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ABD Exam of the Future

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April 6, 2017

TO: Dermatology Program Directors
FROM: The American Board of Dermatology

Thank you to everyone who provided their opinions on the Exam of the Future—whether via the online survey, phone interview, informal discussions, or emails.  The feedback has been invaluable.  We truly appreciate your participation in this process, and have tried to accommodate your input, wherever feasible. Now it is time to launch the Exam of the Future, which was first discussed at the 2014 Association of Professors of Dermatology meeting. Please note that the first residents to follow this new certification process are those beginning their dermatology residency in July 2017.   
 
The BASIC Exam
The first BASIC exam will be held on Thursday, April 12, 2018—the preferred month for program directors who responded to the online survey.  It is a half-day exam for first-year residents, administered at your institution, and is informational only (not pass/fail). 
 
The CORE Exam
The CORE Exam is a required part of the new certification process and is administered by remote proctoring. The modular CORE exam schedule is more complex, thus we need to provide sufficient opportunities for residents to complete the exam.  The CORE schedule for EOTF is shown below:
 
Opportunity 1 2 3 4
Administration March
Year 2
July
Year 3
Nov
Year 3
March
Year 3
Offered on Weekend* Thursday Thursday Weekend
Maximum #
modules allowed
2 4 4 4
 *The first administration of the CORE in March 2019 will be on a Thursday rather than Saturday-Sunday.   
 
The above schedule takes into account the following program director feedback:
 
Don’t disrupt clinic and didactics schedules. 
The above schedule has the same number of affected weekdays as the current In-Training Exam (ITE), that is, an average of one weekday, per resident, per year.  Also, only one year’s worth of residents will be out on a given weekday.  First years will be out in April for the BASIC, and third years will be out in July and (if necessary) November for the CORE.  In contrast to the current ITE scenario, resident clinics will not need to be canceled, but just cut back slightly to account for fewer residents.  

 
Administering the CORE on weekends is resource-intensive for ABD, as it requires twice as many exams to be prepared—one set for Saturday and one for Sunday.  However, the above schedule was created to minimize effects on clinics and didactics.
 
The first opportunity should be during the second half of the second year.
The first offering is in the second half of Year 2.
 
Modules should be offered on a single day. 
When offered during weekdays, modules are on a single day. On the weekend, to accommodate religious preferences, it is necessary to offer the modules on both Saturday and Sunday. 
 
There is a range of opinion about how frequently the CORE should be offered.
In the survey, 40 percent of program directors preferred every three months; 35 percent preferred every six months, and 25 percent preferred every four months. We selected every 4 months, as it is closest to the median. 

 
There is a range of opinion about how many modules a resident should be allowed to take at one time. 
The survey results were evenly split between no more than two and all four.  Separately, there were concerns about second-year residents attempting all four modules.  The above schedule addresses that concern, while still offering opportunities for residents to complete the CORE during their residency, preferably with ample time for them to prepare for the APPLIED exam.
 
Each resident should have no more than three chances per module. 
In the unlikely event that a resident takes the maximum number of modules allowed at each opportunity, and fails each time, they would have had four tries to pass two of the modules and three tries to pass the remaining two. 
 
Minimize resident anxiety about exams.
Providing multiple opportunities to take, or retake modules, may help alleviate resident concern that they must learn everything at once. Sample items and content outlines will be available to help with exam preparation. 
   
 
The APPLIED Exam
The APPLIED exam, given after completion of residency, is primarily a series of case presentations, intended to simulate clinical decision-making.  The best preparation is gaining clinical experience and discussing cases in clinics, didactics, and CPC settings.  Sample items and content outlines will be available. 

In the interest of helping you understand what is expected of residents taking each exam, we prepared a sample set of items as well as a content overview. These are preliminary drafts and are subject to change as the Exam of the Future evolves, but we hope they clarify the objective of our new staged approach to certification.
 
We appreciate your continued feedback in this process and are eager to roll out these changes. If you have additional questions about the Exam of the Future, please contact Dr. Lela Lee (lee.lela.a@gmail.com), Dr. Thomas Horn (thorn@mgh.harvard.edu) or the ABD office (abderm@hfhs.org).

Sincerely,
 
Thomas D. Horn, MD, MBA, Executive Director
Lela A. Lee, MD, Associate Executive Director
Randall K. Roenigk, MD, Assistant Executive Director

 
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