Another Take on the OLA for Maintaining Certification with the American Board of Radiology

A small cascade of emails hits my inbox every time a new month begins. A slightly bigger one happens when the year turns over.

The American Board of Radiology (ABR) provides a couple of these emails. The first one is along the lines of: Pay your annual fee deadbeat! Everything that happens afterward is an indication of the good use to which my money and that of many thousands of other rads like me is being put. It’s a robust, well-oiled machine that functions so efficiently that only curmudgeonly individuals (who, me?) would criticize.

The ABR’s other annual January missive is from the online longitudinal assessment (OLA) program. Each year, after I hit my required quota of OLA test questions, the system lets me turn off notifications of when new questions populate. It is good that those reminders automatically turn back on in January. Otherwise, God knows if/when I would remember.

This year, I encountered a little speed bump. The ABR’s log-in page insisted that my password was incorrect. I knew that couldn’t be right since it is on “autocomplete” for my home PC. Still, with no alternatives, I dragged out the notebook I keep with all my user IDs and passwords in it, ludicrously cluttered as it has become.

Yep, the password matched what I had written down but the website insisted. In my experience, that means one of two things: The website has temporarily lost its mind and is denying entry to everyone or they have decided they want me to change my log-in info.

A lot of sites, evidently including the ABR website, don’t bother telling you the latter: “Hey, valued customer, we need you to update your log-in since it’s too old or doesn’t meet our new requirements.” Instead, they just execute the subroutine as if you entered the wrong keystrokes. In other word, it’s not them, it’s you.

I don’t much care for that blame shifting. I especially resent that the only link they give you for the situation is “I forgot my password.” To appease the ABR system, you have to agree that the whole situation is your fault.

Of course, you could fail to take the hint or refuse to do a digital mea culpa. Your alternative is to wait until the next business day and try to get one of their people on the phone: “Hey, your site says my log-in is wrong, but I know it isn’t.” You will eventually wind up in the same place, just wasting a lot more time in the process. I simply wanted to get on with my life, so I went ahead and did it, updating my notebook in the process.

This allowed me to get on with the privilege of forking over a few hundred bucks and answering the eight OLA questions that were available. For some reason, these things expire. Why on Earth can’t I just answer all the questions that accumulated after I hit my quota last year? Nobody has explained this to me yet. It is not like these radiology quizzes are perishable produce. I routinely see questions that I am pretty darned sure I have answered months if not years before.

I went through them quickly enough. Really, you have to since they are timed. That simulates taking an actual exam I suppose but how does it approximate practicing radiology in the real world? How many of us encounter something we don’t know during a typical workday and think, “Well, I had better just guess an answer, since looking it up would take more than a minute?”

Maybe the ABR assumes (not unrealistically) that we all have productivity quotas and can’t or won’t spend more than X amount of time on any given case. I would fail by that criterion. If I get unlucky and have a series of imaging studies that make me reach for references more frequently than normal, I am going to wind up reading fewer cases in that hour.

Then again, I have made a point of avoiding jobs where I have to meet rigid productivity metrics. In my per-click world, if I read a little less in the name of doing my work properly, I will just live with making a little less money for the day. Not everyone gets to choose the same in our world of perverse incentives.

Back to my reunion with OLA. I am done with all the questions available to me. That leaves 44 for the coming months. Unless the ABR changes the way it does things, the questions will dribble out at a rate of two per week. I will be done sometime in June, a little less than half of the year. It reminds me of “Tax Freedom Day,” the theoretical point at which one’s gross income reaches one’s annual tax burden. That breath of fresh air is significantly earlier, though, typically hitting in April.

Getting just two questions a week is a peculiar pace, especially since, as I said above, an awful lot of these feel like retreads if not straight repeats. Two per week comes nowhere near feeling like sitting down for an actual test, which was kind of the point of doing things this way. It also doesn’t come close to simulating our actual work. Even if one were to “save up” a few weeks of questions, they expire before long. The most that can be available in a sitting are eight like I just did.

So, each Monday morning when I fire up my workstation, I do the two questions available. With such a small sample size, they can really skew my sense of capability for the day. Get two right. Yeah! I’m a radiological rockstar! Give me your worst, worklist! Get one wrong. Ugh, only 50 percent? What’s wrong with me?

I haven’t gotten both wrong yet, thank heaven, but I can’t imagine that would make me feel like I had any business proceeding to do my work for the day. If I had a more traditional job, I might try doing administrative or academic stuff instead. Gosh, I am batting zero with radiology today. Better answer some emails until my brain’s back on kilter.