After 2 decades of innovation in blending education and entertainment, not even a pandemic can slow down CHEST Challenge.

The competition will mark its 20th anniversary during a virtual championship event Tuesday, from 6:00 – 7:00 pm CT. Viewers will recognize all the hallmarks that have made CHEST Challenge one of the most beloved events at the annual meeting—high-quality educational content, technical and theatrical flourish, and a celebration of the hard work of fellows from across the country.

In that respect, CHEST Challenge’s 20th anniversary might be a bit of comfort food amid a year of hardships, said creator and host William Kelly, MD, FCCP.

“Even though we can’t be there in person for that hour, you do get to have a shared exciting experience, learn together, and just kind of laugh and have fun,” Dr. Kelly said. “It’s very invigorating and restorative. And that is what we all need right now, for sure.”

Tuesday night’s event will celebrate the 20th anniversary with several fun surprises for viewers, Dr. Kelly said. In the 20 days leading up to the championship, CHEST gave away prizes each day on social media. And during the live event itself, viewers will have a chance to win more prizes, including free meeting registrations and even a getaway to Washington, DC.

Each year, the competition narrows down the field before the annual meeting with a live test that can rival the difficulty of board examinations. Finalists are scored not only on medical knowledge but also procedural abilities and other skills such as communication. Three-person teams from three institutions compete at the championship, which can often be as much of a quiz for the audience as it is for the contestants.

“You’re getting a referenced, peer-reviewed, thoughtful medical question in pulmonary, critical care, or sleep medicine, at a pace of about one a minute,” Dr. Kelly said. “So you’re really getting a rich review in a short amount of time.”

This year’s teams—Interfaith Medical Center, SUNY Buffalo, and The Ohio State University—are part of a legacy that includes more than 4,000 fellows who have participated in CHEST Challenge over 2 decades. In that time, CHEST has awarded fellows more than 350 full scholarships to attend CHEST annual meetings, several hundred free board exam review courses and other travel awards, and more than $180,000 in direct financial support to training programs.

• Read more: Who are the CHEST Challenge 2021 finalists?

The competition has continued to evolve on multiple fronts. Variations of the game have been played in China, India, and Spain, and there are plans to bring it to Italy in February for CHEST Congress. Organizers added procedural skill testing a decade ago, then began broadcasting those surprise simulated procedures live in 2017. Numerous other smaller improvements have contributed to the event’s growth since its inception.

“Every year or two, we’ve added something new—either to enhance the fellows’ education, thrill the audience, or just add to the fun experience for all. Usually, it’s all three at once,” Dr. Kelly said. “And we still have not plateaued after 20 years.”

Dr. Kelly credits the program’s sustained success to what has become a family of CHEST members and staff. Leadership took a chance on the idea 20 years ago when Dr. Kelly, Lisa Moores, MD, FCCP, and friends and colleagues on the Affiliate NetWork came forward with the project. Now, CHEST’s Training and Transitions Committee (T&T)—under the leadership of Mauricio Danckers, MD, FCCP; Subani Chandra, MD, FCCP; and Matthew C. Miles, MD, MEd, FCCP—oversees a year-round effort that has quickly adapted to the virtual format.

“We get to take advantage of fresh ideas while still maintaining that tradition and quality,” Dr. Kelly said. “Every year when we’re done, we say ‘that was the best one ever; we can never top it.’ And then somehow the next year, the T&T team manages to pull it off.

“The joy of working, learning, and playing with such amazing educators and trainees every year is contagious.”