RadExam: the Resident Perspective


We live in a world of metrics. In this month’s JACR®, Dr. Petra Lewis et al. describe a new question bank, RadExam. The current problem: The evaluation of residents’ knowledge is too sporadic and not specific to their level of training. The authors’ suggestion was to create a large question database, from which questions could be sourced to create content- and level-specific tests. …What does this mean for current residents?

For the time being, not much, as this question bank isn’t being released until spring of 2018. At this time, it is anticipated that program directors (PDs) will have access to the question bank. Participation will not be mandatory, but, as the authors point out, residents must meet certain milestones; and RadExam may be an effective way to evaluate residents’ knowledge on a more consistent, as well as content- and level-specific, basis.

In the longer term, RadExam may replace the current annual in-service exam with a more frequent iteration of a general exam; conversely, RadExam may evolve to become a shelf-type exam, with residents being tested at various points in their training, according to their program’s preferences. Examination may still remain a yearly process for some, while other PDs may elect to make it a more frequent, perhaps quarterly, process. Other PDs may wish to use RadExam to create a subject-based exam, administered at the end of a particular rotation.

As the mandates from the ACGME continue to expand, it is critical that PDs understand that adding further requirements for the sake of completing mandatory metrics may solve one problem, but it may also come at a detriment to resident learning and engagement. However, while the additional testing may seem onerous to many residents, it also may be beneficial.

Both current and proposed testing models offer different strengths. As pointed out in the JACR article, the current in-service exam is limited by the number of questions asked, and, therefore, the results may not be particularly meaningful, especially in the first few years of training, during which residents may not have had experience in certain modalities. The current in-service exam, however, enables residents to have a better understanding of their weaknesses, and therefore, gives them time to remedy any foreseen weaknesses, which is especially important given the timing of the Core exam. Conversely, many of us have Type-A personalities — the promise of an exam at the end of every rotation, even one of only a few weeks, may prompt us to be more on top of our reading.

Residents, how do you feel about RadExam? Please comment below, then head to Engage to further the conversation!

 By Michele Retrouvey, MD, ACR-RFS education liaison and pediatric radiology fellow, Children’s Hospital of Philadelphia, Pa.

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