Surrounded by family and friends and freshly returned from the beach, fellows from the University of Texas Health Science Center at Houston (UTHealth Houston) outlasted the competition to win the CHEST Challenge Championship on Tuesday, October 10, at CHEST 2023 in Hawaiʻi.

The UTHealth Houston team of Khalid Ahmed, MBBS; Maria Azhar, MD, MBBS; and Saad Farooq, MD, maintained a narrow lead after each of the three rounds of the Jeopardy!-style quiz of pulmonary, critical care, and sleep knowledge. Fellows from the University of Oklahoma finished in second place, and the team from the University of Southern California (USC) placed third.

“The game was very close, with all the teams in it until the end, so there was significant relief once it was over, and we had won,” Dr. Farooq said.

Each of the three teams were already winners at the start of the evening, CHEST Challenge Host, Bill Kelly, MD, FCCP, reminded the audience. The fellows earned their spots on the stage, along with free accommodations for CHEST 2023 and access to CHEST Board Review educational products, during a highly competitive qualifying quiz earlier in the year. And by the end of the night, each of the finalist teams had secured an additional prize for their training program—$5,000 for first place, $3,000 for second, and $1,000 for third.

The 22nd annual championship event began, as always, with a special intro video. A light-hearted montage of the fellows, their colleagues and program directors, and members of the CHEST Training and Transitions Committee was interspersed with music and visuals reminiscent of the 1960s TV show Hawaii Five-O in honor of the meeting’s location in Honolulu.

Aloha print shirts and dresses, leis, and other reminders of the Hawaiian islands’ unique culture and beauty filled the stage and ballroom. Meeting attendees played along from their seats and the standing room-only edges of the crowd, laughing and cheering along with each question and live challenge.

“The atmosphere was full of encouragement, with positive reassurances and unrelentless support from everyone,” Dr. Azhar said.

The championship game itself consisted of a mix of written trivia, diagnostic image review, and even some video. First round categories included “Rise of the Machines,” focusing on medical devices; “HA,” the Hawaiian word for “breath,” with medical facts related to Hawaiʻi; “Weezer,” for obstructive lung diseases; “Karakinos,” the original Greek etymology for cancer; and “No Silver Lining,” for pleural diseases. In the second round, the fellows picked from “Lungs to the Rescue,” on respiratory failure; “Epochalypse,” on sleep medicine; “Workin’ 9 to 5,” on occupational lung injuries and diseases; “Rheum with a View,” on rheumatology; and “Nervous About Infections,” on microbial infections of the nervous system.

Live challenges hidden throughout the board offered additional opportunities for the fellows to showcase their creativity, quick thinking, and teamwork. In one minigame, Team Oklahoma was tasked with identifying 10 symptoms commonly associated with lung diseases using only charades. Later, Team UTHealth Houston was required to rapidly identify radiographic images in less than 90 seconds. And Team USC was presented with virtual reality headsets and the challenge of successfully intubating a virtual patient in under 2 minutes.

Several special guests joined Dr. Kelly; Training and Transitions Committee Chair, Subani Chandra, MD, FCCP; and the contestants under the lights throughout the night. CHEST 2023 Program Committee Chair, Aneesa Das, MD, FCCP, gave away an island helicopter tour to a lucky member of the audience. Later, she returned along with CHEST Past, Present, and Future Presidents, David Schulman, MD, MPH, FCCP; Doreen J. Addrizzo-Harris, MD, FCCP; Jack Buckley, MD, MPH, FCCP; and John Howington, MD, MBA, FCCP, to assist with a final live challenge. Each of the presidents represented patients on medications that discolored their urine, and Team USC was tasked with swiftly matching drug names to bags of brightly colored liquid held by the presidents.

Before the Final Challenge wager, all three teams were still in the running for first place. UTHealth Houston led with 3,200 points, followed by Oklahoma with 3,100 and USC with 1,900. The final answer came from the category of “History of Medicines”:

This natural product of Streptomyces hygroscopicus with antimicrobial, immunosuppressant, and anticancer properties was discovered in the soil of Easter Island (Rapa Nui) in 1972.

In the end, all three teams missed the correct question—“What is rapamycin (or sirolimus)?”—but the order of the teams remained unchanged after wagers were revealed, and each team took a moment to celebrate with their supporters. Team UTHealth Houston was joined by Program Director, Mark T. Warner, MD, FCCP, faculty, friends, and family and lifted the Rosen Cup, named in the memory of former host and CHEST Past President, Mark J. Rosen, MD, Master FCCP.

Drs. Ahmed, Azhar, and Farooq said they were proud of their practice and preparations, which coincided with boards exam review, and mentioned the importance of having fun throughout the process, especially once in Hawaiʻi in the days and hours before the championship.

“The cheering from UT family, the lovely crowd, the sense of humor of Dr. Kelly, and the competitiveness of Oklahoma and USC all turned this event into a great memory,” Dr. Ahmed said.