The ABR Certifying Exam will change (in 5 years?)

The American Board of Radiology came to the Texas Radiological Society annual meeting this past weekend and presented an update.

Some things have changed recently. For example, the ABR is now handling all remote-proctoring in-house instead of using Procturio.

Something things haven’t really changed: You still have to do your MOC OLA in small batches at a pace designed to emphasize its longitudinal nature.

And the initial certification process will change, though it’s currently unclear how.

Last year, the ABR conducted a stakeholder input survey about initial certification (i.e. the Core and Certifying exams). This slide was their summary of those findings, which is a compellingly honest accounting of the current situation:

Multiple choice questions (MCQ) can adequately (though not optimally) assess knowledge, but the overall process is a poor measure of clinical competence as it pertains to interpretation skills, communication skills, and professionalism.

I think we can all agree with that conclusion.

They then went on to (vaguely) describe their ongoing process to evaluate potential solutions. They plan to announce proposed changes in June 2023 (though potentially earlier in April, even).

Reading between the lines, it sounds like the ABR plans to focus on changing the Certifying Exam component of the initial certification duo, as they basically acknowledged that they have a hard time justifying the post-training Certifying exam as providing any additional value when it’s functionally just an awkwardly timed and arguably easier version of the same test people already took. Even the NBME realized that USMLE Step 3 had to be at least partially different than Step 1 and Step 2 if it was going to pretend to be anything other than a money grab.

Whether the ABR is able to make the Certifying Exam usefully different or just demonstrably different is of course another story entirely. Doing what I have suggested and focusing on radiology simulation isn’t easy.

Current residents, if that scares you, no need to fret:

ABR committed to providing at least 5 years’ notice before any substantive changes with be implemented in the DR Initial Certifying process to ensure that residents currently in training are not impacted.

We are a lifecycle away from any change.

But the ABR did reiterate that their hope for the Certifying Exam is a better demonstration of the skills needed for general practice.

But no, I don’t think they’ll be bringing back the oral boards.