the ABR. This exciting new mechanism could bean extremely powerful way to advance quality andsafety nationally. As long as he/she meets the criteriafor meaningful participation in a project, an individualdiplomate in a department or institution that developssuch a program will receive ABR MOC Part IV credit forparticipation.MOC ResourcesThe Board’s MOC Coordinating Committee is chaired byTrustee and President-elect James Borgstede, MD, andincludes the following trustees: Thomas Berquist, MD,Lifelong Learning & Exams Subcommittee chair; LaneDonnelly, MD; Donald Frey, PhD, co-chair for medicalphysics; Milton Guiberteau, MD, PQI Subcommitteechair; Bruce Haffty, MD, president; Geoff Ibbott, PhD;Vince Mathews, MD; Brent Wagner, MD; Lynn Wilson,MD, MPH; Anthony Zietman, MD, co-chair for radiationoncology; and Robert Zimmerman, MD.Through this committee, the ABR strives to increasethe MOC program’s value to diplomates and to fostera higher level of understanding of the program and itsrequirements. Additionally, the committee has establishedan MOC Advisory Committee for each specialty;the diagnostic radiology group is convened by TrusteesBorgstede and Guiberteau, the radiation oncologygroup by Trustee Zietman, and the medical physicsgroup by Trustee Frey with Steve Thomas, PhD, AEDfor medical physics. Each group includes diplomatesparticipating in MOC from both private and academicpractice settings. The advisory groups have providedsignificant input into the development of convenientand easy-to-use resources for streamlining MOC participationand reporting, including the following:Personal Database: The ABR has provided access to apassword-protected Personal Database (PDB) for everyMOC diplomate. This is THE tool for communicatingwith the ABR about a variety of things, including medicallicensure information, continuing medical education(CME) and self-assessment module (SAM) completion,yearly PQI participation, fee payment, and contactinformation.ABR Staff and Leadership at National Meetings: ABRstaff and trustees regularly attend most major annualsociety meetings and are available to answer questionsabout the MOC process and requirements. The ABRbooth is usually located in the technical exhibit area ormeeting registration area. The ABR continues to distributeits new custom MOC lapel pins at the booth. Thepins are free of charge to all MOC participants and toanyone who signs up for MOC at the booth. The ABR willcontinue to distribute the pins at upcoming 2012 societymeetings. Please see meeting guides for the locations ofABR staff and trustees at the meetings you attend.CME and ASTRO Gateways: As a result of workingwith a variety of partner organizations, the ABR hassecured the ability to transfer CME and SAM creditsfrom several radiology societies directly to each diplomate’sPDB. To register for the CME Gateway, pleasevisit www.cmegateway.org. If you are a member of theAmerican Society for Radiation Oncology (ASTRO), youcan also transmit CME and SAMs completed throughASTRO to your PDB. This process is automatic and onlyrequires a few simple steps on your My ASTRO account.MOC Helpline: MOC staff members are available from7 a.m. to 5 p.m. MST, Monday through Friday (notethat Arizona does not participate in Daylight SavingsTime). Please feel free to contact us at (520) 519-2152 orabrmocp@theabr.org.14

Reports from ABR DivisionsTo provide readers with more information about ABRactivities, this year’s annual report includes reportsfrom several ABR divisions. Note that the CertificationServices Division is covered in the articles on initialcertification (Page 9) and Maintenance of Certification(MOC) (Page 12).Board AffairsKey governance activities of the ABR include strategicplanning, volunteerism, and professionalism, andtrustee committees oversee each of these. Trustee MattMauro, MD, chairing the Strategic Planning Committee,led the Board in 2010 through an extremely valuablescenario-planning process. Building on the conclusionsof that activity, he and the committee are presentlyfacilitating the development of a three-year strategicplan to guide and direct the ABR in 2012-2014.Trustee Duane Mezwa chairs the Volunteerism Committee.This committee creates systems and policiesdesigned to facilitate the relationship between diplomateswilling to volunteer their time and energy for theABR and the staff who produce examinations and otherelements of the Board’s initial certification and MOCprograms. He and his committee face the dauntingprospect of planning the 2013 “final diagnostic radiology(DR) orals” event