Sub-specialization is the key to the future of radiology and represents one of the cornerstones of the European Society of Radiology’s (ESR) work. In order to harmonize standards of knowledge among European subspecialty societies, the European Society of Musculoskeletal Radiology (ESSR) has recently changed the architecture of the Diploma in Musculoskeletal Radiology creating a new ESR-endorsed scheme with more robust content, structure and eligibility criteria following the guidelines of the European Training Curriculum for Sub-specialization in Radiology (level III). The ESR-endorsed Diploma in Musculoskeletal Radiology is only awarded to certified radiologists who have satisfied specific criteria related to continuing education and practice in musculoskeletal radiology.

Our contribution focuses on the revised requirements for obtaining and maintenance of the diploma of the ESSR.

Step one consists of the completion of a program of CME accredited activities over a five-year period. Registrants should be member of the ESSR and ESR during the full duration of the program. A logbook of recorded activities should be provided.

Step two consists of a written and oral examination. In the written test, the candidate is asked to answer 40 MCQs on all aspects of musculoskeletal radiology in one hour. In the oral examination, the candidate discusses two cases shown at the workstation.

The ESSR Diploma certification has a five-year validity and should be renewed.

Although the Diploma cannot replace any national board certificate, it may contribute to reinforce the candidate’s curriculum vitae, thus helping to build up a career profile of musculoskeletal radiologists. The ESSR Diploma will be increasingly identified as an instrument to assess competency standards and be incorporated in certification programs at national and supranational levels.