Physics & Radbio

[VulgarDisplayOfPower]

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Unfortunately I dont think the pass rates are so outrageous to demand any real recourse other than a possible early retake (doubtful). 26% fail is really really tough, but that means 74% of people did better than you if you failed.

The actual pass rates for each section are even lower when you include all test takers, and the overall failure rate approaches 50%.
This is a complete disaster for the field. The level of corruption it demonstrates is humiliating for all of us. This is the body that is supposed to certify us to the public. The biology exam was the most irrelevant piece of trash test I've ever seen. It is revolting that we are to be certified as competent clinicians based on such inanity. It's not that it would have been difficult to memorize these pathways if they had told us we needed to. This is easy - we can all spend every waking free hour in the spring brute force memorizing these acronyms and everyone will pass, and then it will quickly fade out of our minds because we have never used it before and will never use it again. People failed this year because it was an exam unlike anything ever given before. It's that they might as well certify us based on how well we can memorize baseball stats.

Anyone who doesn't understand that the exam this year was used for another purpose isn't paying any attention at all. If you believe the ABR's lies you deserve what's coming. The ABR let it get this far because they wanted it to get this far. They wanted it to happen. They wanted to harm us. Unless you were at one of the programs in the know. "The larger programs did just fine." Not from what I heard. This is confirmation bias, Paul Wallner.

 

[RO2019]

People at 'big name programs' that have 'recalls' had failures.

The test was different. Tested lots of new things, and when they tested normal/usual concepts, the questions were poorly worded.

I WISH recalls mattered, because the types of things in recalls are the same things that come up in Hall and ASTRO tests, which means more of you guys that failed would have passed.

 

[Pointless]

If you think this is bad, just wait until you go face-to-face with an oral board examiner who got mad at you because you didn’t quote his retrospective review that is currently in press.

That is most certainly not a thing. The oral board process can be random and frustrating, but I've never heard of anything like that. Fear mongering for those that have not taken it yet.

 

[RO2019]

Fear mongering and paranoid delusions fueled by some type of weird inferiority complex have become rampant on this once great forum over the last few years. This thread is the pinnacle now.

 

[RO2019]

I think we can all agree on one thing. We are all adults. You should not be writing the ABR, or any of its representatives. Everyone who failed this exam should follow due process. If you truly believe this breaks antitrust laws, file a complaint like any other citizen:

Report Violations

Contact the Antitrust Division
Main address:
950 Pennsylvania Avenue, NW
Washington, DC 20530
E-mail: [email protected]

I’m like 70-80 percent sure you’re not even in Rad Onc or a resident. You’re in it for the lulz, trolling. No shame in that game, I see you. Keep grinding

 

[RadOncDoc21]

That is most certainly not a thing. The oral board process can be random and frustrating, but I've never heard of anything like that. Fear mongering for those that have not taken it yet.

So I’m the fear mongorer on a thread in which one of the responses is to actively get the NY times involved?

Also, I had no idea you were sitting in the hotel room when I got that question.

 

[Pointless]

So I’m the fear mongorer on a thread in which one of the responses is to actively get the NY times involved?

Also, I had no idea you were sitting in the hotel room when I got that question.

Two things can exist in crazy town at the same time. Would you believe me if I told you that one of my examiners produced a full-bodied patronus charm during one of my sections? You weren't there, so you can't say they didn't!

 

[RadOncDoc21]

Two things can exist in crazy town at the same time. Would you believe me if I told you that one of my examiners produced a full-bodied patronus charm during one of my sections? You weren't there, so you can't say they didn't!

I don’t claim to make assumptions about other people’s experiences but see that is something you are more comfortable in doing.

 

[RadOncDoc21]

I don't believe you. But please file a complaint:

Report Violations

Contact the Antitrust Division
Main address:
950 Pennsylvania Avenue, NW
Washington, DC 20530
E-mail: [email protected]

No thanks, it’s over, I’m board certified but I’m definitely not going to put my neck out for any of ya’ll!

