With the introduction of Online Longitudinal Assessment (OLA), immediate feedback is now available for physicians and physicists for Part 3 of Maintenance of Certification (MOC).
That’s great news for Jonathan Kleefield, MD, and his peers. A certified radiologist since 1974, Dr. Kleefield had grown accustomed to waiting for results under the old 10-year MOC exam format.

“The first Certificate of Added Qualification (now called subspecialty certification) Neuroradiology Examination was an oral test, which I took and passed in 1995,” said Dr. Kleefield, an associate professor of radiology at Harvard Medical School. “The only feedback was ‘pass.’ I took the Neuroradiology CAQ Recertification Examination, which was presented on a computer, in 2009, and again, all I knew was that I passed.”
While Dr. Kleefield usually felt confident that he had passed his MOC exams, occasionally a little uncertainty would creep in. All that is now gone because OLA instantly lets participants know whether they answered a question correctly.
“This lack of any detailed feedback from these tests is in sharp contrast to OLA, where you are provided with immediate indication of whether you chose the right answer,” he said. “Moreover, you receive an excellent summary of the entity which the question is supposed to address. In case you are too busy to deal with that further investigation at the time of the response, the questions are available for later review – terrific!”
A former ABR volunteer, Dr. Kleefield appreciates the opportunity to serve as an OLA question rater. Participants help set the passing standard by answering a few feedback questions after responding to each OLA question.
“You are given the opportunity both before and after your answer is given to inform the ABR regarding the relevancy of the question – a unique feature, to be sure,” he said.
The new system is of particular value when a participant gets a question wrong. Participants receive an explanation of the correct answer and references and then a similar question within a couple of weeks to retest their knowledge. This educational opportunity helps both diplomate and patient.
“A particularly difficult question is an opportunity to learn if you pick the wrong answer,” Dr. Kleefield said. “How better can one be served, and later to serve one’s patients, if you learn something you may not know in the most controlled environment – better to know your limitation in that circumstance than to make a mistake when a patient’s welfare may be at risk.”
Dr. Jonathan Kleefield, an associate professor of radiology at Harvard Medical School, became board certified in 1974. After a two-year neuroradiology fellowship at Massachusetts General Hospital, he has practiced since 1978 at Beth Israel Deaconess Medical Center, Boston, and was neuroradiology section head from 1988 through 2003. He also served as section head of neuroradiology at the Boston VA Medical Center from 1979 through 1982.