Maintenance of Certification Exam, Thanks for the Memory

I mentioned a few columns ago that I was prepping for my maintenance of certification (MOC) exam. Well, time has marched on, and in just a few days I'll be finding out how relevant my studying has been.

As said in the previous column, I was experiencing a surprising wisp of nostalgia at being back in study mode. I think I've put my finger more firmly on this phenomenon, now that some more weeks have gone by.

Simply put, radiology cases, as presented in the context of testing an examinee's knowledge, are "clean" as compared with the mess I've come to expect in my daily workload over the past decade.

Right off the bat, a studying (or test taking) radiologist knows what subspecialty area is involved. There's no forgetting that you decided to study your neuro cases today, for instance, or that you selected the MOC neuro module. Even if there was, you'd probably figure out pretty quickly that you were looking at a bunch of head, neck, and spine images. You'd be zeroing in on neuro-related pathology, and quite a bit more comfortable not checking the nearby soft tissues for an incidental renal carcinoma or lung-apex nodule - which you'd darned well better not miss in "real life" cases.

Another nice, "clean" aspect of studying cases (and at least in the sample questions shown on the MOC website) is that you are presented with a single image from which the diagnosis can be made. Maybe a handful of images, such as if it's an MRI. The findings (or lack thereof, since the MOC exam is supposed to include normals) are right there, rather than buried in a thousand-image multiphasic CTA with recons.

Then, the crowning glory: With the notable exception of "history withheld" cases, your study source (or exam question) proceeds to give you a nice, pertinent bit of history. Bingo, your six-item differential just got narrowed - maybe to a single disease entity! Or at least, if you hadn't yet noticed the subtle abnormality, you might now be clued in on where to look.

How frequently do you get that kind of clinical info in your daily workload?

So, again, it's been a surprisingly nice trip down memory lane, studying for this thing. I've rediscovered the purer aspects of radiology which made the field appealing to me in the first place. Perhaps regained some hope that we may see a greater degree of "cleanliness" in our field in years to come (hopefully I pass muster and continue to be a part of it).

And, oh yes, managed to learn a thing or three along the way.