By Shauna Campbell, DO
In comparison with most medical specialties, radiation oncology offers a more family friendly schedule, for both a trainee and practicing physician. However, the board certification process is extensive, including four individual examinations spanning an average of three years. This prolonged process often leaves early career physicians trying to coordinate major life events, such as family planning, with the intensive study required to obtain board certification. From 2018 to 2020, there were several unfortunate events that left a divide between many young physicians and the ABR. This included an unprecedented failure rate in the basic science examinations, examinees who reported their request for accommodations were not fulfilled and cancellations due to the COVID-19 pandemic. In response, there has been a concerted effort by several stakeholder organizations, including the ABR, ARRO, ADROP, SCAROP and ASTRO, to improve the board certification process. As we emerge from the COVID-19 pandemic, I would like to highlight the recent changes that have been implemented.
- As of 2021, all ABR written and oral examinations are now virtual. The ABR should be commended for creating this platform on such a limited timeline, as well as their commitment to continuous improvement.
- Candidates taking the oral examination are no longer required to travel to Tucson, Arizona, limiting the time and financial burden of board certification.
- Candidates are now able to take the written and oral examinations in the environment of their choice, improving the ease of special accommodations.
- The ABR now has improved ability to schedule examination dates based on feedback from stakeholder organizations, as it is no longer dependent on a third-party company for examination administration.
- This change made the extra April 2021 basic science and clinical written examinations possible.
- ARRO has provided feedback requesting the clinical written examination be permanently moved from July/August following graduation to May of PGY-5. This feedback was received favorably by the ABR, and the 2022 examination dates will be released in early June.
- ABR personnel now have direct access to the examination platform and no longer depend on a third-party administrator to implement special accommodations, such as longer breaks or increased testing time.
- Residents are now eligible, with the permission of their program director, to sit for the medical physics and/or radiation and cancer biology examination at the beginning of PGY-4. This is one year earlier than previous requirements and provides residents with personal choice and flexibility to accommodate other life events with board certification.
Family & Medical Leave Policy:
- The ABR is expected to announce their official family and medical leave policy in early June 2021. All medical boards under the American Board of Medical Specialties were called to establish a maximum amount of time away permitted during residency before extension of training is required, as of July 1, 2021.
- The ABR has been responsive to feedback from stakeholder organizations informing this policy, and in the latest draft has introduced a leave policy inclusive of 28 weeks’ leave over four years for radiation oncology trainees. This policy accounts for time away, inclusive of vacation, family, medical and caregiver leave.
- There is also consideration for additional leave, without extension of training, for residents deemed competent by their program director and with special permission of the ABR.
- The ABR will be a leader among medical boards should it finalize this contemporary policy, which is consistent with the recent editorial published in Radiology, Family and Medical Leave for Diagnostic Radiology, Interventional Radiology, and Radiation Oncology Residents in the United States: A Policy Opportunity, which was endorsed by ARRO and ADROP. If this policy is finalized as proposed, it would be in agreement with Resolution 48, passed at the 2021 ACR meeting, recommending all residents receive 12 weeks of family and medical leave during residency, with additional time at the discretion of the program director and the ABR.
As we emerge from a difficult few years, the board certification process in radiation oncology has undergone substantial modernization. The changes implemented thus far represent a collaborative effort by several organizations and significant dedication by the ABR to support the growing workforce of radiation oncologists. Continued collaboration and improvement in board certification will help ensure radiation oncology continues to attract talented and diverse physicians that represent the future of our specialty.
Join us on the Gender Equity community on the ROhub to continue the conversation. What future changes do you think should be considered for the continuous improvement of board certification in radiation oncology?”
For additional information, read the ASTRO letter to the ABR on parental leave. This page also includes a link to SCAROP’s letter to the ABR.
Shauna Campbell, DO, is a PGY-5 resident at Cleveland Clinic and immediate past chair of the ARRO Executive Committee.
By Gita Suneja, MD, MS, and Robert C. Miller, MD, MBA, FASTRO
The Radiation Oncology Institute (ROI) is delighted to announce new research awards to four teams of investigators who seek to understand how biomarkers can be used to optimize outcomes for patients receiving radiation therapy. A record-breaking number of applications were submitted in response to this request for proposals, highlighting the promise that many in the radiation oncology community see for biomarkers to transform the field. The ROI always seeks to fund the highest quality research that will have an impact on practice and patient care, and these new grants are the result of the ROI’s comprehensive and diligent peer-review process. The awarded projects utilize a variety of scientific methodologies and focus on four different disease sites, many of which are new within the ROI research portfolio. The following four research teams are the recipients of this year’s Biomarkers for Radiation Oncology Awards.
David Miyamoto, MD, PhD, and his team at the Massachusetts General Hospital will develop a new blood test to detect and analyze circulating tumor cells in patients with muscle-invasive bladder cancer. This non-invasive liquid biopsy test will help identify patients who can be effectively treated with bladder-preserving trimodality therapy, a combination of radiation therapy, chemotherapy, and limited surgery that avoids removing the entire bladder. The test could also be used to monitor patients for recurrences after therapy.
Nina Sanford, MD, and Wen Jiang, MD, PhD, will be co-Principal Investigators on a project to develop a novel microscale biochip device to monitor disease progression and treatment response in anal cancer. Their innovative technology will be used to capture circulating exosomes and to detect a microRNA specific to anal cancer in patient blood samples before, during and after chemoradiation that would allow for greater personalization of treatment. Dr. Sanford specializes in the care of gastrointestinal cancers at the University of Texas Southwestern Medical Center and Dr. Jiang studies microfluidic and nanoengineering at MD Anderson Cancer Center.
Two ASTRO Members-in-Training are receiving special recognition as recipients of James D. Cox Research Awards. Their grants are supported by generous gifts made by Ritsuko Komaki-Cox, MD, FASTRO, in honor of her late husband and their shared commitment to training the next generation of radiation oncologists.
Hesham Elhalawani, MD, MSc, a clinical fellow at Brigham and Women’s Hospital, will use radiomics to develop a decision-making tool to help diagnose radiation necrosis (RN) earlier in patients being treated with immunotherapy and stereotactic radiosurgery (SRS) for brain metastases. Along with mentor Ayal Aizer, MD, MHS, Dr. Elhalawani will use artificial intelligence to conduct a longitudinal analysis of MRIs performed before and after SRS to identify imaging biomarkers to predict which patients are most likely to develop RN.
Sonal Noticewala, MD, MAS, a resident at MD Anderson Cancer Center, will explore the role of the microbiome in how patients with pancreatic cancer respond to neoadjuvant chemoradiation. Together with mentor Cullen Taniguchi, MD, PhD, Dr. Noticewala will examine bacterial profiles in paired tissue samples of pancreatic tumors and peri-tumoral regions to define a signature microbiome associated with patient response to chemoradiation. They aim to show that differences in the microbiome can account for variations in treatment response and lay the groundwork for future studies that target the microbiome to optimize treatment and improve outcomes.
Together with the support of donors, we are investing in these talented investigators who are exploring how biomarkers can advance radiation oncology, and we look forward to sharing their progress and outcomes with you in the future. Be sure to keep up with the ROI’s latest research news by visiting our website or following us on Twitter and Facebook.