Dr. Phillips is a Professor of Radiology, Director of Head and Neck Imaging, at Weill Medical College of Cornell University, New York–Presbyterian Hospital, New York, NY. He is a member of the Applied Radiology Editorial Advisory Board.
I’ve been examining for the ABR for a while, and I view it as a labor of love. Not that I really dig Louisville. It’s the memory thing. The oral boards have memories for all of us in this field (at least for now), and I’d love to hear anyone’s favorite board stories. In fact, I’ll reserve a column for the good ones, if you all would be kind enough to e-mail them to me. The boards are both the most human and inhuman thing we can do. We give people a chance to converse and make observations and “pretend work,” and also make it so pressure-infused as to be mind-bending. Most people will say in retrospect, the cases were largely fair, and the examiners helped them through the ordeal. And, most people pass.
Well, all good things must end (debatable point, I realize), and the oral boards are on the way out. We will soon have “the exam of the future,” and it will be computer-based. Now, for those who don’t understand some of the way this works, let me just break out a few basic differences.
If you don’t understand which way the case is going, a live, interactive examiner can refocus you. A PC will not. You are punching buttons for a multiple choice, not playing chess with HAL. This isn’t 2001: A Radiology Odyssey. If you need a gentle nudge (or a swift kick in the ass) to reorient yourself, an examiner can provide it. They can ask you a few questions about the finding on the film, which you have, to this point, ignored. Maybe you just didn’t see it. They get you thinking that you shouldn’t have dwelled on that artifact too long. A PC will not. HAL will move to the next question. At the end of the day, a single examiner who thought you were close, but not quite just ready for prime time, could potentially be dissuaded by other examiners who thought you kicked exam booty from making you return. HAL will not.
I am (gulp) completely in line with what the ABR thinks is right, and I am sure that they have much brighter and more in-tune people than me working with them on this. If they say we need a new exam, I will defer to them. And, in the spirit of full disclosure and fairness, I will say that I was a complete lunatic by the time I got on a plane to Louisville for my oral exam. Babbling. I think the only reason I wasn’t placed in a padded cell was that there were other humans in the US who were equally as nuts as me during that period of time, and ALL were headed to Louisville, and there is some special relaxation of the laws of time and space, (Stephen Hawking would understand) as well associal mores that was in evidence during that lead-in to the oral radiology boards. But, the system worked. It did reflect practice, and it left wiggle room. And, it will be missed. Send those board stories. Keep ‘em short. And funny. Mahalo.