in Louisville and determining howto continue to promote the camaraderie and collegialitythat have been the rewards valued by thousands of ABRoral examiners over the past 77 years.The Professionalism Committee has been chaired sinceits inception in 2010 by Trustee Kian Ang, MD, PhD, withTrustee Mary Mahoney, MD, as vice-chair. This groupaddresses certificate actions based on disciplinaryreports from state medical boards (subcommittee ledby Trustee and President-elect James Borgstede, MD);appeals (subcommittee led by Trustee Matt Mauro,MD); and conflicts of interest (subcommittee led byTrustee Kian Ang, MD, PhD). It also adjudicates allegationsof violations of exam security policies.In support of ABR volunteers, the Board Affairs Divisionhas begun piloting the use of electronic conflict of interestforms and, in tandem with other divisions, improvedthe volunteer service manual. Lastly, the ABR is in thefinal stages of trademarking “DABR,” or “Diplomate,American Board of Radiology,” allowing diplomates asimple and concise way to show their board certificationstatus on letterhead and business correspondence.The ABR will notify its diplomates when the new DABRdesignation is available for use.Considering the economic landscape the U.S. facestoday, efficient and effective use of resources is paramount.The Board Affairs Division serves an administrativerole in the organization, including providingreception, preparing agendas, scheduling meetings,managing external relationships, and facilitating legalmatters and contracts. In the past year, the divisionimproved ABR shipping processes to decrease costs;created extensive repositories to allow simplifiedsearches of minutes, policies, and procedures; and,most importantly, changed from using a national certificatevendor to a local one. This decreases costs and thewait time for diplomates to receive their certificates,while still maintaining excellent quality.FacilitiesSolar panels were recently installed on the roof of the ABRbuilding, taking advantage of Tucson’s sunny climate toproduce clean energy and reduce the ABR’s carbon footprint.At the Fall 2010 Board Retreat, ABR trustees approved aproject for installing a 75.9-kilowatt solar electric powersystem, furthering the ABR’s effort to “go green.” Theamount of solar electric power generated by the newsystem represents 20 percent of total office usage.Negotiating the contract, drafting plans, and obtainingcity permits began at the time of approval and continueduntil March 17, 2011, when construction began.On June 24, 2011—255 roof penetrations and 330 solarpanels later—the ABR’s power system was connected tothe grid, and the system became operational.During the past year, the ABR Board of Trustees alsomade three decisions that have led to plans for majorchanges in the ABR building:15

Reports from ABR Divisions• To offer future Western region examinations at theTucson Board office; this decision was a compromisebetween geographic convenience (Californialocation) and fiscal responsibility (space in ownedproperty).• To commit resources to ensure that an examinationcontent database will be operational in early 2012; toaccomplish this goal, several temporary employeeshave been hired for approximately eight months.• To increase ABR personnel to meet expressed needsof diplomates and the volunteers who provideneeded certification services.These changes have resulted inthe need for a construction projectto create a large exam center andadditional spaces for needed staff.These changes have resulted in the need for a constructionproject to create a larger exam center and additionalspaces for needed staff. Existing space, whichwas previously leased or used for other purposes, will beremodeled.Communications and Editorial ServicesThe Communications and Editorial Services Division isresponsible for ABR external communications and examinationitem editing. During the past fiscal year, thedivision edited approximately 12,000 items, made itemwritingpresentations at volunteer committee orientationmeetings, and attended test assembly meetings.Two issues of the ABR’s newsletter, The Beam, and the2009-10 Annual Report were emailed to the ABR’s listof 27,000 diplomates, candidates, program directors,and radiology societies. The division also distributed 10internal electronic newsletters and conducted surveysregarding The Beam, MOC communications, and thetrustee newsletter.Updating content for the ABR website is anotherdivision responsibility. In 2010, the three ABR associateexecutive directors and the communications