At the time of this writing I have just finished interviewing prospective radiology residents who will begin their training. Soon I will submit my match list and I await the announcement of my roster in late March. I must say that despite the grumbling that Radiology may not be so attractive financially as it has been over the last decade, the quality of the applicants is outstanding. In fact it is the best I have ever encountered over the past 30 years which augurs well for the continuing vitality of our specialty. But this class is also special because it will be the first one to be trained under the new rules of the American Board of Radiology for first-time takers. As many of you may know the ABR has made radical changes in the content, context and timing of the board examinations. The former written examination will be transformed into a comprehensive qualifying exam to be taken at the end of the third year of residency. Among other modifications it will encompass physics in an integrative fashion and will include images to a greater extent than the current written test [1].

The end of the fourth year will not be the time of the certifying exam. That final test will occur 3 months into the year after the fellowship year (the present PGY-6). It will be computer-based like the aforementioned qualifying exam. No longer will the trainee have to endure the often stressful preparation for an oral exam and contemplate the lurking presence of an evaluator next to him or her for 10 half hour sessions. And no longer will getting right the first and second unknowns presented to him or her become the litmus test of equanimity during each session. Moreover, not only will the certifying test occur beyond residency and in a different format from the oral exam, it will be tailored to the practices, competencies and preferences of the individual test-taker. It will be intense in content but limited in scope. Thus one can be examined primarily in neuroradiology for example, and avoid having to answer a spectrum of questions across the range of the separate areas of imaging. For example, doing well in breast radiology will not be what could distinguish passing from failure for neuroradiologists.

The changed nature of the certifying exam and its removal to after the last year of residency and the following year of fellowship raises issues about the content of the curriculum of the final year of Radiology residency, now freed from the clutches of the dreaded oral exam experience.