EDGAR - ESGAR Subspecialty Diploma

Introduction

The ESGAR Diploma is a new qualification, established due to the growing need for subspecialised recognition in gastrointestinal and abdominal radiology. The ESGAR diploma offers a recognition of expertise at a European level for radiologists who have reached a subspecialised level of knowledge in abdominal radiology and who are keen to maintain this level through continuous education and involvement in the field, and by taking the examination.

The ESGAR Diploma, as a form of testing gastrointestinal and abdominal radiology knowledge, presents several advantages:

The examination objectively verifies that radiologists possess the required expert knowledge, skills and competences at the end of their specific gastrointestinal and abdominal radiology training.
It is a qualification developed in line with the standards defined by the ESR for gastrointestinal and abdominal imaging knowledge and competences (Level III) and will facilitate standardised training in Gastrointestinal and Abdominal Imaging in Europe.
It confirms specific expert knowledge and competences of radiologists to perform, interpret and report fluoroscopy, X-rays, CT, ultrasound, MRI and hybrid imaging (PET-CT, PET_MRI) studies of the abdomen as well as in basic abdominal interventional procedures.

EDGAR is endorsed by the European Society of Radiology (ESR) and equals a final Level III subspecialty examination.

How to acquire the ESGAR Diploma

Fulfilment of eligibility criteria, completion of the application form and providing the required documentation as laid out under "Eligibility" and "Application".

Taking the examination which consist of 2 parts: MCQ’s, Core Cases. The examination is offered once a year during the annual meeting of the Society. Only a limited number of candidates can be accepted for the examination. Applications will be accepted on a first come, first served basis – date of receipt of application form and documentation.

Scoring by the examiners. The total score consists of results of all components of the exam. The scores for each candidate will be reviewed and potential fail candidates will be discussed. Candidates will be informed accordingly by email.

Successful candidates will be awarded the EDGAR, ESGAR Diploma in Gastrointestinal and Abdominal Radiology to their name.

Diplomas may only be awarded to fully trained, licensed and practicing radiologists
At least two years of subspecialty training following radiology certification (national board examination or EDIR)
Applicants have to prove at least five years of radiology training (alternative: proof of supervised staff radiologist). The training has to be in line with the basic principles of radiology training as laid out in the ESR Training Curriculum.
Within the two years prior to application, the candidate should have reported at least:
100 abdominal ultrasounds including CEUS
200 abdominal CT
100 abdominal MR
50 abdominal X-Ray examinations including fluoroscopy.
Attendance of at least two ESGAR events within the last three years prior to the application (min. 50 CME credits):
Annual Meeting & Postgraduate Course and/or ESGAR workshops
ESGAR and ESR Membership

Application form
The completed application form must be submitted to the ESGAR Office. Please use the standard form to provide a clear overview.

Kindly return the completed form as well as the following documents - combined in one single PDF - to the ESGAR Office:

Training in radiology / Certificate of completed training
Applicants have to prove at least five years of radiology training. As a certificate of completed training a national board examination or the EDIR needs to be provided. For candidates with less than five years of training only, a proof of equivalent experience as a supervised staff radiologist is required (will be considered if appropriate).

Subspecialty training
Please provide a letter of support from the head of department, confirming that the candidate was trained in Gastrointestinal and Abdominal Imaging for a cumulative duration of at least two years after board certification.

Proof of practice
Please provide a proof of practice from your institution. Specialists from other fields and radiologists no longer in practice are specifically excluded from being granted the ESR-endorsed ESGAR diploma.

RIS documentation or Logbook
All candidates must present a RIS documentation or logbook with a total record of their abdominal and gastrointestinal Radiology experience of the last 24 months. This should present the candidate’s abdominal / GI related experience according to the requirements listed below. The RIS documentation or logbook should be countersigned by candidate’s programme director. Preferably provided as an excel sheet, the RIS documentation/logbook should be sorted by modalities with clearly identified and anonymous information.

