Creation of a National In-Training Examination in Radiation Oncology ― Impact Evaluation

Purpose/Objective(s) 2020 marked the first ever administration of a national in-training radiation oncology examination coordinated through the collaborative effort of radiation oncology program directors across Canada. The primary aim of this project is to see if a national written examination in radiation oncology is perceived as useful by residents and program directors (PDs) and if so, how can it be improved for future years. Materials/Methods A written examination including both short answer questions and clinical cases addressing exam subjects covered as per the Royal College was designed for radiation-oncology residents from years 2 to 5 (PGY2-5). An anonymous electronic survey was distributed to residents and program directors of the 13 programs in Canada immediately following the completion of the examination and again after examination results were released. Likert scale and free text questions regarding their preparation and overall impression of the examination were asked. Results Of all PGY2-5s, 33 of 102 completed a pre-examination survey and 9 a post one. There was a greater amount of participation from senior residents, about 60% of responses were from PGY4 and 5. Pre- and post- answers were very similar with less than 10% difference for almost all questions. Overall, more than 95% agreed that the examination should be administered again in future years and that results would highlight areas that needed reviewing prior to the Royal College examination. Of the 12 eligible PDs, 9 responded to the pre-examination survey. Over 75% agreed that this standardized national exam was more efficient than the local examination and that the results would help refine teaching topics. 33% of residents expressed a need for more radiation biology questions on the examination. Other recurrent recommendations included more physics questions, increased question clarity and consideration for transitioning to an online platform. Conclusion The first ever national written examination for radiation-oncology residents was administered in 2020. It was viewed positively by both residents and program directors. The PD survey feedback indicated that it was an efficient method to prepare residents for their Royal College examinations. Resident feedback indicated that some subjects were lacking. This information will be used to improve the quality of the examination for future years.