Volunteers Play Crucial Role in Creating Relevant and Appropriate Exams
By Cheri L. Canon, MD, ABR President; Matthew B. Podgorsak, PhD, ABR Board of Trustees Chair; and Brent Wagner, MD, MBA, ABR Executive Director
2025;18(5):2
To attain ABR certification, individuals who have completed rigorous prescribed training must demonstrate that they have the knowledge and skill to effectively and safely practice in the radiologic professions. This is accomplished by passing a series of qualifying and certifying exams for each of the four disciplines (diagnostic radiology, interventional radiology, medical physics, and radiation oncology).
Volunteers are invaluable to the ABR because they are responsible for establishing and refining the three major elements of these exams.
First, volunteer subject matter experts define the knowledge domain represented by each discipline. Most of our volunteers are actively involved in resident education, and all are familiar with the practice within the field. They seek a balance between the knowledge required for a broad range of potential practice settings and the core knowledge one should expect of trained professionals who aspire to be certified in the specialty.
Second, volunteers create and optimize exam content that is representative of and relevant to that domain. Exam questions vary in difficulty and scope, but all attempt to assess the application of knowledge to relevant components of anticipated clinical practice. Exam content is continually updated and refined as understanding of the science and practice evolves.
Third, subject matter experts set the passing standard. Acknowledging that perfection will be difficult to achieve, even for highly skilled individuals, the Angoff process is used to establish the difficulty of each question, which is then aggregated to determine the passing threshold for the exam (corresponding to attainment of a level of competence to practice effectively and safely). Questions that are ambiguous or otherwise confusing are reviewed and, when appropriate, removed from scoring so that an incorrect answer does not penalize the examinee.
As part of an ongoing quality improvement process, we survey candidates after each exam. We occasionally hear criticisms regarding questions that are perceived as irrelevant or poorly constructed. Judgments about the breadth, depth, and scope of the exams are, by design, the responsibility of the volunteer committees who ensure that exam content is relevant and appropriate to the practice of the discipline. ABR staff work with volunteers on question construction, with each question undergoing extensive editorial and subject matter expert review. Comprehensive discussions among groups of thoughtful experts are part of the creation process for every ABR exam.
