New Oral Exam Will Change Pedagogy in DR Residencies
By Desiree E. Morgan, MD, ABR Governor; Kate Maturen, MD, MS, ABR Trustee; and Michelle Miller-Thomas, MD, future ABR Trustee
2025;18(4):4
Since the 2023 announcement that the current Diagnostic Radiology (DR) Certifying Exam would be transitioning from a computer-based exam focused on subspecialization to an oral exam in general diagnostic radiology beginning in 2028, the radiology community has been focused on the effects of this change on trainees, faculty, and programs.
Educators across the U.S. have rightly pointed out that the change in format will require alterations in radiology training programs to effectively equip candidates for the new DR Oral Exam. These changes will involve faculty, education teams, department leadership, and academic institutions.1 The transition to the oral board format offers an opportunity to enhance radiology education by reinforcing the importance of clinical reasoning and communication skills.2 Implementation of programmatic modifications will also augment the significance of radiologists as indispensable members of multidisciplinary teams.1 Concrete suggestions include re-envisioning and revamping case review conferences,3 encouraging resident participation in multidisciplinary conferences, and changing daily resident checkouts.4 Indeed, having the resident approach each clinical case in a structured way, as if it were a board exam case, may help cultivate critical skills necessary for effective clinical practice and successful exam performance.2 Finally, DR faculty can lean on interventional radiology, medical physics, and radiation oncology faculty, who have been continuously preparing their trainees for oral exams, because the certifying exams for those ABR disciplines never changed from an oral format.
Following the announcement of the new exam, the ABR pledged to continue engaging with interested parties throughout the implementation process.5 The ABR website offers frequently asked questions, video enactment of the new exam format, articles, updates, and, most recently, sample cases across the seven categories that make up the exam, so that candidates and faculty alike can keep abreast of the latest information as they plan changes to their educational programs. ABR leadership has presented information at national meetings and engaged with educational leaders in settings ranging from ABR-led town halls to roundtable discussions of the Association of Program Directors in Radiology (APDR) in efforts to help smooth the transition to the new exam format.
The transition requires infrastructure development, committee and blueprint reorganization, and recruitment of a volunteer pool comprising both item (case) writing committee members and oral examiners. Currently, the Board of Trustees is assembling DR Oral Certifying Exam item-writing committee members, who will be invited and onboarded this fall and start work in early 2026. Potential oral examiners from academia and private practice are encouraged to sign up now and offer details on their areas of expertise to enable optimal matching to DR categories. To apply to be an ABR volunteer, log in to myABR and click on the volunteer tab.
- Sheng M, Ritchie, B, Ramaiy N, and Mohamed I. Rewinding the clock: Preparing the next generation of radiology residents for oral boards. Acad Radiol 2024 Nov;31(11):4715-4722. doi: 10.1016/j.acra.2024.06.016. Epub 2024 Jun 29.
- Belfi LM, Bartolotta RJ, Catanzano T, et al. The “new” diagnostic radiology oral boards: Strategies for success J Am Coll Radiol. 2025 Jun 9:S1546-1440(25)00309-6. doi: 10.1016/j.jacr.2025.06.003.
- Made AA, and Mathur M. Level up your radiology case conferences: Preparing residents for success in oral board examinations using gamification. Curr Probl Diagn Radiol. 2025 Apr 17:S0363-0188(25)00078-7. doi: 10.1067/j.cpradiol.2025.04.006. Online ahead of print].
- Deitte LA, Huang JJ, Morgan DE, and Peterson RB. Welcome back! How the new oral examination will change radiology education. J Am Coll Radiol. 2024 Nov;21(11):1813-1815. doi: 10.1016/j.jacr.2024.06.001. Epub 2024 Jun 13.
- Larson DB, Flemming DJ, Barr RM, Canon CL, and Morgan DE. Redesign of the American Board of Radiology Diagnostic Radiology Certifying Examination. Am J Roentgenol. 2023 Nov;221(5):687-693. doi: 10.2214/AJR.23.29585. Epub 2023 Jun 7.
Opportunities Popping Up Everywhere for ABR Stakeholders
By Desiree E. Morgan, MD, ABR Governor
2025;18(4):1
“If opportunity doesn’t knock, build a door.” – Milton Berle
I really like this quote — it’s all about action. At the ABR, some opportunities are known commodities, like volunteering for a question-writing committee for one of our four disciplines. In the pandemic, the “opportunity” to revamp testing to a remote administration took much energy on the part of volunteers and ABR staff. And maybe we weren’t so excited about executing that tremendous pivot, but the processes employed today because of that “opportunity” have enabled a more personalized testing environment for our candidates and diplomates, and more versatility for our volunteers. From creating the Image Quality Committee, providing more paths to certification, and changing the preparation of trainees to heeding the call to volunteer for the ABR at different career junctures, this issue of The Beam is all about opportunities. Enjoy!
