In the wake of a Jan. 13 CNN exclusive detailing widespread sharing of exams questions, known as “recalls,” the American Board of Radiology (ABR) has issued a pair of statements regarding the security of its qualifying exam and emphasized a new case-based test format that will debut in 2013.
The CNN investigation reported endemic use of “recalls,” in which residents memorize questions on the qualifying exam and write them down after the test to share with others. Because one-half of each year’s questions are taken from prior exams, residents may view the use of “recalls” as a study aid. According to CNN, the practice has been encouraged by some training programs, including San Antonio Uniformed Services Health Education Consortium.
ABR plans to replace the previous qualifying exam with computer-based core and certifying exams beginning in October 2013. “Almost every question on our new computer-based core and certifying examinations will be case-based and image-rich, and therefore very clinically relevant material that a well-prepared young radiologist should know,” ABR wrote. In addition, this format does not lend itself to memorization.
The exam will test knowledge and comprehension of anatomy, pathophysiology, all aspects of diagnostic radiology and physics concepts important for diagnostic radiology. Trainees must pass all 18 categories: breast, cardiac, gastrointestinal, interventional, musculoskeletal, neuroradiology, nuclear, pediatric, reproductive/endocrinology, thoracic, urinary, vascular, computed tomography, magnetic resonance, radiography/fluoroscopy, ultrasound, physics and safety.
One step to prepare for the transition is an exam security culture change implemented in March 2011. Residents are required to sign a document detailing their understanding of ABR’s Exam Security Policy, which prohibits giving or receiving confidential exam information before, during or after the exam and possessing study materials during the exam.
The crackdown extends to training programs as well. ABR has requested that the Accreditation Council for Graduate Medical Education consider programmatic recall-sharing “as evidence of deficiency in teaching program professionalism,” which is a required core competency.
Other steps to address the issue include attacking the root cause, ABR wrote. The organization is developing and providing study guides and preparation aids. A study guide is available on the ABR website, and it will release a practice version of the updated exam by the end of 2012. Residents scheduled to take the first core and certifying exam will take a pilot exam in spring of 2013 and be provided detailed feedback. “In the past, the absence of these kinds of tools and opportunities may have played a contributing role in the use of recalls by radiology trainees,” ABR wrote.