Vascular interpretation credential gains momentum

May 23, 2013. Jan Greene – Staff Writer, Mint Medical Education

Medical credentialing can be a moving target, as vascular surgeons are finding with the Registered Physician in Vascular Interpretation (RPVI) credential. Created about two years ago, the exam offers physicians a chance to prove their competence in analyzing images of the vasculature.

The exam, which takes about four hours and involves 200 questions, is put on by the American Registry for Diagnostic Medical Sonography (ARDMS). Vascular surgeons aren’t the only ones doing vascular interpretation. Increasingly, cardiologists are taking an interest in vessels some distance from the heart. Both specialties, along with radiologists and others, have begun taking the exam. As of March 2012, 1,475 physicians held the credential, according to an ARDMS presentation. It also noted that 55% of those were vascular surgeons, 25% cardiologists, 10% radiologists and 10% another specialty.

“A lot of doctors out there have been reading this stuff for 20 years but have never had the credential,” says CC Todd-Edwards, Technical Director of Vascular Services for Mint Medical , which is offering a three-day vascular interpretation preceptorship that prepares doctors for the RPVI exam. “It’s going to be a big change for a lot of people.”

In the past, vascular specialists might have taken the Registered Vascular Technologist exam to document their expertise in reading images (1,490 physicians hold the RVT credential, ARDMS reports). Now they have their own test. The exam will be required for vascular surgeons to become board certified in 2014, and is also required for many fellowship programs.

Dr. Arnold Levine, a retired vascular surgeon in northern California, is one of the instructors in Mint’s new vascular interpretation preceptorship. He recalls the days in the early 1980s when all it took to do vascular interpretation was to put up a vascular lab shingle. “It was more trial and error back then,” he says. “It got more sophisticated as time went on.”

What hasn’t changed is the usefulness of ultrasound in getting good information, often obviating the need for a more expensive test. “I’ve been in the business since 1984, and it’s just grown and grown,” Dr. Levine says. “The indications for using it and the accuracy have gotten better and better. Ultrasound should be the first way to go.”

The review course offered by Mint provides preparation for the exam, but also covers the fundamentals of ultrasound interpretation for vessels all over the body. Topics include the physics of ultrasound, how technologists conduct ultrasound studies and essentials of interpreting the images. “It’s a little bit of test prep but also broader issues in general,” Todd-Edwards says. “We want them to be OK with the test and also out in the real world.”

To sit for the exam, a physician must have fellowship training, 12 continuing medical education hours and have interpreted at least 500 vascular laboratory studies. Mint Medical is compiling a Case Study Review system that will offer providers more than 4,000 patient case studies, complete with images. It will soon be available for easy online review for preparation for the RPVI exam.

–Jan Greene, staff writer