Editing Radiology (section)

== Professional training ==

=== United States ===

Radiology is a field in medicine that has expanded rapidly after 2000 due to advances in computer technology, which is closely linked to modern imaging techniques. Applying for residency positions in radiology has become highly competitive. Applicants are often near the top of their medical school classes, with high [[United States Medical Licensing Examination|USMLE]] (board) examination scores.<ref>{{Cite web|url=https://www.aamc.org/download/94976/data/raddiag09.pdf.pdf|title=USMLE Scores and Residency Applicant Data, 2009: Diagnostic Radiology}}{{Dead link|date=November 2023 |bot=InternetArchiveBot |fix-attempted=yes }}</ref> Diagnostic radiologists must complete prerequisite undergraduate education, four years of medical school to earn a medical degree ([[Doctor of Osteopathic Medicine|D.O.]] or [[Doctor of Medicine|M.D.]]), one year of internship, and four years of residency training.<ref>{{Cite news|url=http://cmescience.com/a-day-in-the-life-of-a-radiologist/|title=A Day in the Life of a Radiologist|date=2017-12-28|access-date=2018-03-15|language=en-US|archive-date=2018-04-14|archive-url=https://web.archive.org/web/20180414083712/http://cmescience.com/a-day-in-the-life-of-a-radiologist/|url-status=live}}</ref> After residency, most radiologists pursue one or two years of additional specialty fellowship training.

The [[American Board of Radiology]] (ABR) administers professional certification in Diagnostic Radiology, Radiation Oncology and Medical Physics as well as subspecialty certification in neuroradiology, nuclear radiology, pediatric radiology and vascular and interventional radiology. "Board Certification" in diagnostic radiology requires successful completion of two examinations. The Core Exam is given after 36 months of residency. Although previously taken  in Chicago or Tucson, Arizona, beginning in February 2021, the computer test transitioned permanently to a remote format. It encompasses 18 categories. A passing score is 350 or above. A fail on one to five categories was previously a Conditioned exam, however beginning in June 2021, the conditioned category will no longer exist and the test will be graded as a whole. The Certification Exam, can be taken 15 months after completion of the Radiology residency. This computer-based examination consists of five modules and graded pass-fail. It is given twice a year in Chicago and Tucson. Recertification examinations are taken every 10 years, with additional required continuing medical education as outlined in the Maintenance of Certification document.{{citation needed|date=May 2024}}

Certification may also be obtained from the [[American Osteopathic Board of Radiology]] (AOBR) and the American Board of Physician Specialties.{{citation needed|date=May 2024}}

Following completion of residency training, radiologists may either begin practicing as a general diagnostic radiologist or enter into subspecialty training programs known as fellowships. Examples of subspeciality training in radiology include abdominal imaging, thoracic imaging, cross-sectional/ultrasound, [[magnetic resonance imaging|MRI]], [[Human musculoskeletal system|musculoskeletal]] imaging, [[interventional radiology]], [[neuroradiology]], [[interventional neuroradiology]], [[paediatric radiology]], nuclear medicine, emergency radiology, breast imaging and women's imaging. Fellowship training programs in radiology are usually one or two years in length.<ref>{{cite web |url=http://www.healthsystem.virginia.edu/internet/radiology/educ-opps/fellowships.cfm |title=Department of Radiology and Medical Imaging — School of Medicine at the University of Virginia |publisher=Healthsystem.virginia.edu |date=2012-02-17 |access-date=2012-08-03 |archive-date=2010-06-16 |archive-url=https://web.archive.org/web/20100616055854/http://www.healthsystem.virginia.edu/internet/radiology/educ-opps/fellowships.cfm |url-status=dead }}</ref>

