Neuroradiology Certificate of Added Qualification (CAQ) exam preparation

The neuroradiology CAQ exam is a challenging exam to prepare for. People taking it have done a neuroradiology fellowship and should ideally be performing more than 50% neuroradiology in their practice. They should ideally already be at the top of their game, which makes writing on-topic questions that are not controversial somewhat challenging.

The exam is approximately 180 questions distributed over approximately 120-130 multi-question units. The time limit is approximately 4 hours, although most test takers probably won’t require the entire time.

There is an online ABR “study guide” which is pretty worthless, as it is simply a list of all topics in neuroradiology. The most useful statement it makes is that, “The exam will sample the entire domain of neuroradiology.” Geez. Thanks!

What isn’t mentioned anywhere is that you can actually condition individual sections.

Topic coverage

As described in the study guide, the exam is divided into 3 sections

  • Brain
  • Spine
  • Head & Neck

Each makes up 1/3 of the test. What isn’t mentioned anywhere is that you can actually condition individual sections. Yikes! I didn’t know that myself until I started hearing from other people. I think it’s a bit of a secret because no one wants to admit they conditioned/failed and the ABR doesn’t want to acknowledge failing totally qualified neuroradiologists on the basis of 60 questions. It is hard to know how many people may be failing out there. It’s a black box.

Web resources

There is one online question bank specifically geared towards the test, Sulcus. To be honest, I wasn’t going to do it but I got a little bit nervous as the test drew closer. I thought doing a question bank would help build my confidence and consolidate knowledge as the test approached.

Boy was I wrong!

I think the makers of the test have their hearts in the right place, but there are way too many anatomy questions, too many multipart true/false questions, and too many nitpicky answer choices to really make this bank worthwhile. Plus it’s $400. Unless you really think you need it, I wouldn’t bother.

Books

There aren’t many specific resources out there to prepare for this exam. Most books are at the level of residents and not those taking this test, although some may be a good review.

Case based books such as the Case Review Series may be useful, as they are likely useful to your general practice anyway. They have been useful on many occasions throughout my career, and they are cheaper than Sulcus.

I have also used the following book, but I found it a little bit more wordy and hard to get though:

Books like Neuroradiology: The Requisites are probably just going to get you too bogged down.

A full description of these books (as well as others) is found below:

Detailed Book Recommendations

Question Type/Quality

Here is where the trouble really begins. I would say that half of the questions should be relatively easy for anyone who did a neuroradiology fellowship and was awake. The other half are going to be extremely frustrating for anyone who was awake for a neuroradiology fellowship.

For example, if you have small cortical tumor in the temporal lobe, you can’t reliably differentiate between a DNET and ganglioglioma. But this test will expect you to. Spinal ependymoma versus astrocytoma, schwannoma versus paraganglioma, etc. There are too many cases on this test where they are looking for you to use some textbook clue that doesn’t exist in real life. Expect to be frustrated.

Study Plan

Take a 2 pronged attack:

  • Find a series of short books that you like
  • Watch primarily case review videos or powerpoint slides

From this website, I would recommend the following playlists

Board Review Lecture 1

Board Review Lecture 2

If you have access to it, the UCSF lectures on DVD are good but probably a bit too basic and slow. You could watch them in high speed if you want.

Overall Advice

Unfortunately, if you are taking this test, you are likely required to and there aren’t a lot of good materials out there. As this site grows, I’ll try to make more CAQ specific materials, but I expect it will be a large gap for the forseeable future. Simply not enough people take the exam.

Good luck though and let me know if you have any feedback after taking the exam.

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