CME credits in abdominal imaging
The necessary 50 CME credits in abdominal imaging topics need to be proved by submitting a CME confirmation (ESGAR Annual Meeting or Workshops). CME credits from other sources will be considered if appropriate.

Curriculum Vitae
Please send your CV in pdf format.

Initial examination:
€ 400.00 (for all ESGAR membership types)
Re-examination:
€ 200.00
Renewal:
€ 50.00 or free of charge for ESGAR members in good standing

The examination is held during the ESGAR Annual Meetings and is limited to 50 persons taking the examination in parallel.
The date of the next examination is:

Monday, May 27, 2024, 16:30 - 18:00
ESGAR 2024 Congress Centre:
Swenska Mässan, Mässans gata 24
412 51 Gothenburg, Sweden

Date of next on-line examination
September 2024, date tbc

Re-examination: Candidates failing the examination have the opportunity to retake the examination once during the subsequently following year at a reduced fee of 200,00 Euro.

The Diploma is valid for 5 years.

Renewal of the Diploma is free of charge for ESGAR Members in continuous good standing during the 5-year following the original examination or renewal. There is a renewal fee of 50.00 Euro for all other Diploma holders who do not fulfil the 5 years of continuous membership in good standing.

Pre-requisites for Diploma renewal:

Renewal application form
Proof of active membership of ESGAR in ESR in the year of application for the renewal.
Proof of at least 150 CME credits in the last 5 years, earned by attending or lecturing at ESGAR Annual Meetings, ESGAR Workshops, or other events recognised by ESGAR, such as Level III sessions at ECR, National subspeciality meetings (BSGAR, SEDIA, SIAD, ARGANZ, ASAR). A minimum of 50 % of the required CME credits must have been earned with ESGAR activities.

The EDGAR contains the following elements:

30 Multiple Response Questions, single best answer format with a mixture of GI and Abdominal Viscera questions
(max. 60 minutes)
Two CORE Cases - Clinically Oriented Reasoning Evaluation (max. 30 minutes)

Duration
90 minutes maximum (2 min per MRQ, 15 min per core case).

Candidates will be tested in their knowledge as laid out in the subspecialty interest component of the ESR Training Curriculum for Subspecialisation in Radiology, Level III including all aspects relevant to gastrointestinal and abdominal radiology such as anatomy, physiology, clinical practice, pathology, CT and MR, Ultrasound, Endoscopy, PET/CT and Interventional procedures:

Esophagus: Motility disorders, neoplasia, inflammation, GERD and perforation.
Stomach and Duodenum: Neoplasia, inflammation, perforation and obesity treatment.
Small Bowel: Obstruction, inflammatory diseases, and neoplasia.
Colon and Rectum: Colorectal cancer, IBD, diverticular disease, bleeding, and perforation.
Peritoneum and Abdominal Wall: Outer and inner hernias and complications, inflammatory and neoplastic diseases.
Vessels: Visceral arterial and venous diseases like obstruction, thrombosis, aneurysms and vasculitis.
Liver: Infection, parenchymal disease, focal lesion detection and characterization.
Biliary Tract: Gallbladder and bile duct pathology, including stones, inflammation, infection and obstruction.
Pancreas: Acute and chronic pancreatitis, benign and malignant focal lesions.
Spleen: Inborn anomalies, causes of enlargement and assessment of focal lesions

Both parts of the examination are scored separately:
For the MRQ part a maximum of 30 points can be reached, for the Core cases a maximum of 20 points can be reached. Both parts must be passed to obtain the EDGAR.

The pass mark will be defined by the Diploma Committee depending on the overall quality of the examination. To ensure a minimal level of quality in a very weak examination cohort on one hand and in order not to let fail candidates with sufficient knowledge in a very strong examination cohort on the other side, the minimal and maximal pass rates for both parts are set to each 55% - 65%.