Doctors 'Cheating' On Board Certifications

There is a lot of confusion among people who aren't physicians about what, exactly, is meant by "boards" and "board certified". Just remember: medicine is populated entirely by people who are good at tests. They may have other skills, and they may not. But they're all good at taking tests.

When a physician is described as "board-certified", that means that s/he has taken a specialty examination given (in almost all cases) by a member of the American Board of Medical Specialties. In some fields, this only has a written component; in others, especially surgical fields, oral examinations are standard as well as the writtens. These examinations serve to certify that you know that particular specialty. They are not required to practice medicine, and physicians are not limited by law to practice only in areas of medicine for which they have received formal training. Insurers providing coverage and hospitals allowing privileges outside of your area are a different matter, but as a matter of law, a general-practice MD can perform neurosurgery in his office.

A permanent, unrestricted medical license in the US is predicated on passing the US Medical Licensure Examination Steps 1, 2, and 3 (unless you're an osteopath and you take the COMLEX, but that's a small number of people and in any case the principle is very similar). Furthermore, you will have to do at least an internship (the first year of residency after medical school) in order to be granted a permanent, unrestricted medical license. (Graduates of non-US/Canada medical schools may have to do two or even three years of residency.)

So yes, people do get together and discuss things. In particular, memorizing questions serves the purpose of identifying what the question-makers think is important. This is not always trivial; as medical specialties have moved their written examinations onto computers in recent years and K-type (Choose A if 1 and 3 are right, B if 2 and 4 are right, C if 4 only is right, D is 1, 2, and 3 are right, and E if all are incorrect) questions have been eliminated, there has been a significant influx of new questions from younger examiners. Like all examiners, they tend to submit questions from their own interests rather than just covering a broad enough base to be sure that the examinee is capable of practicing safe medicine. The line between pass and fail has to fall somewhere, and if you're academically relatively weak, knowing the likely subject matter (or the likely rare association between two things) can make the difference between pass and fail.

The USMLE 1/2/3 all have prep courses and study books with sample questions, just like the SAT. If you don't study how the questions are asked, you are unlikely to do your best. However, the base of knowledge is just immense - Step 3 considers anything that you might encounter in a general practice to be fair game. To pass the test, you're going to need to know the stuff.

The specialty board examinations don't take anyone who couldn't 1) get a residency in that specialty and 2) pass their way through it (which is not a given - people fail out of residencies all the time). Dermatology, the subject of this article, is populated exclusively by people who gradated in the top 5-10% of their med school class. Their intelligence and drive to study isn't really in question. What's happening is mostly a matter of pride; even though only a vanishingly small percentage of people who take the test will fail, it is incredibly embarrassing to be the one who does.

Source: http://rss.slashdot.org/~r/Slashdot/slashdotScience/~3/QjaTNvL4avA/doctors-cheating-on-board-certifications

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