 

[Tony&lisa]

Bringing it back to what we were talking about earlier with perhaps less controversial interventions, 2 points:
1. Everyone please send your emails to ARRO. They are collecting all of our greivances. I don't know yet what they'll do with them but lets make sure there is a massive voice behind them.
2. Make sure your PD is involved. Get them talking to your chair. Get them talking to one another. Get the ppl who have a little more weight behind them involved.

 

[Tony&lisa]

Dr. Wallner has basically stopped answering my emails. All of his responses explain how the test is fair, questions chisen through a rigorous process, grading is fair etc.... but not once did he address the OBVIOUS absurdity of such high fail rates. The point is that irrespective of how clean the test was, there was a change. It was not the test we had been preparing for for 3 years. If they want to change the test focus, fine. But to change it without telling ANYONE and then saying oh, I guess you guys aren't as smart as the other years , sorry, why don't you study some more and pay some more money and do better next time, is unacceptable and inexcusable.
I just reached out to my PD and chair to encourage them to keep going. I want to see an effort on the part of PDs and chairs to stand up for their programs, their residents and their science instructors!

 

[Gfunk6]

I realize it's no consolation to this year's test takers, but I'm pretty sure the Rad Bio/Physics pass rate next year will be close to 100%.

 

[Tony&lisa]

Has anyone resched out to and heard back from Dr. Kachnik? If so, what did she say, and how did you reach her?

 

[radbioistheworst]

I realize it's no consolation to this year's test takers, but I'm pretty sure the Rad Bio/Physics pass rate next year will be close to 100%.

It’s a perfectly fine consolation prize. Just not sure why we would expect that when, as pointed out earlier, the ABR saw that up to half the class failed one or the other and simply didn’t care to do anything about it.


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[Corgi4Prez]

How many program directors are aware of this change?

All of them. The proposed changes were sent out a long time ago with plenty of time to comment. It's a good change. You want programs to be on the hook for residents passing. The ABR + ACGME joining forces to tank residency programs is my favorite conspiracy theory on this thread. Kudos.

 

[RadOncG]

All of them. The proposed changes were sent out a long time ago with plenty of time to comment. It's a good change. You want programs to be on the hook for residents passing. The ABR + ACGME joining forces to tank residency programs is my favorite conspiracy theory on this thread. Kudos.

What were the proposed changes specifically and why are they good?

 

[ARRO official 2018]

Thank you again for all of your emails and for those that have reached out to us. We have been working on a letter to summarize the concerns and will make these public in the near future. Thank you again for being patient and ARRO continues to support you.

 

[Corgi4Prez]

What were the proposed changes specifically and why are they good?

I looked back in my email and our PD sent the notification of changes around on October 31st, 2017. It just directed to the ACGME accreditation review and comment section (https://www.acgme.org/What-We-Do/Accreditation/Review-and-Comment). The comment period was through December 13th, 2017 for Rad Onc. All the (now approved) changes can be reviewed in the tracked ACGME guidelines document (https://acgme.org/Portals/0/PFAsset...ogyCore2019-TCC.pdf?ver=2018-06-18-083751-487).

While heterogeneity in teaching rad bio/physics was likely not the only cause of the failures, its hard to believe it didn't contribute a little. The ACGME does not ask for very much in terms of Rad Bio training and lists no specific curricular training requirements (see requirement II.B.8). Departments should be required to effectively train residents (including to pass their boards). If they can't, maybe they aren't equipped to have a residency program.

 

[Chartreuse Wombat]

I looked back in my email and our PD sent the notification of changes around on October 31st, 2017. It just directed to the ACGME accreditation review and comment section (https://www.acgme.org/What-We-Do/Accreditation/Review-and-Comment). The comment period was through December 13th, 2017 for Rad Onc. All the (now approved) changes can be reviewed in the tracked ACGME guidelines document (https://acgme.org/Portals/0/PFAsset...ogyCore2019-TCC.pdf?ver=2018-06-18-083751-487).

