People who cheat should lose their board certification.
There is no gray area for anyone who fed board questions to Arora Board Review, knowing full well that those questions would then be disseminated to people taking the review course. And while ethical judgments can’t be based on pass/fail rates, you have to ask yourself how nonsensical is it to take such a big risk when only one in 20 internists who takes the ABIM boards fails anyway.
But aside from the alleged dishonesty, a few other things give me dyspepsia in this whole fiasco. I suspect I’m having a particularly visceral reaction because I took the medicine recertification boards less than two months ago.
One, I believe the board owes test takers some transparency concerning any financial relationship it may have with the whole universe of board review courses. For months after I registered for the boards, I received more mail from suitors than a prized high school football recruit.
As I posted before, I find it extremely coincidental that suddenly everyone knew I was taking the board exam. My board status is public record so it is very possible that the board was not selling my name–but if it is, I should know this and be able to opt out. (As an aside, I am still getting ads for recertification courses while awaiting my results two months after taking the test. I pray they don’t know something I don’t!)
Second, cheating is cheating. But were there any gray areas in the board review material I used? There is a finite amount of material, thank goodness, so no doubt any good board review course will present information that looks a lot like actual test questions.
I certainly found that to be true of the material I used. There were questions that almost seemed lifted right from the board review material, not the other way around. In fact, one of the review books I used stated on numerous occasions: “The Boards like to ask questions about this–be sure to know well.” I can’t help but wonder how similar that may be to what certain members of the Arora Board Review are accused of doing.
Third, I sure hope the ABIM is being exceptionally judicious about the punishments being meted out, given the impact on the careers of the physicians involved. Yes, if the doctors actually committed these offenses, then they did this to themselves.
But how guilty are these accused 134? From the sound of it, some are plenty in the wrong. But all of them? For example, say I e-mailed a friend, “Be sure to know priapism well, it was all over the exam.” While that’s certainly an act of questionable integrity, would that be suspension worthy? (ABIM: Just for the sake of making a point, I NEVER wrote such an e-mail, nor am I implying here that the boards did or did not have a single question about priapism.) Attorneys will be the only winners in this process as the disgraced and the de-certified will no doubt be forced to “lawyering up.”
Finally, I read this in the Wall Street Journal: “Doctors who took the Arora course but weren’t sanctioned or sued will get letters of reprimand.” I know several people who took the course. They tell me that no one ever said to them that they were being exposed to actual board questions. I don’t understand how they deserve any more of a reprimand than I might for using one of the many other board review vendors.
At the end of the day, this is a just a colossal shame. Our good name has already been blighted by all the business of medicine, which has without question brought down the overall respect of our profession. When the public reads that more than 130 physicians cheated on a test that supposedly defines our ability to practice medicine, the actions of those physicians bring a terrible shame upon us all.
After writing this blog, I came across this damning communication from the ABIM on KevinMD, and it includes actual e-mails from people who were sharing questions. More black and white than gray in these e-mailed exchanges. Regardless of one’s take of the current boarding practice, these actions debase any value of “board certification” for all of us. Again, what a shame.