In this issue …
ABR Executive Director Brent Wagner, MD, MBA, discusses the essential role of volunteers and staff in developing and maintaining the relevance and robustness of the Online Longitudinal Assessment (OLA) platform.
ABR Trustee Daniel C. Davis, MD; Governor Stephen F. Simoneaux, MD; Trustee Brian J. Davis, MD, PhD; Associate Director of Exam Services Lydia Warg; and Director of IT Scott Segal describe how the ABR Image Quality Committee sets standards for image submission and editing to ensure the highest quality for images used on ABR assessments.
ABR Governor Desiree E. Morgan, MD; ABR Trustee Kate Maturen, MD, MS; and future ABR Trustee Michelle Miller-Thomas, MD, discuss how programs can update their training to prepare residents for the upcoming new DR Oral Exam, how the ABR is engaging with stakeholders through this transition, and call for volunteers to be oral examiners.
ABR Board of Trustees Chair Matthew B. Podgorsak, PhD; ABR Associate Executive Director for Medical Physics Geoffrey S. Ibbott, PhD; ABR Trustees Kalpana M. Kanal, PhD, and Jennifer Stickel, PhD; and future ABR Trustee Sameer Tipnis, PhD, describe the ABR’s alternate pathway to board certification for medical physicists and physicians trained in foreign countries.
ABR Communications Manager Rodney Campbell talks with interventional radiologist Riddhi Borse, MD, about how she chose her specialty and her experience volunteering with the ABR’s IR Initial Certification Advisory Committee.
Arti Gupta, MD, enjoys giving back to her field by using her three decades of experience as a diagnostic radiologist and educator to inform her question writing for the ABR DR Qualifying (Core) Exam.
After 17 years as an ABR volunteer on Continuing Certification committees, Will Breeden, MS, has switched to Initial Certification, now writing oral exam questions for nuclear medical physicists.
Last month, several ABR Trustees and one associate executive director received awards. Congratulations are in order to:
- ABR Trustee Catheryn Yashar, MD, was voted president-elect by the membership of the American Society for Radiation Oncology (ASTRO).
- ABR Associate Executive Director for Medical Physics Geoffrey Ibbott, PhD, was awarded the William D. Coolidge Gold Medal by the American Association of Physicists in Medicine (AAPM).
- ABR Trustee Kalpana Kanal, PhD, was named the recipient of the AAPM’s Edith Quimby Lifetime Achievement Award.
- ABR Trustee Jennifer Stickel, PhD, was named an AAPM fellow.
ABR Staff and Volunteers Contribute to OLA Relevance and Robustness
By Brent Wagner, MD, MBA, ABR Executive Director
2025;18(4):2
A major part of the ABR’s Continuing Certification program is Online Longitudinal Assessment (OLA), in which approximately 38,500 diplomates are enrolled. Collectively, they have answered 14 million questions. Since the introduction of the platform for diagnostic radiologists in 2019, we have received positive comments about most of its features. This is a testament to the efforts of approximately 200 talented and committed volunteers who develop the content in a committee setting; their careful deliberations attempt to avoid minutiae but encourage all of us to be better at what we do in our daily work.
Developed between 2017 and 2019 as an alternative to the “every 10-year MOC Exam,” OLA represents evaluations that are not only summative (assessment of learning) but also formative (assessment for learning). The formative function allows individuals to identify and correct knowledge gaps by providing a rationale for the correct answer and, if a diplomate offers an incorrect answer, by revisiting the subject matter after a few weeks with a related (but not identical) question.
The summative function satisfies Standard 14 of the American Board of Medical Specialties (ABMS) Continuing Certification Standards, specifically that “continuing certification assessments must meet psychometric and security standards to support making consequential, summative decisions regarding certification status.” This relates to the public-facing mission of the ABR and the value of the certificate for diplomates and those outside the profession who view certification as an indicator of high-quality care. The Standard also states, “In order for users to have confidence in the value of the certificate, sufficient psychometric standards must be met for reliable, fair, and valid assessments to make a consequential (summative) decision.”
The design features we considered nearly 10 years ago were intended to create a system that minimizes burden for diplomates while providing content that is relevant to their practice. The relevance element is challenging because of the wide range of practice, especially for those who are highly specialized. The “decline” function allows diplomates to skip over a question that is outside of their practice without being penalized in their score.
In addition to the volunteers, dozens of ABR staff are committed not only to keeping the process running, but also to implementing refinements we have introduced along the way, including many enhancements suggested by diplomates. Committees are directly assisted by exam development staff. Editors, psychometricians, data analysts, and software developers contribute to optimizing the delivery of approximately 3,000 new questions each year. They also continuously monitor older items to ensure they remain accurate and relevant to practice. While this infrastructure represents a significant commitment of ABR resources, we believe the success of the program depends on careful maintenance of the question pool and a robust scoring model that provides space for learning and growth, while also being sufficient for accurate, consequential summative decisions.