While heterogeneity in teaching rad bio/physics was likely not the only cause of the failures, its hard to believe it didn't contribute a little. The ACGME does not ask for very much in terms of Rad Bio training and lists no specific curricular training requirements (see requirement II.B.8). Departments should be required to effectively train residents (including to pass their boards). If they can't, maybe they aren't equipped to have a residency program.

Departments should be required to effectively train residents (including to pass their boards). If they can't, maybe they aren't equipped to have a residency program.

I agree but it is difficult to train residents if there is no consensus on the curriculum. If there is no agreed upon curriculum then pedagogy is irrelevant. I think that this is the central problem.

How to fix it? The ABR has historically been less than forthcoming about the content of the test relying on outdated outlines which are useless. The other stakeholders (ACGME, ASTRO) don't have the resources or inclination to produce something like this. Perhaps this event will lead to a consensus on the curriculum but until that happens events like this will take place.

 

[Chartreuse Wombat]

The two paragraphs above are taken from the most recent ACGME requirements. Not very many specifics. This is a bug if one is trying to define a curriculum by themselves but it is a feature if a group of individuals want to flesh this out in more detail as it is not too prescriptive.

The ABR study guides provide more detail but they cannot be considered comprehensive

https://www.theabr.org/wp-content/uploads/2017/05/ic-ro-study-phys.pdf

https://www.theabr.org/wp-content/uploads/2017/05/ic-ro-study-bio.pdf

For example one of the subjects is "molecular profiling of cancer" without further specification. PubMed has more than 23000 papers on this subject.

 

[RadOncG]

I looked back in my email and our PD sent the notification of changes around on October 31st, 2017. It just directed to the ACGME accreditation review and comment section (https://www.acgme.org/What-We-Do/Accreditation/Review-and-Comment). The comment period was through December 13th, 2017 for Rad Onc. All the (now approved) changes can be reviewed in the tracked ACGME guidelines document (https://acgme.org/Portals/0/PFAsset...ogyCore2019-TCC.pdf?ver=2018-06-18-083751-487).

While heterogeneity in teaching rad bio/physics was likely not the only cause of the failures, its hard to believe it didn't contribute a little. The ACGME does not ask for very much in terms of Rad Bio training and lists no specific curricular training requirements (see requirement II.B.8). Departments should be required to effectively train residents (including to pass their boards). If they can't, maybe they aren't equipped to have a residency program.

Maybe I am slow today but I have no idea how those tracked changes are germane to the topic. Posters are wondering why the content of the exam shifted to more transnational cancer biology instead of relevant aspects with clinical implications.

I do not understand how heterogeneity in teaching can lead to 3+ standard deviation changes in one year. Maybe you could make somewhat of an argument if it happened slowly over several years. Radiation oncologists love their data but nobody has been able to explain how this could be possible with a similar exam as the ABR claims.

I also find it amusing how out of touch some people are when it comes to learning and memorizing material today. Lectures were great before the internet. Most of us did well in medical school and did not go to a single lecture. How does heterogeneity impact medical schools when we purchase resources on our own and do self-directed learning? This material is not challenging. It is mostly unimportant minutiae trivia. You are claiming that if someone taught me really well the name of protein AGAF835823 that I would be better prepared than if I read the protein name from a resource and then memorized it?

 

[VulgarDisplayOfPower]

While heterogeneity in teaching rad bio/physics was likely not the only cause of the failures, its hard to believe it didn't contribute a little. The ACGME does not ask for very much in terms of Rad Bio training and lists no specific curricular training requirements (see requirement II.B.8). Departments should be required to effectively train residents (including to pass their boards). If they can't, maybe they aren't equipped to have a residency program.

