Program Directors' Perspectives on the Transition to the Oral Boards: Results From a National Survey

In 2028, the American Board of Radiology will reinstate an oral certifying examination for diagnostic radiology, replacing the multiple-choice format introduced in 2013. This study evaluates program directors' perspectives and their programs' adaptations by surveying members of the Association of Program Directors in Radiology (APDR). The survey focuses on challenges, strategies, and curricular changes in response to the new examination format.

A voluntary, anonymous 20-question survey was distributed to APDR members in February 2025. The survey included multiple-choice, Likert scale, and open-ended questions covering topics such as resident conferences, mock oral board exams, faculty development, support for external review courses, and anticipated challenges. Descriptive statistics and comparative analyses were performed.

Of 262 APDR members, 87 responded (33.2%), representing residency programs across the country. 76% of program directors supported the transition to the oral boards. Those who personally took the oral boards viewed this change more favorably than those who did not (P = 0.048). To prepare residents, many programs plan to increase hot-seat sessions and decrease didactic and multiple-choice question-based conferences. Over half plan to offer mock oral board exams, primarily to senior residents. Top challenges identified were exam timing, lack of faculty experience with the oral format, and uncertainty about exam content. Faculty shortages and burnout were also noted as barriers to preparation.

Program directors generally support the transition to an oral certifying exam. However, addressing challenges related to exam timing, faculty experience, and content uncertainty will be essential.