I’ve been sitting on this for awhile, but this is probably the best thread to throw this out into the universe:
CONSPIRACY THEORY: I actually think there’s evidence that the ABR (particularly Paul Wallner) intentionally increased the fail rate of the 2018 RadBio/Physics exams.
Why do I think this?
1) Amdur and Lee publish “Thoughts on the American Board of Radiology Examinations and the resident experience in radiation oncology” on
March 13th, 2018, ~4 months before the exams. Within it, they state that “we are concerned that this overemphasis on passing examinations is not in the best interest of our specialty”, and use USMLE scores to argue that “ABR Board Certification examinations are becoming more difficult, [a statement which] depends on comparing standardized tests that all radiation oncology residents take before, during, and after their training”. Similar to Mudit’s paper at the start of this thread, Amdur and Lee observed that by all metrics, RadOnc residents were becoming “better” (at least in an academic/test taking sense) yet spending significantly more time preparing for board exams.
The editorial.
https://www.practicalradonc.org/article/S1879-8500(18)30080-8/fulltext
2) The now infamous Wallner and Kachnic “residents are dumb” editorial is released online on
April 10th, 2018, ~3 months before the exams.
3) Key dates:
2018 Exam Day - July 12th, 2018
2018 Score Day - August 24th, 2018
4) Hypothesis: I think Paul Wallner, Senior VP of arguably the most unscrupulous corporate RadOnc practice in America, man who sends threats of lawsuits to women who note that there are no breastfeeding accommodations during ABR exams, would absolutely tweak the cutoffs of exams to “prove” Amdur/Lee and their supporters wrong. The cutoffs weren’t changed tremendously - just enough to demonstrate that “the quality of RadOnc residents has gone down over time”.
I don’t think anyone else at the ABR is involved in this. I think Wallner, as the Executive Director and final arbiter of who passes and who fails, did this on his own. While that may sound crazy, remember that there are no checks and balances to this process. The ABR and their exams are a black box - we’re not allowed to see ANYTHING about this process. I assume all the other volunteers who work on these exams that year had nothing to do with this.
Is this timeline and pattern/history of behavior coincidence? Maybe. I’m sure we’ll never know what actually happened.
#RadOncRocks