Some medical schools in the US have started to incorporate a basic radiology introduction into their core MD training. [[New York Medical College]], the [[Wayne State University School of Medicine]], [[Weill Cornell Medicine]], the Uniformed Services University, and the University of South Carolina School of Medicine offer an introduction to radiology during their respective MD programs.<ref>{{cite web |url=http://www.nymc.edu/Academics/SchoolOfMedicine/UndergraduateMedicalEducation/FourthYearCurriculum/index.html |url-status=dead |archive-url= https://web.archive.org/web/20100528084709/http://www.nymc.edu/Academics/SchoolOfMedicine/UndergraduateMedicalEducation/FourthYearCurriculum/index.html |archive-date=2010-05-28 |publisher=New York Medical College |title=School of Medicine }}</ref><ref>{{cite web |url=http://www.springerimages.com/Images/MedicineAndPublicHealth/1-10.1007_s13089-011-0052-9-0 |title=Integrated ultrasound curriculum (iUSC) |publisher=SpringerImages |date=2011-03-25 |access-date=2012-08-03 |archive-date=2012-03-13 |archive-url=https://web.archive.org/web/20120313192541/http://www.springerimages.com/Images/MedicineAndPublicHealth/1-10.1007_s13089-011-0052-9-0 |url-status=live }}</ref><ref>{{cite web |url=http://www.jultrasoundmed.org/cgi/content/abstract/27/5/745 |title=A Pilot Study of Comprehensive Ultrasound Education at the Wayne State University School of Medicine |publisher=Jultrasoundmed.org |date=2008-05-01 |access-date=2012-08-03 |url-status=dead |archive-url=https://web.archive.org/web/20100713124805/http://www.jultrasoundmed.org/cgi/content/abstract/27/5/745 |archive-date=2010-07-13 }}</ref> [[Campbell University School of Osteopathic Medicine]] also integrates imaging material into their curriculum early in the first year.{{citation needed|date=May 2024}}

Radiographic exams are usually performed by [[radiographer]]s. Qualifications for radiographers vary by country, but many radiographers now are required to hold a degree.{{citation needed|date=May 2024}}

Veterinary radiologists are veterinarians who specialize in the use of X-rays, ultrasound, MRI and nuclear medicine for diagnostic imaging or treatment of disease in animals. They are certified in either diagnostic radiology or radiation oncology by the American College of Veterinary Radiology.{{citation needed|date=May 2024}}

=== United Kingdom ===
Radiology is an extremely competitive speciality in the UK, attracting applicants from a broad range of backgrounds. Applicants are welcomed directly from the [[Foundation Programme]], as well as those who have completed higher training. Recruitment and selection into training post in clinical radiology posts in England, Scotland and Wales is done by an annual nationally coordinated process lasting from November to March. In this process, all applicants are required to pass a Specialty Recruitment Assessment (SRA) test.<ref>{{cite web|url=https://www.rcr.ac.uk/clinical-radiology/careers-recruitment/specialty-recruitment|title=Specialty recruitment|website=[[Royal College of Radiologists]]|access-date=2017-03-02|archive-date=2017-03-03|archive-url=https://web.archive.org/web/20170303043350/https://www.rcr.ac.uk/clinical-radiology/careers-recruitment/specialty-recruitment|url-status=dead}}</ref> Those with a test score above a certain threshold are offered a single interview at the London and the South East Recruitment Office.<ref name=oriel>{{cite web|url=https://www.pathway.oriel.nhs.uk/Web/Sys_Pages/Programme/ProgrammeDetail.aspx?filterProgrammeID=7E3613A0-ED9E-4B65-9A02-4A37FC472FA4|title=Vacancy / Clinical Radiology|website=oriel.nhs.uk|access-date=2017-03-02|archive-date=2017-03-02|archive-url=https://web.archive.org/web/20170302195802/https://www.pathway.oriel.nhs.uk/Web/Sys_Pages/Programme/ProgrammeDetail.aspx?filterProgrammeID=7E3613A0-ED9E-4B65-9A02-4A37FC472FA4|url-status=dead}}</ref> At a later stage, applicants declare what programs they prefer, but may in some cases be placed in a neighbouring region.<ref name=oriel/>

The training programme lasts for a total of five years. During this time, doctors rotate into different subspecialities, such as paediatrics, musculoskeletal or neuroradiology, and breast imaging. During the first year of training, radiology trainees are expected to pass the first part of the Fellowship of the [[Royal College of Radiologists]] (FRCR) exam. This comprises a medical physics and anatomy examination. Following completion of their part 1 exam, they are then required to pass six written exams (part 2A), which cover all the subspecialities. Successful completion of these allows them to complete the FRCR by completing part 2B, which includes rapid reporting, and a long case discussion.

After achieving a [[certificate of completion of training]] (CCT), many fellowship posts exist in specialities such as neurointervention and vascular intervention, which would allow the doctor to work as an Interventional radiologist. In some cases, the CCT date can be deferred by a year to include these fellowship programmes.