That sounds just fine of course, but the reality is far different.
Many, if not most, programs did not alter their rad bio curriculum to adjust for changes in the exam this year as it was done in secret.
The responsibility for the failure is falling back on the residents. Faculty do not want to hear things like "the exam changed" and are blaming residents for being complacent because they remember it as an easy exam that assessed minimal competence, not the weed out tool it has now morphed into. It's a double-edged sword for residents. Programs do not want their residents out of clinic, but at the same time residents are expected to teach rad bio to themselves on the weekends and use their vacation time prior to the test. Whereas other programs will send residents to the Maryland course, give them protected time out of clinic for weekly rad bio instruction, and give them protected dedicated study time prior to the exam (a few days up to as high as a week that I'm aware of).

The bottom line is that residents are being penalized for which program they are in because the ABR is exercising a vendetta against less academically focused small programs. The test items they are using to weed out residents from less dedicated programs are frivolous. Residents from both types of programs are equally clinically competent in terms of radiation biology. One just spends a lot more time and resources keeping the residents out of clinic to prep them for rad bio and physics, which is completely unnecessary and a detriment to clinical development, as pointed out in the recent PRO article.

Minimal competence for clinical practice in rad bio and physics can be achieved with only a couple of weeks (if that) of dedicated study (how long is the Maryland course?). You're kidding yourself if you honestly think otherwise, but clearly the ABR disagrees (hint it's not about minimal competence). My program had weekly classes in both for 3 YEARS, and people still failed. And they (both the program and the ABR) have the nerve to tell us we were complacent.

Message to med students this year is overwhelmingly clear: With all of this nonsense still going on, if you still think it's a good idea to go into this field, make sure you match at a large program and rank a backup specialty. They are stacking the odds against you if you don't. Expect multiple unmatched slots in small programs filled out of the match by people that failed to match into less competitive specialties.

 

[Corgi4Prez]

@RadOncG My response about the ACGME changes was to someone who specifically asked about them. To be clear, I do not think heterogeneity in teaching caused the large drop in pass rate this one year, but I do think it contributes to failures. I also think that if residents this year were taught a clear curriculum that matched the test, more would have passed. I agree with @Chartreuse Wombat that the central problem is the curriculum. I dont want to say its "secret" because I dont think the ABR is doing this on purpose, but who knows. The bottom line is that the curriculum needs to be updated, made more specific, and teachers need to be filled in on the details.

Only the ABR knows why the curriculum is changing. Wallner's publications give some info on at least his thought process. I posted about this a little while back in this thread. Things will not get better if the attitude is that rad bio is unimportant for practice. I assure you there are people up in ASTRO and the ABR that strongly disagree.

@VulgarDisplayOfPower "Programs do not want their residents out of clinic, but at the same time residents are expected to teach rad bio to themselves on the weekends and use their vacation time prior to the test." I feel you 100%. Trust me, I really do. I came from one of these types of programs. A clear curriculum that matches the test makes it easier for everyone to study in a focused way and to balance rad bio with clinical training. The ACGME rule change says nothing about how much time is spent studying, just that programs need to make sure people pass. Im sorry people are telling you that you are complacent. I am sure that is not the case. Super competitive fields don't attract complacent people when it comes to test prep.

 

[OTN]

What really needs to happen is we as radoncs need to ask why on Earth there's even a bio exam. Is there any other specialty/discipline which requires this? Biology, naturally, touches each and every specialty in medicine. Do neurosurgeons have to pass a neurobiology board exam? Do medical oncologists have to pass a molecular oncology exam? Of course not. Why? Because knowledge of cancer biology at a level high enough to require a board examination has no utility when it comes to the practice of radiation oncology. It is a waste of time, energy, and effort for academic physicians to teach radiobio and for residents to learn it. If a few concepts are important (alpha/beta ratio, though SBRT data has shown the radiobiologists really don't know what's going on there), put them on the clinical written exam.

I am a full-time private practice radiation oncologist, and I can say with 100% certainty that learning about and studying radiobiology had zero impact on my clinical competence. Instead of begging the ABR to allow a retake of the exam, tell residents what's on it better, etc, I say go back to the drawing board and trash it entirely.

