Focus on IR/DR

Focus on IR/DR

Candidate Patience Appreciated as We Pivot to Remote Exams

by James Spies, MD, MPH, Associate Executive Director for Interventional Radiology

2020;13(5)5

For the past six months, our world has been turned upside down by COVID-19, and it is becoming clear that our lives will be disrupted for many more months. We all hope for a successful vaccine and a corresponding regression of the pandemic, but that is unlikely before early to mid-2021 at the earliest.

Everyone has had to adapt on the fly, both at home and at work. For imagers, the workplace has been radically modified to allow safe practice, with our reading stations dispersed and remote reading dominating imaging practices. Interventional radiology has faced just as much disruption to normal practice, with cancellation of elective cases, incorporation of testing into pre-procedure evaluation, adjustment to enhanced personal protective equipment mandates, and delays to allow for new protocols for cleaning procedure rooms. For all of us, in-person meetings and conferences were abruptly abandoned, and we suddenly were in the world of Zoom and Webex. In-person CME meetings may not be resumed into well into 2021 or later. Everything is different.

It is the same with the ABR. Suddenly, we needed to make decisions about in-person exams scheduled for the spring and fall in all our disciplines. Clearly, the May exams were impossible to administer in person safely, but we needed to understand the challenge in front of us. For many people, the logical choice seemed to be a switch to all remote exams. Many candidates assumed this could be done easily and quickly. The ABR’s decision to cancel all exams for 2020 and reschedule them for 2021 raised an outcry.

The challenge for the ABR was to make a clear-eyed assessment of the software infrastructure necessary to provide remote exams in a safe and reliable way. This included analyzing the differing needs of computer-based and oral exams. We couldn’t just provide a computer-based exam remotely with the existing software, as it is not designed for delivery on the Internet. The commercial exam centers could not provide the technical support necessary for these image-based exams, plus they were initially shut down and cannot be relied upon if the pandemic continues. It was also important to plan for adequate security protocols to ensure the integrity of the administration.

The oral exam presents even more challenges, as it requires an examiner and examinee to be connected live with a software platform that allows the cases to be visible to both and provides a means of scoring for the examiner. There must be the ability to scroll through image stacks, view videos, and simultaneously use a pointer. A platform such as this that is secure does not exist and must be developed de novo.

These considerations have been the subject of intense review by the ABR staff, the Board of Governors, and the Board of Trustees. Based on the work done to date, we are confident that we can meet the technical requirements of both the oral and computer-based exams, and the development of these platforms is underway. As a result, the ABR has announced specific dates for the Core Exam and the certifying computer-based and oral exams for the spring. Work on the software is progressing rapidly, and we are confident we will meet the challenge of pivoting to remote exams.

This is a trying time for us all, and candidates for these exams have had to deal with the added stress of waiting while the ABR builds the robust platform necessary to meet the IR/DR exam requirements. We appreciate the patience of our candidates, and we believe it will be rewarded with a sound exam environment.

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