UK radiology registrars are represented by the Society of Radiologists in Training (SRT), which was founded in 1993 under the auspices of the Royal College of Radiologists.<ref>{{cite web |url=http://www.thesrt.co.uk/ |title=The Society of Radiologists in Training |publisher=Society of Radiologists in Training |access-date=8 February 2015 |archive-date=15 August 2015 |archive-url=https://web.archive.org/web/20150815211318/http://www.thesrt.co.uk/ |url-status=live }}</ref> The society is a nonprofit organisation, run by radiology registrars specifically to promote radiology training and education in the UK. Annual meetings are held by which trainees across the country are encouraged to attend.

Currently, a shortage of radiologists in the UK has created opportunities in all specialities, and with the increased reliance on imaging, demand is expected to increase in the future. [[Radiographer]]s, and less frequently [[Nurse]]s, are often trained to undertake many of these opportunities in order to help meet demand. Radiographers often may control a "list" of a particular set of procedures after being approved locally and signed off by a consultant radiologist. Similarly, radiographers may simply operate a list for a radiologist or other physician on their behalf. Most often if a radiographer operates a list autonomously then they are acting as the operator and practitioner under the Ionising Radiation (Medical Exposures) Regulations 2000. Radiographers are represented by a variety of bodies; most often this is the [[Society and College of Radiographers]]. Collaboration with nurses is also common, where a list may be jointly organised between the nurse and radiographer.

=== Germany ===
After obtaining medical licensure, German radiologists complete a five-year residency, culminating with a board examination (known as ''Facharztprüfung'').

=== Italy ===
Italian radiologists complete a four-year residency program, after completing the six-year MD program.

=== The Netherlands ===
Dutch radiologists complete a five-year residency program, after completing the six-year MD program.

=== India ===
In India, one must obtain a bachelor's degree which requires 4.5 years of training, along with 1 year internship, followed by NEET PG examination which is one of the hardest examinations in India. Previous rank data shows only top rankers take radiology which means if the score is less, one might get accepted into other branches, but not radiology. The radiology program is a post graduate 3-year program (MD/DNB Radiology) or a 2-year diploma (DMRD).<ref>{{cite journal | vauthors = Arora R | title = The training and practice of radiology in India: current trends | journal = Quantitative Imaging in Medicine and Surgery | volume = 4 | issue = 6 | pages = 449–50 | date = December 2014 | pmid = 25525575 | pmc = 4256238 | doi = 10.3978/j.issn.2223-4292.2014.11.04 }}</ref>

=== Singapore ===
Radiologists in Singapore complete a five-year undergraduate MD program, followed by a one-year [[Internship (medical)|internship]], and then a five-year residency program. Some radiologists may elect to complete a one or two-year fellowship for further sub-specialization in fields such as [[interventional radiology]].

'''Slovenia'''

After finishing a six-year study of medicine and passing the emergency medicine internship, MDs can apply for radiology residency. Radiology is a five-year post-graduate program that involves all fields of radiology with a final board exam.

'''France'''

To become a radiologist, after having validated the common core of medical studies, one must obtain a DES (Specialized Studies Diploma) in radiology and medical imaging (specialized studies in 5 years), or a DES in advanced interventional radiology (specialized studies in 6 years). At the end of their DES, once validated, the future doctor will have to defend their "practice thesis" in order to validate their DE (State Diploma) as a doctor of medicine (common to all doctors of medicine therefore) and to be able to practice in France.

=== Specialty training for interventional radiology ===

Training for interventional radiology occurs in the residency portion of [[medical education]], and has gone through developments.