directorreviewed and edited the entire website. In addition tochanges from this annual audit, more than 200 updateswere coordinated throughout the year. Along with theABR IT director, the communications director is a memberof a volunteer-run committee on website redesign.In the area of media relations, the division distributed16 press releases and responded to numerous informationalrequests from reporters, societies, journals, andthe American Board of Medical Specialties (ABMS).The communications director is an active member ofthe ABMS Communicators’ Network. Other interestingprojects included the ABR time capsule, an MOCparticipation pin, publications for the ABR informationalbooth at society meetings, various ABR Foundationresponsibilities, and research on social media.Digital ImagingThe Digital Imaging Division is responsible for developing,maintaining, and establishing standards for allof the ABR’s multimedia assets, including images andvideo files. During the 2010-11 fiscal year, the divisionhosted more than 10 oral exam committee meetings,assembled and administered two oral exams, processedall imaging requests submitted by the Core/Certifying/MOC committees, and processed roughly 5,000 newimages for use on the oral exam.In addition to processing all finalized content, the divisionis responsible for “scrubbing” all raw content toremove patient health information (PHI). This past yearsaw an unusually high amount of this activity, due inpart to a raw submission of 30,000 files that requiredscrubbing. The ABR’s newly instituted Health InsurancePortability and Accountability Act (HIPAA) policies andprocedures are functioning well, and thus far volunteerfeedback has been largely positive.Digital Imaging is considered a member division ofthe ABR Standards Division and cooperates with theother member divisions (Psychometrics/Evaluation andCommunications/Editorial Services) to create standardsfor the ABR. This past year, the Standards Divisiondeveloped standards for volunteer exam developmentcommittee meeting support, exam monitor calibration,and mammography layout and labelling for ABR exams.Other projects involving Digital Imaging personnelincluded the ABR Testing Organization and ManagementSystem (ATOMS) rollout project, the ATOMScoding project, the new ABR Chicago Exam Center, andremodeling of the Tucson Exam Center.16

Information TechnologyLooking back over the last year, the focus in the InformationTechnology (IT) Division can be described bythe words availability, scalability, accountability, andpreparation. The 2010-11 fiscal year saw many changesin ABR systems, but the real emphasis was on preparationfor the future.The ATOMS project, which will provide the infrastructurefor the management of exam material, from volunteersubmission to final exam creation, was a primaryfocus. Trustee Duane Mezwa, MD, led the efforts of theBoard to provide guidance regarding ATOMS development.The Board bears the ultimate responsibility formeeting the needs of the volunteers who generateexam content and for managing the ABR’s resources tomost efficiently achieve the needed results.ABR volunteers participated in two pilot phases forATOMS in 2010 and provided critical feedback to ensurea successful launch of the ATOMS software. Thanks tothe efforts of the volunteers and staff dedicated to theproject, as well as the ABR trustees, the ATOMS softwarewill be rolled out in early 2012.IT infrastructure for the Exam of the Future took centerstage as preparations began to lease, equip, staff, andadminister ABR examinations in two newly designedexam centers in Chicago and Tucson. The Board’s TestCenters Task Force, under the leadership of TrusteeJeanne LaBerge, MD, provided the strategic and policyguidance for this crucial effort to create the best possibletesting environment for candidates and diplomateswho will take image-rich examinations. DR MOC examswill be administered in the Chicago center beginning in2012 and in both centers in 2013, and the newly designedCore and Certifying exams will be administeredin both centers beginning in late 2013.In addition to many enhancements to ABR systems, theABR software development team has been laying thegroundwork for major updates to both internal andexternal systems (such as the Personal Database, orPDB). Many behind-the-scenes “Phase I” efforts werecompleted, providing the infrastructure for more visiblechanges in the near future.To assist with defining the vision and direction for futuretechnology initiatives, the ABR formed the InformationTechnology Advisory