 

[RO28]

What really needs to happen is we as radoncs need to ask why on Earth there's even a bio exam. Is there any other specialty/discipline which requires this? Biology, naturally, touches each and every specialty in medicine. Do neurosurgeons have to pass a neurobiology board exam? Do medical oncologists have to pass a molecular oncology exam? Of course not. Why? Because knowledge of cancer biology at a level high enough to require a board examination has no utility when it comes to the practice of radiation oncology. It is a waste of time, energy, and effort for academic physicians to teach radiobio and for residents to learn it. If a few concepts are important (alpha/beta ratio, though SBRT data has shown the radiobiologists really don't know what's going on there), put them on the clinical written exam.

I am a full-time private practice radiation oncologist, and I can say with 100% certainty that learning about and studying radiobiology had zero impact on my clinical competence. Instead of begging the ABR to allow a retake of the exam, tell residents what's on it better, etc, I say go back to the drawing board and trash it entirely.

Can we trash physics too? The relevant stuff can just be incorporated into the clinical exam. My older colleagues said that’s how it used to be....

 

[OTN]

Can we trash physics too? The relevant stuff can just be incorporated into the clinical exam. My older colleagues said that’s how it used to be....

This might not be the most popular opinion at the moment, but I did find studying for the physics board exam to be a useful exercise. It helped me talk more intelligently with my dosimetrists and physicists once I was an attending, and physics knowledge is used much more frequently than bio in the clinic. I do agree that incorporating the relevant stuff into the clinical exam would be perfectly fine, though.

 

[RadOncLazers]

This might not be the most popular opinion at the moment, but I did find studying for the physics board exam to be a useful exercise. It helped me talk more intelligently with my dosimetrists and physicists once I was an attending, and physics knowledge is used much more frequently than bio in the clinic. I do agree that incorporating the relevant stuff into the clinical exam would be perfectly fine, though.

If the exam was relevant, clear, and graded fairly - certainly. But this is not the case.

 

[deleted18755]

What really needs to happen is we as radoncs need to ask why on Earth there's even a bio exam. Is there any other specialty/discipline which requires this? Biology, naturally, touches each and every specialty in medicine. Do neurosurgeons have to pass a neurobiology board exam? Do medical oncologists have to pass a molecular oncology exam? Of course not. Why? Because knowledge of cancer biology at a level high enough to require a board examination has no utility when it comes to the practice of radiation oncology. It is a waste of time, energy, and effort for academic physicians to teach radiobio and for residents to learn it. If a few concepts are important (alpha/beta ratio, though SBRT data has shown the radiobiologists really don't know what's going on there), put them on the clinical written exam.

I am a full-time private practice radiation oncologist, and I can say with 100% certainty that learning about and studying radiobiology had zero impact on my clinical competence. Instead of begging the ABR to allow a retake of the exam, tell residents what's on it better, etc, I say go back to the drawing board and trash it entirely.

To be board certified in medical oncology one needs to take a single 3-4 hour written exam ... why on earth are we required to take three written exams AND an oral exam!?!

 

[VulgarDisplayOfPower]

This might not be the most popular opinion at the moment, but I did find studying for the physics board exam to be a useful exercise. It helped me talk more intelligently with my dosimetrists and physicists once I was an attending, and physics knowledge is used much more frequently than bio in the clinic. I do agree that incorporating the relevant stuff into the clinical exam would be perfectly fine, though.

Agree 100%. Physics is actually useful and makes us better clinicians. There is some basic radbio we need to know. Alpha/beta, BED/EDQ2, 4 Rs, oxygen effect, late/early effects with respect to fractionation, etc. But that's not what they tested. They tested if we know the difference between protein xyz123 and protein xyz456. Stupid, useless, weed out knowledge rewarding those with inside info on the test.

I am tired of having to tip-toe around radiation biologists' feelings. Especially the cancer biologists. I have tried to raise concerns at my program. The response I got was "Don't piss Dr. so-and-so off. We need him to remain accredited." As a result he gets to do whatever he wants and continue to teach the dumbest most irrelevant radbio course. Most of what they do is irrelevant to our clinical practice. They have infiltrated the ABR and have bone to pick. I am tired of letting them act as gatekeepers for our careers. It's time to stand up to these non-physician bullies.

