[Past, Present, and Future of the Radiology Board Examination: Transition Toward Assessment of Actual Reading...

The board certification examination in radiology comprehensively assesses candidates' interpretive skills in clinical situations and their ability to support therapeutic decision-making. It is essential that the examination consistently upholds validity and reliability, with the overarching goal of producing an appropriate number of well-qualified specialists. The Examination Committee plays a pivotal role in the administration and management of the certification process. Recently, the testing format has shifted from paper-based methods to smart device-based test (SBT). Question banks have been organized and computerized. Test items have transitioned from simple memory-based questions to case-based problem-solving formats. Additionally, imaging presentation has evolved from still images to stacked or video formats that closely simulate real-world reading environments. Test item development should progress beyond conventional arrow-marked questions, allowing candidates to independently identify lesions and provide differential diagnoses in realistic interpretation settings. In an era increasingly shaped by artificial intelligence, examination formats must adapt to incorporate and reflect these technological advances. The Examination Committee must remain committed to continuous reflection, innovation, and adaptation to address these challenges.