Committee (ITAC). Under theleadership of ABR Trustee Richard Morin, PhD, ITACconsists of four subcommittees with specific areasof focus: Personal Database, chaired by Paul Chang,MD, with Trustee Liaison Ella Kazerooni, MD; Website,chaired by William Boonn, MD, with Trustee LiaisonDuane Mezwa, MD; Key Performance Indicators/DataWarehouse, chaired by Trustee Lane Donnelly, MD,with Trustee Liaison Jack Crowe, MD; and ExaminationTechnologies, chaired by Keith Dreyer, DO, PhD, withTrustee Liaison Mary Mahoney, MD. The volunteerswho work on these subcommittees bring expertise andnew levels of insight to building the vision for futureABR systems.Throughout the year, the IT Division also designed andbuilt an infrastructure to ensure high availability for ABRproduction systems. Leveraging storage area networks(SANs) and a highly virtualized server deployment, thehigh availability infrastructure will be fully deployedin late 2011, and capped off by the migration of theproduction servers to a five nines (99.999% uptime) colocationdata center facility. This architecture providesthe scalability and flexibility to accommodate increasingdemands on ABR systems, as well as the redundanciesrequired to ensure maximum uptime.ATOMS will provide the infrastructurefor the management of exammaterial, from volunteer submissionto final exam creation.Finally, the ABR has designed, developed, and implementeda robust set of internal controls that providethe framework for managing and deploying its systems.These controls define the repeatable processes thatensure predictable results for all system deployments.Looking ahead, the ABR anticipates more challengesand opportunities to adjust its systems to the meet thechanging requirements in medicine, and radiology inparticular. The steps already taken, along with plannedenhancements for next year, ensure the ABR’s abilityto meet these challenges and provide an efficient andeffective diplomate experience.Psychometrics and EvaluationDuring the 2010-11 fiscal year, the Psychometrics andEvaluation Division scored 32 computerized (“written”)(continued on Page 18)17

ABR Foundation ReportPsychometrics and Evaluation Division Report(continued from Page 17)tests and produced technical reports for the majorityof those examinations. The division also produced aprocedural documentation on standard setting usingthe Angoff procedure and gave a presentation on theAngoff procedure and the hierarchy of learning at allABR test assembly meetings. Division staff participatedin numerous conference calls, including Category SteeringCommittee calls and calls with vendors regardingexam security matters.Practice analysis survey instruments for DR, radiationoncology (RO), and medical physics were developed;surveys were conducted; and results were reported tothe Board. A report on the DR practice analysis surveywas also prepared. Two articles on Certifying Examinationtransparency were published: one in the AmericanJournal of Roentgenology (DR) and one in the Journal ofthe American College of Radiology (RO). The division prepareda report on comprehensive evaluation, an internalanalysis of the ABR’s testing program. A study on thereliability of the RO oral examination was conducted,and results reported.Division staff attended psychometrics and testingmeetings conducted by the ABMS, the Association ofTest Publishers, and the American Educational ResearchAssociation. ABMS Member Boards were surveyedregarding their re-examination fees and reference policies.Finally, division staff began work on conversion toan Item Response Theory (IRT) scoring method.An ABMS program providing assistance in creatingappropriate certification exams has been launched inSingapore. ABMS boards in selected specialties havebeen offered the chance to review the training, certification,and healthcare delivery systems in Singaporeas a basis for making a decision regarding participationin this ABMS-International program. Trustee DennisBalfe, MD, assistant executive director for DR initialcertification, and Kay Vydareny, MD, AED for DR, haveperformed the evaluation for the ABR and recommendpursuing participation, conditional upon agreementto specified protections for the primacy of the ABR’smission benefiting patients and diplomates in the U.S.This progam has not financially impacted the ABR; infact, 10-year projections include a revenue stream thatshould help keep downward pressure on fees for U.S.candidates and diplomates.18by William R. Hendee, PhDChair, ABR FoundationBoard of Directors, 2009-2011The American Board of RadiologyFoundation (ABRF) hasbeen engaged in several productiveventures over the past year.In August 2010, the ABRF held itssecond multidisciplinary summitin White Flint, Maryland (asuburb of Washington, DC) on the topic of “ImprovingPatient Care through Effective e-Communication inImaging.” Invited speakers included:• William Crounse, MD, senior director of worldwidehealth for Microsoft Corporation;• Ronald Arenson, MD, chair of radiology and biomedicalimaging, University of California, San Francisco(UCSF);• Keith Dreyer, DO, PhD, vice chair of radiology (informatics),Massachusetts General Hospital;• Joel Goldwein, MD, senior vice president and medicaldirector, Elekta, AB; and• Kevin Grumback, MD, professor and chair of familyand community medicine, UCSF.On November 2, 2010, James Thrall, MD, president ofthe American College of Radiology, delivered the 2ndAnnual Steven A. Leibel, MD Memorial Lecture duringthe annual meeting of the American Society of RadiationOncology (ASTRO). The lecture was co-sponsoredby the ABRF and is given each year in recognition of themultiple contributions of Dr. Leibel to radiation oncologyand radiology, as well as his leadership as president ofthe ABR from 2004 to 2006.On August 1, 2011, the ABRF co-sponsored the LeibelLecture at the annual meeting of the American Associationof Physicists in Medicine in Vancouver, BritishColumbia. This year, the lecture took the form of asymposium on “Advanced IMRT Planning and Deliveryand Future Directions.”Last July, ABRF representatives participated in the IntersocietySummer Conference in Santa Fe, New Mexico,sponsored by the ACR. The topic was “The RadiologicalConglomerate: Optimizing the Structure and Functionof Our 50+ Radiological Societies.”The ABRF has produced 10 web modules on Ethics andProfessionalism, with the support of six organizations—

the American College of Radiology(ACR), the Radiological Society ofNorth America (RSNA), the AmericanSociety for Radiation Oncology(ASTRO), the American Associationof Physicists in Medicine (AAPM),the American Radium Society(ARS), and the ABR. The topics ofthe modules are:• Attributes of Professions andProfessionals• Physician-Physician and Physician-Patient Interactions• Personal Behavior, Peer Review,and Contract Negotiations withEmployers• Conflicts of Interest• Ethics of Research• Human Subjects Research• Vertebrate Animal Research• Relationships with Vendors• Publication Ethics• Ethics in Graduate and ResidentEducationCritical reviews of the modules wereprovided by members of two committees:the ACR-RSNA Committeeon an Ethics Curriculum and theACR Committee on Professionalism.The availability of the moduleson the RSNA website began inOctober 2011, with direct links tothe modules provided on websitesof the sponsoring organizations.The ABRF hopes to engage federalagencies in its efforts to improve thesafety and accountability of medicalimaging and radiation therapy.Members of the ABRF Board ofDirectors have discussed this objectivewith representatives of severalagencies, including the Centers forMedicare and Medicaid Services,the Food and Drug Administration,the Agency for Healthcare Researchand Quality, and the National CancerInstitute. Also, cooperation hasbeen explored between the ABRFand patient advocacy groups, includingthe National Patient SafetyFoundation and the MassachusettsCoalition for the Prevention ofMedical Errors.Consistent with its mission toimprove accountability to the publicin the medical use of radiation, theABRF is working on a collaborativeinitiative entitled “The Safe Use ofRadiation in Medical Imaging.” Thegoals of this initiative are (1) loweringthe frequency of preventableerrors and risks in radiation-basedprocedures, and (2) reducing themagnitude of unavoidable risksin radiation-based procedures.The ABRF views this initiative as amultidisciplinary effort to enhancethe value and reduce the risk of themedical use of radiation.In July 2011, several individualsfulfilled their commitment to theABRF Board of Directors: Robert E.Campbell, MD; N. Reed Dunnick,MD; Beth A. Erickson, MD; and C.Douglas Maynard, MD. New boardmembers are John D. Forsyth,MA, the first public member of theboard; Valerie P. Jackson, MD; R.Gilbert Jost, MD; Vijay M. Rao, MD;and Paul E. Wallner, DO. Also, GlennS. Forbes, MD, succeeded William R.Hendee, PhD, as chair of the Boardof Directors.The ABRF looks forward to continuedpursuit of its mission to improvepublic accountability and patientsafety in the medical use of radiation.Board of Directors(as of July 1, 2011)• Glenn