Brent Wagner, MD, MBA, completed his first year as the ABR’s executive director in June. He recently took time to offer a few thoughts about his experience in the position so far.

How unusual has it been having a largely remote workforce since your first day here?

Much of the work we do at the ABR can be accomplished remotely. However, as a new arrival to the office, I would have preferred to get to know people – both collectively and as individuals – face-to-face rather than via videoconference. 

There are opportunities for informal collaboration that are lost when a group is confined to video meetings, and some of the detailed “projects within the projects” were less well understood than they otherwise might have been. The good news: a sense of the “team” persisted – and even seemed to grow stronger – throughout the past year.

What are some things that candidates might not know about the ABR’s transition from in-person to remote exams?

First, there are dynamic compromises to consider when altering major parameters of a high-stakes exam. We needed to maintain security so the exam would continue to represent both a recognition of the expertise that results from a lengthy and rigorous course of study as well as a valid credential. However, in view of the inherent stress of the exam, we also continuously focused on improving the experience for the candidates.

Secondly, rapid innovation inherently entails risk. While we accepted that complacency was not an option, there were substantial unknowns that had not yet been encountered in the testing environment of medical board certification. Because of an aggressive timeline, we had limited time for QA testing, pilot programs, and iteration. It worked very well overall, but we have continued to learn along the way – and we’re not done yet.

The ABR is trying to communicate more effectively with stakeholders. How much did their opinions shape the new residency leave policy?

The volunteer members of the governing board asked the ABR staff to facilitate engagement at multiple levels with external stakeholders, especially residents and program directors. We sought opinions from small groups and offered an open webinar and anonymous input to our website. Although the ABR policy has a very limited scope (most decisions regarding time off allowances are left to the programs, subject to local regulations), we heard that flexibility was critical to both trainees and academic departments. The solution we posted in late June was an amalgam of those inputs, balanced against the need to maintain a meaningful length of training.

What are important priorities the ABR wants to accomplish by the end of 2022?

Although there are several important opportunities for improvement in the remote exam platforms over the next 18 months, there are a number of other projects that will need attention:

• We’ll be following through on a recent preliminary rollout of enhanced exam development software for our many volunteers to assist in question-writing and test assembly.
• We have IT and administrative infrastructure pieces that need work. While they are not very exciting, they help us serve tens of thousands of candidates and diplomates. Many are exemplary of high-impact processes that run in the background and are taken for granted (until they fail to function).
• We’re trying to systematically optimize OLA to make it more relevant for participants in Continuing Certification.