CNN story about cheating on radiology boards

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When are we going to get a break? Doctors constantly get crapped on now a days. What happen? Didn't we use to be a very respected profession, waking up at night saving lives (surgeons/procedures), making the blind see (optho), treating cancer patients and giving them a new lease on life (onc), delievering babies, etc. What happen? :confused: When, and why?
 
Really?

This ain't the 1950s - doctors aren't held in the high regard they used to be.

When it comes to healthcare, its the hardworking, overworked, in-touch, sensitive, caring, tired (but not dangerously over-tired), working class (+/- single mom), no-nonsense, practical, common-sense, slang-speakin' NURSES that the public adores because they selflessly protect patients from those greedy, over-educated, insensitive, golf-addicted, BMW/Mercedes/Porsche-driving, impatient conversation-cut-offing DOCTORS.

We may not be hated like lawyers are, but doctor schadenfreude is a proven news headline winner.

This basically sums it up.

Nursing has great PR through television and other media. You have companies like Johnson and Johnson with their pro nursing commercials on from time to time. Funny thing is, at least as an OB resident, when it comes time to change of shift, every single nurse I've seen can't wait to get the F### out of the hospital even if their patient is fully dilated and pushing.

The physician patient relationship is broken nowadays. Doesn't matter if a patient with no health insurance rolls in with a ruptured ectopic, is having a post partum hemorrhage or any other life threatening situation, patient's have such an antagonistic relationship toward physicians today.

The 'cheating' stories that CNN is pimping out is just another example of this. I'm not too surprised though, this kind of s### is on the NYTimes as well.
 
Hmm... As a specialist in a suburban/rural area, I don't ever feel there is an antagonistic relationship with my patients. Perhaps one in a hundred, but that would be it.

I think it's what people are saying - it's a sexy story - highly paid, prestigious professionals cheating.

What I had a greater problem with is that people didn't close ranks. The ABR sold out the dx rads. Other specialties feigned shock and ignorance of the issue. Other students/ doctors on this board are wagging their fingers and saying accusatory things.

Every specialty is going to have leaks like this now - there is going to be "whistle blowers" all over the place. Don't even try to tell me that dermatologists and radiologists are less ethically sound than the other specialties. We ought to be protecting each other, not helping the media try to bring us down.

This is not cheating. It's studying. Otherwise the board wouldn't let you re-take exams.

S
 
Hmm... As a specialist in a suburban/rural area, I don't ever feel there is an antagonistic relationship with my patients. Perhaps one in a hundred, but that would be it.

It helps if you're a subspecialist in a suburban/rural area. A lot of resident patients are uninsured, poor, and barely take care of themselves (not all of course, but a vast majority). This is in stark contrast to some of the private groups whose patients are the exact opposites.


In regards to the story, I think the overwhelming sentiment in this thread is that the story is grossly overblown and that this is just another example of sensationalism in journalism aimed at physicians.
 
Much of the above is true. In the mid-1980s/early 1990s, a group of medical physicists and the AAPM (the medical physics group) formed an alternate certification group called the Amercan Board of Medical Physics and encouraged every medical physicist to get their certification through the ABMP rather than the ABR. Why? Because the ABR's mercurial questioning made the medical physics exams nearly impossible. One of my best grad students failed the ABR exam 3 times, though clinically this student was sound. Ultimately the student passed the ABMP and ABR exams, but the ABR questions were not what I would have expected.

After the ABMP began making headway, the ABR rapidly mended its ways at least in medical physics, and the ABMP disbanded a few years back. Almost immediately, complaints about the ABR med-phys certification process resumed.

Now, the ABR has the audacity to say they release questions in response to CNN. Where's the beef? They could at least release for all comers the ACR In service exams with answers and explanations. They could start eliminating the "what am I thinking?" questions with ones that actually have clinical merit instead of putting "gopher" questions on the exam. I am told by them 'as knows', that the landscape is changing. I certainly hope so.

In the mean time, I think CNN is asking the wrong question. The real question is: Does board certification (any board, lest the ABR think I'm taking a shot at them) do any good? Again, where's the beef? The real value in studying for these exams is to learn the material better to apply it to clinical situations. The boards themselves are secondary.

So, if board certification is a useful discriminant, then we need proof that they are more than just jumping through hoops. We need comparably trained residents taking the boards or not with comparative effectiveness evaluations and outcomes measures in practice to determine whether or not board certification is a true measure and not just a money grab. That goes for temporary certifications (i.e. time limited) as well as the lifetime grants.

We demand evidence based medical practice in all other areas, why not in training certifications as well? Why are the ABMS not held to providing qualified Phase III studies that demonstrate they are worth the millions of hours and dollars spent on them? Not to mention the ever increasing MOCs being required and added to nearly daily?

Where's the beef?
 
Cheating?! Seriously? Half of you seem to have your holier-than-though moral/ethic compass completely outta whack....

And the LORD God took the man, and put him into the garden of Eden to dress it and to keep it. And the LORD God commanded the man, saying, Of every tree of the garden thou mayest freely eat: But of the tree of the knowledge of good and evil, thou shalt not eat of it: for in the day that thou eatest thereof thou shalt surely die. :eek: Genesis 2:15-17

Where do you draw the line? Would book-learnin' be considered cheating? It does give you an unfair advantage over your peers who perhaps don't read as much? Would getting an answer to the proverbial "Will this be on the exam?" question cheating? Would rotating with someone who actually writes questions for the boards cheating?