S. Forbes, MD, ChairRochester, Minnesota• Richard L. Morin, PhDTreasurerJacksonville, Florida• Jennifer L. Bosma, PhDExecutive DirectorTucson, Arizona• K. Kian Ang, MD, PhDHouston, Texas• Dennis M. Balfe, MDSt. Louis, Missouri• Gary J. Becker, MDTucson, Arizona• James P. Borgstede, MDDenver, Colorado• John D. Forsyth, MADes Moines, Iowa• Bruce G. Haffty, MDNew Brunswick, New Jersey• William R. Hendee, PhDWhitefish Bay, Wisconsin• Valerie P. Jackson, MDIndianapolis, Indiana• R. Gilbert Jost, MDSt. Louis, Missouri• Vijay M. Rao, MDPhiladelphia, PennsylvaniaThe American Board of Radiology Foundation is a not-for-profit organization.Your contributions are fully tax-deductible. To make a donation, go to: www.abrfoundation.org/donate.html.• Paul E. Wallner, DOBethesda, Maryland19

ABR Foundation DonorsThe ABR Foundation thanks the following donors for gifts made from Sept. 1, 2005, through Sept. 30, 2011. Gifts of $500 or more made to theSteven Leibel, MD Memorial Fund from Dec. 1, 2008, to April 30, 2010, include a matching gift from the ABR. All other gifts made fromMay 1, 2010, to Sept. 30, 2011, also include a matching gift from the ABR.Platinum ($10,000 or more)American Board of Radiology 1,2American Association of Physicists in MedicineAmerican College of Radiology 1William A. Murphy, Jr., MDSilicon Valley Community Foundation 1Gold ($5,000-$9,999)Patricia G. Becker, MD, & Gary J. Becker, MD 1In Memory of Irving BeckerRebecca S. Cornelius, MD 2Sally & Lawrence W. Davis, MD 1Sarah S. Donaldson, MD 1Beth Erickson, MD, & Thomas Wittmann, MD 1Kathy & Bruce Haffty, MD 1David Leibel 1Carol & Richard L. Morin, PhD 1David M. Panicek, MD 1Anne C. Roberts, MD, & John Arnold, MD 1Donna B. & Lee F. Rogers, MD 2In Memory of Kenneth L. Krabbenhoft, MDIn Memory of Theodore E. Keats, MDUniversity of Wisconsin Dept. of Human OncologySilver ($2,500-$4,999)Mary & Thomas Berquist, MD 1Kenneth & Jennifer Bosma, PhD 1Laura & Milton J. Guiberteau, MD 1,2Diane & Robert Hattery, MD 1Diane & Geoffrey S. Ibbott, PhD 1Valerie P. Jackson, MD 1,3Donna & Larry E. Kun, MD 1Marcia & Robert Lukin, MD 1Julie A. Matsumoto, MD, & Alan H. Matsumoto, MDPatricia Mauro, MD, & Matthew Mauro, MD 1Lori and Cristopher A. Meyer, MD 2Stacey Rosenzweig, MD, & Kenneth Rosenzweig, MDMarilyn Roubidoux, MD, & N. Reed Dunnick, MD 1Margaret & Steven Spector 1Sally & Robert Stanley, MD 1Karim Valji, MDKay Vydareny, MD, & William Casarella, MD 1Constance Whitehead & M. Paul Capp, MD 1,2Andrea & Jerome Wiot, MD 1In Memory of Kenneth L. Krabbenhoft, MDIn Honor of M. Paul Capp, MDBronze ($1,000-$2,499)Sunny & K. Kian Ang, MD, PhD 1Margaret & Dennis M. Balfe, MD 1Cile & Frederick Bonte, MD 1Martha & James P. Borgstede, MD 1Alison Brooks, MD, & Anthony Zietman, MDNancy J. & Robert E. Campbell, MD 2Edward L. Chaney, PhDSandra W. Cohen, MD, & Harris L. Cohen, MDIn Memory of Duree H. Eaton, MDKatharine M. & John K. Crowe, MD 1Mary A. & Lawrence Paul Davis, MD20Helen & Gerald D. Dodd, Jr., MD 2Pat & G. Donald Frey, PhD 1Elaine S. Gould, MDKathryn & Leonard Gunderson, MDBarbara & Tom Harle, MD 1Nancy Lee Harris, MD, & Jay R. Harris, MD 1,3Jeannie & William R. Hendee, PhD 1Bebe & Richard Hoppe, MD 1Mindy M. Horrow, MDPeter R. Hulick, MD 1Miriam & David Hussey, MD 1Jeanne M. LaBerge, MD 1Patrick & Colleen Lawton, MD 1Patsy & George Leopold, MD 1Louise & Richard G. Lester, MDGerald A. Mandel, MDBeryl McCormick, MD, & Alvaro Vallejo, MD 1Theresa C. McLoud, MDMarlene & Anthony V. Proto, MDArthur J. Segal, MDAnnabelle & Dennis Shrieve, MD, PhDPatricia & Guy Simmons, PhD 1Janet L. Strife, MD, & C. Frederic Strife, MD 1SUNY Upstate Medical University, Dept. of Radiation Oncology 1Robert G. Swanton, MDIngrid & Stephen R. Thomas, PhD 1Gregory M. Videtic, MD 1Eric A. Walker, MDDoris & Douglas H. Yock, Jr., MDOther Gifts (Up to $999)Linda and Donald Chakeres, MDDenise Collins, MDStamatia Destounis, MDMaxine & Paul Ellenbogen, MD 1Celeste & Glenn Forbes, MDJudith M. Ford, MD, PhD 1Karen Frush, MD, & Donald Frush, MDLisa Kachnic, MD, & Stephen EnglertElias Kazam, MDJeffrey Klein, MDVasantha & Mahadevappa Mahesh, PhDMary Mahoney, MDNina Mayr, MDBruce McClennan, MD 3James B. Naidich, MDNicholas Papanicolaou, MDThomas B. Poulton, MDRobert Quencer, MDAndrea L. Sakse, MD, & Michael A. Bruno, MDGeorgianne Snowden, MDMichael Sullivan, MDMerwin ThomasSusan & Paul E. Wallner, DO 1In Memory of Anthony Mauro1 All or part of gift was made to the Steven Leibel, MD Memorial Fund.2 All or part of gift was made in memory of Jerome Wiot, MD.3 All or part of gift was made in memory of Merwin Thomas.

