Nature & Scope of the Radiology Examination

American College of Veterinary Radiology
Examination Policies & Procedures

Revised: 3/2013

Note: This document pertains only to the ACVR examination in diagnostic imaging. Policies regarding the examination for the Recognized Veterinary Specialty of Radiation Oncology are detailed in a separate document.

General

Examination Format

The ACVR Examination in Diagnostic Imaging is a two-part examination composed of the Preliminary Examination and the Certifying Examination. A candidate must pass the Preliminary Examination according to the criteria set forth in this document in order to qualify to sit the Certifying Examination. A candidate who passes the Certifying Examination is eligible to become a Diplomate of the American College of Veterinary Radiology. Diplomate status is ultimately conferred by majority vote of the ACVR Executive Council.

Honor Code

The ACVR requires all candidates to agree to and sign the ACVR Honor Code prior to participation in the Preliminary Examination and the Certifying Examination. Any violation of the honor code may result in nullification of a candidate's examination results.

Location

The examination is given at a time and location determined by ACVR. The date and location of the examination is published on the ACVR Calendar annually.

Preliminary Examination

Content

The Preliminary Examination is a written examination which is composed of multiple choice questions. All questions will be referenced to a specific objective listed in the current ACVR Preliminary Examination Objectives. The Objectives will be published on the ACVR website no later than the deadline for candidate applications to sit the Preliminary Examination.

Images will be used in the examination and will include normal and abnormal cases. While emphasis is given to the dog, cat and horse, other species will be included where appropriate and noted. The current literature relevant to examination sections and diagnostic imaging is a source of examination material. In addition, past literature pertinent to specific radiographic techniques, special procedures, radiobiology and alternate imaging are used for questions. While there is no stated specific time limit regarding the literature, particularly for Veterinary Radiology & Ultrasound, outdated, obsolete, or obscure material is avoided.

Scoring

The Preliminary Examination is a criterion referenced examination. The philosophy of a criterion referenced examination is based on the concept that candidates are measured against an absolute standard that represents critical skill and knowledge. The difficulty of each item on the examination is the basis for establishing the initial standard on a Benchmark Scale. The data from the examination is used to establish a Benchmark Scale, and the criterion referenced standard is transcribed to determine a pass point represented in scaled score points. Future tests are equated to the Benchmark Scale and criterion referenced pass point after differences in the difficulty of the test have been taken into account.

To establish a criterion referenced standard and benchmark scale, ACVR follows these steps:

1. Select items (questions) that are used to construct the examination will be used as the Benchmark Scale.

2. ACVR Examination Committee members assess individually the probability that a minimally capable candidate will answer an item correctly. To do this, they will consider the relevance, frequency, and construction of the item. All items on the test that are used to construct the Benchmark Scale will be evaluated. After the standard setting study is completed, the probabilities for each item is averaged across the members of the Examination Committee and an overall percent correct is established. This is transcribed to a scaled score during the analysis and for purposes of test equating.

3. Administer, score and analyze the Benchmark examination. The analysis uses traditional and Rasch model (IRT) statistics.

4. Establish and review the Criterion Standard on the Benchmark Scale. Determine the appropriateness of the Standard.

5. Refine the Criterion Standard using the error of measurement, if necessary.

6. Implement the Criterion Standard established by the Examination Committee.

7. Equate subsequent examinations to the Benchmark Scale and Criterion Standard. This is accomplished by including “equator” questions from the Benchmark Scale on subsequent exams. These “equator” items are used to identify the differences in the difficulty of subsequent exams, so that appropriate adjustments can be made. After the differences in test difficulty are accounted for through equating, the Criterion standard on the Benchmark Scale is used to determine pass or fail decisions. This process insures that all candidates must meet the same criterion, regardless of when they take the examination. It also insures that all candidates have a comparable opportunity to pass the test, if they are able.

Outcome

Candidates who pass the Preliminary Examination may apply to sit for the Certifying Examination.

Candidates who fail the Preliminary Examination may apply to retake the Preliminary Examination. Failing candidates will receive a letter from the Examination Director detailing specific areas of weaknesses and strengths to aid in their preparation for the next examination.

Certifying Examination

Content

The Certifying Examination is an oral examination which is divided into 6 sections, each of which covers a specific area of diagnostic imaging:

• Thorax
• Abdomen
• Musculoskeletal
• Ultrasound
• Special Procedures (70%) & Nuclear Medicine (30%)
• CT (50%) and MRI (50%)

All cases will be referenced to a specific objective listed in the current ACVR Certifying Examination Objectives.

