Why board exams are like Name That Tune

The American Board of Internal Medicine has been under fire for the excessive testing requirements of physicians and they recently have been seeking clarity for the maintenance of certification process.  In my opinion, the answer is to eliminate the examination completely and create a better, ongoing assessment using CME chosen by the physician that meets their needs, especially in a time where medical knowledge changes so rapidly.

Doctors are essentially tested every day, and we are sick and tired of having to take a closed board examination that has never been proven to be meaningful. We are under the microscope more than anyone else, and we know it. It is time that physicians take control of this situation and work toward the abolishment of a secure test where you are treated like a criminal.

Testing centers are a terrible environment and not anything like the real world in which we work. It is exactly this kind of testing that creates the physician who interrupts the patient after 30 seconds. Think of it. You are trained to think of the answer within 2 minutes and move on. That is not good medicine in most cases. Yes, there are times we need to make quick, sound clinical judgment, but it is not because of a few buzz words that are learned to game a test, solutions are derived from factual and clinical data based not only on literature but experience to make a decision.

I believe the test needs to be eliminated in its entirety and let physicians expand their knowledge in areas they want to learn instead of relearning unless information that mostly will never be seen by the majority. Finally, board certification should never have been used for privileges and should never be used for licensure.

There used to be a show called Name That Tune where they would give you several measures of a song, and you would Name That Tune. The game was based on how few notes could be played so that you could name the tune. The person who could name the tune with the fewest notes wins. This is what the boards are like. It is game of “Name what I am thinking and how little information can I give you so you can get the answer that I am thinking about.” It is the dumbest thing we have ever done to ourselves as a profession. The test is not reflective of the practice of medicine, although it might be better suited for the academician, and should simply be eliminated. It is unnecessary, unwanted and unfair.

We know doctors training far exceeds every other health care professional in the depth and breadth of knowledge necessary to do a great job. This ongoing, money making and antiquated operation needs to stop and if anyone chooses to take a test, then make it something optional like becoming a Master of whatever organization you belong to and not mandatory.

Corey Howard is CEO, Physicians Life Centers.

Image credit: Shutterstock.com

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