ABR Trustees and DirectorsTrustees (As of July 1, 2011)Bruce G. Haffty, MDPresidentNew Brunswick, NewJerseyJames P. Borgstede, MDPresident-Elect and Asst.Executive Director, MOC,Diagnostic RadiologyDenver, ColoradoRichard L. Morin, PhDSecretary-Treasurer andAsst. Executive Director,IC, Medical PhysicsJacksonville, FloridaDennis M. Balfe, MDAsst. Executive Director,IC, Diagnostic RadiologySt. Louis, MissouriDennis C. Shrieve, MD,PhD, Asst. ExecutiveDirector, IC, RadiationOncologySalt Lake City, UtahMilton J. Guiberteau, MDAsst. Executive Director,IC & MOC SubspecialtiesHouston, TexasG. Donald Frey, PhDAsst. Executive Director,MOC, Medical PhysicsCharleston, South CarolinaAnthony L. Zietman, MDAsst. Executive Director,MOC, Radiation OncologyBoston, MassachusettsK. Kian Ang, MD, PhDHouston, TexasThomas A. Berquist, MDJacksonville, FloridaJohn K. Crowe, MDScottsdale, ArizonaLane F. Donnelly, MDOrlando, FloridaDonald P. Frush, MDDurham, North CarolinaGeoffrey S. Ibbott, PhDHouston, TexasLisa A. Kachnic, MDBoston, MassachusettsElla A. Kazerooni, MDAnn Arbor, MichiganJeanne M. LaBerge, MDSan Francisco, CaliforniaMary C. Mahoney, MDCincinnati, OhioVincent P. Mathews, MDIndianapolis, IndianaMatthew A. Mauro, MDChapel Hill, North CarolinaDuane G. Mezwa, MDRoyal Oak, MichiganBrent J. Wagner, MDReading, PennsylvaniaLynn D. Wilson, MD, MPHNew Haven, ConnecticutRobert D. Zimmerman, MDNew York, New YorkExecutive StaffGary J. Becker, MDExecutive DirectorTucson, ArizonaKay H. Vydareny, MDAssoc. Executive DirectorDiagnostic RadiologyAtlanta, GeorgiaPaul E. Wallner, DOAssoc. Executive DirectorRadiation OncologyBethesda, MarylandStephen R. Thomas, PhDAssoc. Executive DirectorMedical PhysicsCincinnati, OhioJennifer L. Bosma, PhDAssoc. Executive DirectorAdministrationTucson, ArizonaDIVISION DIRECTORSBoard AffairsJennifer E. Hutson, MBACertification ServicesDavid J. Laszakovits, MBACommunications/EditingDonna Breckenridge, MADigital ImagingMichael G. Evanoff, PhDFinanceVictoria E. Franz, CPAInformation TechnologyJohn T. AdamsPsychometrics/EvaluationAnthony Gerdeman, PhD21

American Board of Radiology headquarters in Tucson, Arizona5441 E. Williams Blvd.Tucson, AZ 85711 • (520) 790-2900www.theabr.orgAll contents ©2011 The American Board of Radiology. All rights reserved.