Examination Committee members choose the cases used for each section. Each examiner selects cases for their own section but may also provide cases for other sections, as can the Examination Chair and the Assistant Chair. Before being approved for final use, all cases, the expected responses and scoring criteria are reviewed by the entire examination committee for suitability.

Each 90-minute exam section is subdivided into two (2) forty-five minute sessions that are taken consecutively. Candidates are presented with 10 to 15 cases which are presented as video clips on a monitor or optimized graphic files in a PowerPoint® presentation. These 10 to 15 cases are reviewed over the course of the entire 90 minute session so that roughly half of the cases will be given by one examiner prior to switching to the second examiner and completing the remaining cases.

Any animal commonly seen in veterinary practice may be used as the subject of an examination question but dogs, cats, and horses are most frequent. The examination is designed to test recognition of radiographic signs in general (similar in any species) or recognition of species-specific disease. Candidates should expect that the cases used for the thoracic, abdominal and musculoskeletal sections will generally consist of radiographs, but other modalities (such as CT, MRI, sonograms, or scintigrams) may be included, either separately or as part of a multi-modality examination.

Candidates should be prepared to evaluate each case as if providing consultation to another veterinarian. Sufficient clinical information will be provided to evaluate each case. Examiners are listening for a systematic evaluation of the study, listing of pertinent imaging findings, and discussion of which of the findings they believe are significant. Candidates should assess the imaging findings in a meaningful manner without spending a large amount of time on the review of normal findings. Candidates should present a compilation of findings leading to an imaging diagnosis, followed by an appropriate, ranked list of differential diagnoses if the imaging diagnosis is not specific. Candidates should demonstrate an understanding of the pathophysiology of observed abnormalities, and provide a rational justification for the use of any ancillary studies, views or special procedures. The pattern of discussion should convince the examiner that the candidate understands what can be concluded from the images. Though interaction between the examiner and candidate is limited, the examiner may ask for further clarification, description or elaboration of key anatomical, pathophysiological, or biomechanical issues. It is important that the examiner clearly understand the candidate’s thought processes, prioritization, and conclusions.

Scoring

Each case presented in an exam section is worth a total of 8 or 10 points. Up to 4 points are awarded for the candidate's observation of imaging abnormalities. Up to 4 points are awarded for a candidate's ability to synthesize imaging findings with the patient's clinical history and signs. Up to 2 points are awarded (when appropriate) for a candidate's ability to make appropriate patient management recommendations, including both imaging-related diagnostics and other pertinent diagnostic testing.

Outcome

A candidate must complete all six sections of the Certifying Examination during one test period with a minimum score of 70% of the total points possible in each section. A candidate failing only one section may retake the failed section during one of the next two years. The candidate will be allowed one attempt to retake and pass the reexamination within the allowed period. If unsuccessful, then the candidate must retake the entire Certifying Examination. Candidates who fail more than one section must retake the entire Certifying Examination.

Names of candidates who pass the Certifying Examination are referred to the ACVR Executive Council, upon which a majority vote of approval will confer Diplomate status upon successful candidates.

Failing candidates will receive a letter from the Chair of the Examination Committee detailing specific areas of weakness and strengths to aid in their preparation for the next examination.

Examination Honor Code

The contents of the ACVR Preliminary and Certification examinations are confidential. You are prohibited from divulging any information about the questions, images, or case material included in the ACVR Preliminary or Certifying Examination to anyone during or after the examination.

For the Certification examination this includes discussion of format of cases, such as number of images, types of images, “hidden” views or supplemental studies presented to you. Your description of the case, medical management, or final diagnosis may not be discussed with anyone.

For the Preliminary examination, use of any electronic devices during the examination other than those provided to you by ACVR is strictly prohibited and will be considered a violation of the honor code.

Your confidentiality is required in order to ensure each candidate an equal opportunity to pass the examination. If any candidate is thought to be in violation of the Honor Code, a detailed report with charges of the violation will be sent to the ACVR Executive Council for action. A candidate found to be in violation of the Honor Code by Executive Council will have their examination results nullified.

All candidates must read and sign the following statement prior to participating in the examination:

I have read and understand the ACVR Honor Code. I agree to keep the contents of the ACVR Examination confidential. I agree to report any inappropriate discussions or actions I observe to the Examination Committee. I will not provide assistance to, nor accept assistance from anyone during the examination.

Name: ______________________________

Signature: ___________________________

Date: _________________