In 2000, the [[Society of Interventional Radiology]] (SIR) created a program named "Clinical Pathway in IR", which modified the "Holman Pathway" that was already accepted by the American Board of Radiology to including training in IR; this was accepted by ABR but was not widely adopted. In 2005 SIR proposed and ABR accepted another pathway called "DIRECT (Diagnostic and Interventional Radiology Enhanced Clinical Training) Pathway" to help trainees coming from other specialities learn IR; this too was not widely adopted.  In 2006 SIR proposed a pathway resulting in certification in IR as a speciality; this was eventually accepted by the ABR in 2007 and was presented to the [[American Board of Medical Specialities]] (ABMS) in 2009, which rejected it because it did not include enough [[diagnostic radiology]] (DR) training. The proposal was reworked, at the same time that overall DR training was being revamped, and a new proposal that would lead to a dual DR/IR specialization was presented to the ABMS and was accepted in 2012 and eventually was implemented in 2014.<ref>{{cite journal | vauthors = Kaufman JA | title = The interventional radiology/diagnostic radiology certificate and interventional radiology residency | journal = Radiology | volume = 273 | issue = 2 | pages = 318–21 | date = November 2014 | pmid = 25340266 | doi = 10.1148/radiol.14141263 | doi-access =  }}</ref><ref>{{cite journal | vauthors = Siragusa DA, Cardella JF, Hieb RA, Kaufman JA, Kim HS, Nikolic B, Misra S, Resnick SA, Saad WE, Vatakencherry G, Wallace MJ | display-authors = 6 | title = Requirements for training in interventional radiology | journal = Journal of Vascular and Interventional Radiology | volume = 24 | issue = 11 | pages = 1609–12 | date = November 2013 | pmid = 24160820 | pmc = 4485607 | doi = 10.1016/j.jvir.2013.08.002 }}</ref><ref name=DiMarco2016>{{cite journal | vauthors = Di Marco L, Anderson MB | title = The new Interventional Radiology/Diagnostic Radiology dual certificate: "higher standards, better education" | journal = Insights into Imaging | volume = 7 | issue = 1 | pages = 163–5 | date = February 2016 | pmid = 26746975 | pmc = 4729716 | doi = 10.1007/s13244-015-0450-9 }}</ref> By 2016 the field had determined that the old IR fellowships would be terminated by 2020.<ref name=DiMarco2016/>

A handful of programs have offered interventional radiology [[Fellowship (medicine)|fellowships]] that focus on training in the treatment of children.<ref>{{cite web | title = Pediatric Interventional Training Opportunities | url = https://www.pedrad.org/Education/Training-Opportunities/Pediatric-Interventional-Training-Opportunities | publisher = The Society for Pediatric Radiology | access-date = 2020-01-04 | archive-date = 2021-05-16 | archive-url = https://web.archive.org/web/20210516084836/https://www.pedrad.org/Education/Training-Opportunities/Pediatric-Interventional-Training-Opportunities | url-status = dead }}</ref>

In Europe the field followed its own pathway; for example in Germany the parallel interventional society began to break free of the DR society in 2008.<ref>{{cite journal | vauthors = Mahnken AH, Bücker A, Hohl C, Berlis A | title = White Paper: Curriculum in Interventional Radiology | journal = RöFo | volume = 189 | issue = 4 | pages = 309–311 | date = April 2017 | pmid = 28335057 | doi = 10.1055/s-0043-104773 | doi-access = free }}</ref> In the UK, interventional radiology was approved as a sub-specialty of clinical radiology in 2010.<ref>{{cite journal | vauthors = Kassamali RH, Hoey ET | title = Radiology training in United Kingdom: current status | journal = Quantitative Imaging in Medicine and Surgery | volume = 4 | issue = 6 | pages = 447–8 | date = December 2014 | pmid = 25525574 | pmc = 4256234 | doi = 10.3978/j.issn.2223-4292.2014.10.10 }}</ref><ref>{{cite web|title=Guidance on Training in Interventional Radiology|url=https://www.rcr.ac.uk/sites/default/files/docs/radiology/pdf/Guidance%20on%20Training%20in%20Interventional%20Radiology.pdf|website=Royal College of Radiologists|access-date=26 September 2017|archive-date=6 August 2020|archive-url=https://web.archive.org/web/20200806160517/https://www.rcr.ac.uk/sites/default/files/docs/radiology/pdf/Guidance%20on%20Training%20in%20Interventional%20Radiology.pdf|url-status=dead}}</ref> While many countries have an interventional radiology society, there is also the European-wide [[Cardiovascular and Interventional Radiological Society of Europe]], whose aim is to support teaching, science, research and clinical practice in the field by hosting meetings, educational workshops and promoting patient safety initiatives. Furthermore, the Society provides an examination, the European Board of Interventional Radiology (EBIR), which is a highly valuable qualification in interventional radiology based on the European Curriculum and Syllabus for IR.