Will Virtual Oral Board Exams Remain an Option After the COVID-19 Pandemic?

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In the spring of 2020, as it was becoming clear to health providers, educators, and organizations that the rampant spread of COVID-19 was going to necessitate numerous changes in the name of public safety, some member boards of the American Board of Medical Specialties (ABMS) began to explore the possibility of temporarily converting their in-person oral board certification examinations to virtual formats. Candidate polls were taken, and pilot exams were run to test the waters.

The positive results of these, coupled with the harsh reality of a prolonged global pandemic, convinced several ABMS members to devise a virtual oral board exam for residents seeking their certification in 2020, 2021, and beyond.

Moreover, the unconventional testing method isn’t likely to go away any time soon. “Of the 14 [ABMS] boards that offer oral examinations, about one-third are committed to continuing with remote exams, one-third are leaning toward returning to in-person exams, and one-third are still considering the options,” reported Greg Ogrinc, MD, MS, senior vice president, certification standards and programs at ABMS. The American Board of Otolaryngology–Head and Neck Surgery (ABO-HNS) is among the boards that have taken the plunge, and as ABO-HNS executive director Brian Nussenbaum, MD, MHCM, notes, the shift to a virtual format has been both worthwhile and complex.

“The decision of changing from an in-person oral exam to a remote one was made in an intentional way after considering all of the factors involved,” Dr. Nussenbaum said. “What was certain at the time was that it was unsafe from a public health standpoint to conduct the exam in person during the pandemic. What was uncertain was for how long those circumstances would last. So, with that uncertainty, and not wanting to delay the board certification process for our candidates indefinitely, we decided to move forward.”

Venturing into Virtual

Each ABMS board that undertook the transition from in-person to virtual exams faced its own unique set of challenges, because, as Dr. Ogrinc explained, “Each board has a different exam format. Some use standard cases, some use real cases that the candidate submits, and others may use a combination of both. Each board chooses the format of cases that makes the most sense for its specialty.”

In the case of ABO-HNS, the board already benefitted from two distinct advantages. First, the American Board of Surgery and the American Board of Ophthalmology had both already conducted pilot exams, “so we were able to get some great advice from those boards, which had learned through their administrations with smaller groups,” explained Dr. Nussenbaum.

This sharing of information was key, added Dr. Ogrinc, who was impressed by the cooperative learning environment fostered among ABMS member boards. “They have done a remarkable job of taking an improvement approach to the remote oral exams,” he said. “Each started with a clear plan, learned from one another during the monthly AMBS remote oral exam learning collaborative, and assessed and made changes as they implemented their programs.”