As for the issue of copyright, books and journal articles are also copyrighted material. So, by extension, all modern medical knowledge has at one point or another been copyrighted in one form or another. Therefore, aren't attendings and teachers guilty of breaking copyright law when they teach us this copyrighted material? Are we breaking those laws when we take notes? When we share those notes with others? Of course they're not, thanks to "fair use". And I would argue (although I'm no lawyer) that creating and using "recalls", as long as you aren't selling them for profit, falls under the rubric of "fair use", despite what the board agreement you've all signed claims.

Only a couple of you have raised a couple of key issues that were not brought up by CNN, nor much here on this board, namely money and evidence.

First, the money. The boards, and by extension some of it's members, not to mention an entire industry make money hand-over-fist on credentialing, CME, MOC, etc. I would think that's an inherent conflict of interest on the part of the examining boards and would additionally make Becker's arguments moot. He's in it for the money and can suck it.

Second, the evidence. Although touted as a great idea "for the good of the public", there is limited, if not conflicting evidence as to how valuable, besides for the aforementioned money aspect of it, all this credentialing, MOC, etc is in practice, ie. does board certification actually make for better physicians. If no money exchanged hands in this process, would there be a benefit to anyone? I guess the jury is still out on that.

Finally, besides what has already been mentioned, some additional solutions to combat the supposed concerted effort to write down as many questions as possible by having each test taker remember a number of them:
1) Ask the questions in random order. It's all computerized nowadays. It should be trivial for the computer to randomize the question order.
2) Better yet, present each test taker with a different subset of questions; again, very easy in this 21st century world.
3)

After all, what are the boards going to do with true cheaters. "Old School" anyone? Cameras can now be hidden in almost anything, eyeglasses, a lapel pin, a shirt button, etc. If hearing aids can be miniaturized to fit invisibly inside ones ear, why not a wireless receiver? It's only a matter of time before contact lenses will be able to beam a computer screen image directly into our retinas. All you need is a van and a team of friends, and voilà!

Oh look, thanks to the googlez... these are the first couple of links I stumbled upon with a simple search string...
Oh, and this... http://www.extremetech.com/extreme/106263-wireless-contact-lens-display-now-a-reality

So, there, suck it. You guys have no clue what real cheating is. As usual, the Europeans are way ahead! :rolleyes:

Oh yeah, so thanks to this post, don't be surprised if those Rapescan machines show up at test-taking venues. Time to buy some of their stock. Muahahahahahaha....

See, everybody profits.

Except you.
 
...

Finally, besides what has already been mentioned, some additional solutions to combat the supposed concerted effort to write down as many questions as possible by having each test taker remember a number of them:
1) Ask the questions in random order. It's all computerized nowadays. It should be trivial for the computer to randomize the question order.
2) Better yet, present each test taker with a different subset of questions; again, very easy in this 21st century world.
...

neither of these stops recalls/airplane notes, it just requires a bigger collective to assemble the ultimate product. If enough people each remember a few questions well, and a bunch more kind of, etc, as a group they can recreate all the information regardless of the sequence. Or people could divide the test up by topic and have one person responsible for remembering the chest questions, another the peds questions, etc, in whatever order they appear. Even if each person got a relatively distinct test, which would involve tens of thousands of questions, if a good number of the questions were periodically recycled, then in a number of years most of the questions would be known. The right answer here is for the board to simply remove all incentive for recalls/airplane notes by 1. Creating a distinct test each year, and 2. Selling the prior years questions as a study guide, so people won't bother to try and create their own study guide. This creates a level playing field, and eliminates all issues. The money generated by selling old questions can be used to commission new ones.
 
So apparently CNN interviewed a dozen of such residents who testified the recall system. I wonder what kind of twisted "HIPAA" principle CNN follows with regards to that.

The fact that recall is working so great, means the board should revise their policies and make the exam more unpredictable. I think saying something like this .....



"Cheating is the ultimate betrayal of trust to patients, and it's also the most egregious and flagrant violation in academia," Webb told CNN

....sounds really cool on TV, right?
 
Since when does CNN need to follow HIPAA?

They don't. That was just sarcastic. I guess that would just be a resident accountability act, maybe, but they don't even need to follow that.

I was wondering why would a "dozen" residents, all of a sudden, declare they "cheat" to CNN knowing CNN might well become the whistle blower?
 
I was wondering why would a "dozen" residents, all of a sudden, declare they "cheat" to CNN knowing CNN might well become the whistle blower?

Because they don't consider it cheating.
 
FWIW, lawyers in some ways actually get more respect these days -- a story about cheating would never hurt lawyers because people want their lawyers to be unscrupulous.


duh....

if i were ever to be sued or whatever, I would NEVER want a criminal lawyer.. I would want a criminal, lawyer.
 
Interesting until the last two paragraphs when the author declares board exams aren't necessary :rolleyes: because medical schools and residency programs are good weeder-outers ... :laugh: :laugh:

I agree. Boards probably used to be more necessary than they are now, but they still serve a QC for initial applicants and continued certification of competence. CMEs from Up-To-Date don't exactly cut it...
 
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