Slide UX · agency engagement
American Board of Radiology
Replacing a ten-year in-person exam with something radiologists could do in a few minutes a week.
- Role
- UX Designer two-person design team
- Client team
- Director of Analysis Director of IT, developers
- Scope
- User flows, wireframes, visual design, prototype, usability testing
- Duration
- About one year initial engagement
A note on credit. This was agency work at Slide UX, delivered by a two-person design team with a senior designer leading and me as the second designer, alongside ABR’s own analysis, IT, and development staff. The decisions below were the team’s. I’ve written up the parts I worked on and what I took from them. Client artifacts remain the client’s, so the visuals here are representative rather than production screens.
Certification that cost a decade of dread
The American Board of Radiology certifies physicians in radiology. Maintaining that certification meant an in-person exam once every ten years, which radiologists had to travel for and study heavily to pass.
The complaint was not that the exam was hard. It was that it tested the wrong thing. An academically weighted test taken once a decade is a poor instrument for measuring whether a physician is practicing well today, and it rarely touched the working knowledge they actually used.
The shift
One exam every ten years became fifty-two questions a year
A simple surface over a lot of moving parts
A quiz looks trivial. A question is asked, an answer is chosen, a result appears. That is exactly how it should feel, and almost none of the work is there.
Underneath it we had to settle how answers were tracked over a year, what happened when someone got one wrong, which subject bank a question was drawn from, how imaging and other media were handled inside a question, and what the experience did when someone logged in on a device the tool could not support.
Sequencing
Every path mapped before a single wireframe
Progress you can read in a glance or not at all
The hardest single component was the graphic showing a physician where they stood for the year. It had to carry four things at once: how much they had completed, the trajectory that implied, whether they were at risk of missing the requirement, and whether they had already failed for the year.
The ABR palette was almost entirely shades of blue, which is a real constraint when the whole job of the graphic is separating four states fast. Blue-on-blue differences that look fine at full attention disappear at a glance, which is the only way this chart would ever be read.
The fix
Banded zones and a line that changes color
Six radiologists, one thing nobody predicted
We ran a usability study of six one-hour sessions with board-certified radiologists, against a prototype of the initial designs.
Most of it confirmed the direction. Participants were genuinely enthusiastic about the premise, relieved at not having to travel for a heavy academic exam, and found the flow intuitive. The progress data landed.
They didn’t want to look at a white screen. Radiologists spend most of the day in a dimly lit room.
What it changed
The whole thing went dark
No training, because there was no room for any
Radiologists needed to study the imagery in a question the way they would study a real case, which meant the tools for doing that had to be present in the interface. The risk is obvious: every control you add is attention spent on the tool instead of the question.
The tooling was placed close to the asset it acted on, and used icons already familiar from other ABR products, so recognition did the work that a tutorial otherwise would.
The client came back
The quiz replaced a decade-long cycle of preparation and travel with something that fit into a working week, and it measured applied knowledge rather than recall.
ABR returned to the team for further work: a remote oral exam, the certification exam, key pages of their intranet and volunteer hub, and additional usability studies.
The dark mode finding is the one I still bring up. The design was good, the flow tested well, and the thing that mattered most was a detail about the room the work happens in.