Hey everyone, it’s Medicine Mondays. Like I promised before, I’m going to talk about the Online Longitudinal Assessement (OLA) in regards to Maintenance of Certification (MOC) for Radiology.

Online Longitudinal Assessment

I’m not sure how much you may or may not know about the recent trend in Maintenance of Certification (MOC), but I’ll try to catch you up quickly. Previously, MOC was a process where physicians had to take a comprehensive test every 10 years in their specialty/subspecialty to maintain certification. As you can imagine, this is both a time-intensive and labor-intensive process. In addition, the likelihood is that most doctors would take a long course to “refresh” their knowledge prior to taking their MOC.

Unfortunately, because of how varied practices are, the test ends up being pretty generalized. This is problematic for people who subspecialize in certain aspects of their specialty. For example, a radiologist who only does neuroradiology would still have to take a 10 year MOC about all the radiology they had learned in residency decades ago. This would include things like interventional radiology or mammography, which they likely haven’t read in daily practice in many, many years.

Then, after the MOC, doctors would return to their normal practice with little (if any) impact on their daily practice. Obivously, this is not the purpose of Maintenance of Certification (MOC) and Continuing Medical Education (CME)

So what’s the change?

In recent years, there have been plans to phase this out by multiple Specialty and Subspecialty Boards. Originally, the first board to institute a different MOC was the Anesthesia board. They brought out something they called MOCA Minute. Rather than a board exam every 10 years, there are scheduled questions you must answer. Currently, in MOCA 2.0, the number is 30 questions per quarter (120 questions per year).

Attempts are made to tailor the questions to your practice type and data is recorded. If one was to fall below a certain threshold relative to their peers, some form of remediation would be done.

My board, The American Board of Radiology, recently released its version MOCA Minute which is called the Online Longitudinal Assessment. I received emails that I had questions available to answer, so I did them this last weekend.

So… how did it go?

I’m going to give a very general overview of what to expect. The reason for this is because I’m not sure how much I’m actually allowed to say about the Online Longitudinal Assessment. I think that as long as I don’t talk too much about question topics, that should be ok. Mostly I’m going to be talking about formatting and what to expect.

Accessing the OLA is pretty easy. There is a link right on the main ABR site, and you use the same username and password that you would use to access the ABR site. They’re essentially linked in that sense.

Right there on the dashboard it tells you how many questions are available and there is a button that says “Answer Now”. I did a few practice questions to get a feel for things before I started the real questions.

Since I haven’t taken the Core Exam, I can’t directly compare to that. However, I did take the Neuroradiology Subspecialty examination. Basically, the format is pretty similar to that. You may be provided images or you may be provided small video clips. You can zoom and use window/level if you want.

How were the questions?

In my short experience with the 6 questions I felt that the questions were pretty straightforward and fair. Only one of the questions was a little bit “tricky”.

However, it should be noted that the time span allotted for these questions is very short. All of my 6 questions needed to be answered within a 1 minute time limit. I think the rationale for this is because it would be impossible to evaluate whether test-takers were using external resources or not.

I would assume using external resources is not allowed. That said, while it’s probably not impossible to use an external resource, it would be more likely to hurt you rather than help you. Answering the question within 1 minute really only allows for reading the question, evaluating the relevant pathology, and answering the question.

Can I skip questions?

Yes, you can skip up to 10 questions a year. It’s called “declining”.

From the ABR:

” You will receive 10 declines per year for each set of 104 question opportunities you receive. These are intended to be used when a question arises that isn’t a part of your clinical work. “

What’s the bottom line?

So far, I think it’s done very well.

The topics were mostly relevant to my daily practice. The interface is easy to use and I was able to do the 6 questions in less than 10 minutes.

There is a release of 2 questions per week which are available for 4 weeks. This means you can technically wait until you have all 8 questions available and then just answer them all at once. I imagine this or some variation of this will probably be the preferred way to do this. This boils down to doing a little quiz once a month.

Since you only need 52 questions a year and 104 questions are available a year, you don’t need to do every question that becomes available to you. However, I think it’s probably good idea to make sure you do the majority as they become available to you.

A good excerpt from the ABR website is this statement:

How should I study?
The goal with all OLA content is that diplomates won’t have to study. All content is intended to be “walking-around knowledge,” or answers the average diplomate should know.

I would agree with this assessment.

In general, I felt the questions were mostly straightforward and “fair”. “Walking-around knowledge” is probably a good way to put it.

How many do I need to get right?

This hasn’t been set yet. Basically, after you’ve done > 200 questions, the passing standard for MOC will be set on evaluated March 2, 2023.

The first passing standard will occur after you answer 52 questions and you will be able to see how you stack up against your peers. I imagine you will be able to see whether you are “in danger” or not.

It’s important to note the standard is not a curve. 

” The passing standard for OLA is criterion referenced; OLA is not graded on a curve. “

For a more in-depth explanation go to the ABR site here: Scoring

I have a subspecialty, do I need to do more questions?

If it’s only 1, no. If it’s 2 or more, yes.

• DR certificate only, or for a DR certificate and one subspecialty: a minimum of 52 question per year
• DR certificate and two or more subspecialties: a minimum of 52 questions per year for each subspecialty certificate
• IR/DR only: a minimum of 52 questions per year
• IR/DR and any subspecialty certificate(s): a minimum of 52 questions for your IR/DR certificate, and 52 per year for any subspecialty certificate you are maintaining
• RO: a minimum of 52 questions per year
• MP: a minimum of 52 questions per year for each specialty certificate

From the ABR Site: Answering OLA Questions

I think these are pretty fair.

Unfortunately, for my wife’s own MOC in psychiatry, she has to do double the work to maintain both her boards. I think this is a bad idea and should be fixed. I’ll talk more about their MOC in a future post.

Anything else?

Yes.

For some reason, my practice profile is listed as 100% Neuroradiology. I imagine this may be affecting which questions I am being given so I’m going to email the ABR about how to update it. My actual practice profile is probably more similar to 60-70% general (excluding IR and mammo), and 30-40% Neuro.

It probably defaulted me too 100% Neuroradiology because that was the last exam I took.

TL;DR

I remain cautiously optimistic about the new Online Longitudinal Assessment.

I think the interface and format were good and the questions were fair.

What do you guys/gals think?

-Sensei

Agree? Disagree? Questions, Comments and Suggestions are welcome.

You don’t need to fill out your email address, just write your name or nickname.

Like these posts? Make sure to subscribe to get email alerts!