It was super duper gratifying to receive my first OLA email from the ABR this past month. OLA (Online Longitudinal Assessment) is the ABR’s new longitudinal MOC (Maintenance of Certification) process, where diplomates take 52 questions every year instead of a big test every decade.
I took the Certifying Exam in October and received my passing result in November, so the month-long break prior to needing to “maintain” my brand new certification from the ABR feels just about right. Yes, a thousand folks need to maintain a piece of paper they haven’t actually received in the mail yet. I can appreciate why folks fresh off their q10-year MOC victory are irritated at needing to immediately participate in more MOC. Promises are being broken left and right. But, hey, money.
Adding insult to injury, as a neuroradiologist, I still have to sit for the exorbitantly expensive ($3,270) neuroradiology subspecialty exam this October. Which means that I need to maintain my first certification in between getting my second.
The final irritant in this system of paying $340/year (forever) is that the ABR, which is a nonprofit sitting on a war chest of ~$48 million, didn’t apply for (i.e. pay for) ACCME accreditation, so the hours spent doing OLA questions don’t count as official CME. (Update Feb 2020: Now they do, reducing your SA-CME burden from 25 to 15 hours over the 3-year period for MOC attestation)
The Actual OLA Experience
The current OLA paradigm is that 2 questions are released every week (104 a year) and “expire” after 28 days. So while you can log in and batch around 8 questions a month, you won’t be able to do it less often without losing some expired questions. Since you only need 52 questions and can do around 8 a month, you could actually get away with doing it almost bimonthly.
I took my first 8 questions this week and got them all right. They were straightforward, reasonable, and relevant to practice (at least in neuroradiology). My initial impression is that OLA questions are more like what the Core exam should be. You get between 1-3 minutes per question, the website was pretty slick (at least on a desktop), and I did all 8 in around 5 minutes. Can’t complain there. This is clearly a better system and more logical way to fulfill the spirit of MOC than taking an exam full of (even more) irrelevant material every decade.
You get to choose your practice profile and thus what types of questions you receive. I originally chose general diagnostic radiology and neuroradiology, but out of my first 8 questions, 7 were neuro and only 1 ended up being general, and the general question concerned GI fluoroscopy, which I detest, so I switched to 100% neuro. Maybe it’ll help with the subspecialty exam.
Things the ABR should improve:
- Mobile experience. I’ve heard complaints about display issues on phones. You only get a minute for most questions, so it needs to work.
- Lower the price. At the current rates, this is far more expensive than any commercial qbank. And that’s what this is. The ABR makes a lot of profit for a non-profit.
- Increase question shelf-life. Why do questions expire after 28 days? So arbitrary. Let the radiologists hold themselves accountable. How about 90?
- Get official CME accreditation. This feels like apathy and laziness. I know it’s not straightforward or cheap to be a CME-granting organization with the ACCME. But again, this is an expensive process, but it would be far more reasonable if it counted for CME. (Update Feb 2020: They don’t give you hours per se, but they do reduce the obligation for SA-CME for MOC; you’ll still have to satisfy your state requirements)
And finally, how about you let everyone take the certifying and subspecialty exams using the OLA software instead of flying out to Chicago to waste their time?
I will tell you that while the OLA is a great idea, it infuriates me that the American Board of Radiology made some of the diplomats take the 10 year cognitive exam and then invalidate the results. What would have been honorable is that they acknowledge the passing of this 10 year exam and allow those individuals to wait until that time had expired. I spent a lot of money (took time off work, had to travel to Chicago, and studied quite a bit) to take that exam and got 6 years of use with 4 years essentially getting wiped out. I know some like you mentioned who got less than a year out of the promised 10 year exam. Absolutely ridiculous.
Purely a money play. At one point you tell us the cognitive exam is good for a decade and we won’t need further proof of our knowledge base and then you come around and then say no, we made a mistake. Weekly quizzes is the way to go (and I agree the time limit before these questions expire is way too short).
Advocacy and accountability are definitely not their strong suit.
What do you think might improve the OLA mobile experience?
I don’t know. There were a ton of complaints online about it not displaying images properly (or at all sometimes) that I’ve never used it. I spend on average 5 minutes on OLA every two months, so I’ve just done it on my desktop. It takes me about as long to re-find the URL and log in as it does to prove my competence.