Testing, Testing

January 24, 2014
Eric Postal, MD

I'm back in study mode for the MOC exam.

So I'm back in study mode. Last time was for my oral boards in Louisville; now it's for the MOC (maintenance of certification) exam.

I'm experiencing a surprising, almost pleasant wisp of nostalgia. Maybe that's from dealing with a recurrent, rather than new, stressor: Facing an all-important exam that has the power to dictate the future of my career, at least I have the reassurance that, the last time I did this, things turned out well.

It is, nevertheless, a source of anxiety. Onlookers, including friends and family, acknowledge this as a reasonable reaction to having my means of livelihood on the line - but are quick to point out that, surely, there is no real risk. Passing muster with the ABR about a decade ago, working steadily ever since, without trodding on any med-mal or regulatory landmines, and annually exceeding quotas for CME, I repeatedly hear that I am the sort of radiologist the ABR has got to want to keep in the field. Even the MOC website and related ABR sources have routinely told rads like myself that, as long as we have been actively practicing, etc., we shouldn't have difficulty with the exam.

Which is something of a relief to hear, because for the life of me, I had no idea how to study for this thing.

I didn't even know what to do regarding the selection of my clinical exam "modules." Heck, I still don't, even though to sign up for the exam I had to choose something. The logical approach would seem to be to pick areas most commonly represented in my work, but my workload keeps changing. In the past couple of years, for instance, I have done mostly "STAT" cases for ERs or inpatients, while in the preceding (majority) portion of my nine years since residency, my jobs made me a mammo and nukes honcho. Now, I'm not even MQSA-qualified anymore.

As if in answer to my prayers, the ABR is rolling out a new module for "general radiology." So I went to look at their study guide webpage for an overview of what might be considered fair game - but no link has been added for the general section yet. Still, figuring it beat the other options, I selected it. Actually thought about doing more than one general module, but the website said that such doubling-down will result in modules after the first being more "advanced," consisting of tougher, subspecialty-level stuff. I scratched my head for awhile on this; what would be considered general yet subspecialty? Sounded like something the Riddler might ask Batman. I decided not to take a leap of faith and risk finding out for myself.

So, having chosen my testing subjects with slightly more consideration than I do my Lotto numbers, I proceeded to look for study materials. I'm sure some examinees actually trust that ongoing work in the radiology field will suffice, and forego additional studying, but to me that seemed like the sort of thing the hero of a Greek tragedy might do in its opening act. Besides, if this thing is graded on any sort of curve (or otherwise designed so a certain percentage of examinees fail - after all, what good is an exam if you can't statistically weed some people out with it?), I've got to imagine those who study are liable to be better positioned, when all is said and done, than those who do not.

It seems the folks who write review books are just as mystified as I have been, because my search for materials turned up very little. To be sure, there are more than a couple of options for those seeking references in prep for the "initial certification" exams taken by residents and recent graduates. But those tests are unquestionably different from the MOC, at least for now, and one would imagine some enterprising folks (perhaps the ABR itself) would have put forth some MOC-centric resources by now. I know they'd probably have gotten my business.

As it stands, I clicked back and forth on Amazon.com's search-results until I found a board-review casebook that mentioned recertification once on its preface page. Since the other review books didn't, I concluded that the author might have better insight into the exam than I do, and have been studying from the tome ever since. Here's hoping.

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