 

[VulgarDisplayOfPower]

Instead of begging the ABR to allow a retake of the exam, tell residents what's on it better, etc, I say go back to the drawing board and trash it entirely.

Best post on this horrible conversation so far IMO. Trash the rad bio exam, incorporate it into clinical, keep physics and dump Wallner and Kachnic and their six figures salaries paid from our dues for this absolute nonsense. This is such a total waste of everyone's time. I don't know how Wallner and Kachnic are appointed, but I would think the trustees with any common sense would look at this mess and say you guys need to go, this is a really really bad look for us.

 

[RO28]

This might not be the most popular opinion at the moment, but I did find studying for the physics board exam to be a useful exercise. It helped me talk more intelligently with my dosimetrists and physicists once I was an attending, and physics knowledge is used much more frequently than bio in the clinic. I do agree that incorporating the relevant stuff into the clinical exam would be perfectly fine, though.

Oh I agree, I definitely learned a lot by studying for the exam and think there is practical knowledge there, but as Lazers says, accountability for grading has to be part of it.

 

[Tony&lisa]

Here is the objective proof as to why heterogeneity in teaching practices and curricula have nearly nothing, if not absolutely nothing, to do with it. Irrespective of how and what you were taught, we all took a series of unifying exams, namely the RAPHEX, RABEX and in-service exams. As many have openly posted and I'm sure others just haven't said, we all were doing well on these tests! These tests are annual assessments of whether we are keeping up with the standardized expectations for biology and physics. If you do well on these tests, that should be indicative of knowing in the material, again, irrespective of teaching styles. I spoke in depth with our lead physics instructor about this. The only way for him to know if one of the residents is falling behind is if they do not perform well on one of these exams.

What happened was residents who were doing well on all of these exams, who themselves had no concerns for being behind on the material and importantly, about whom their instructors and programs had no concerns, ended up failing the boards! If there was a substantial difference between performance on the "practice exams" and the actual board exam, then that fault lies squarely on the board exam and it's Developers. I can agree with the messages we have received from them that the questions were chosen in a painstakingly rigorous fashion, but ultimately, the test contained radically different information from that which we had been tested on by official bodies over the last 3 years. That is not a fault of residence or programs. That is a fault of an organization giving a test that is different from what was expected, and very importantly, not telling anyone that they were doing this!

That is why this entire experience was unfair and unjustified. That is why our year needs to be addressed and this problem needs to be fixed, not just for years to come, but our year.

 

[Chartreuse Wombat]

Here is the objective proof as to why heterogeneity in teaching practices and curricula have nearly nothing, if not absolutely nothing, to do with it. Irrespective of how and what you were taught, we all took a series of unifying exams, namely the RAPHEX, RABEX and in-service exams. As many have openly posted and I'm sure others just haven't said, we all were doing well on these tests! These tests are annual assessments of whether we are keeping up with the standardized expectations for biology and physics. If you do well on these tests, that should be indicative of knowing in the material, again, irrespective of teaching styles. I spoke in depth with our lead physics instructor about this. The only way for him to know if one of the residents is falling behind is if they do not perform well on one of these exams.

What happened was residents who were doing well on all of these exams, who themselves had no concerns for being behind on the material and importantly, about whom their instructors and programs had no concerns, ended up failing the boards! If there was a substantial difference between performance on the "practice exams" and the actual board exam, then that fault lies squarely on the board exam and it's Developers. I can agree with the messages we have received from them that the questions were chosen in a painstakingly rigorous fashion, but ultimately, the test contained radically different information from that which we had been tested on by official bodies over the last 3 years. That is not a fault of residence or programs. That is a fault of an organization giving a test that is different from what was expected, and very importantly, not telling anyone that they were doing this!

That is why this entire experience was unfair and unjustified. That is why our year needs to be addressed and this problem needs to be fixed, not just for years to come, but our year.

I have tried for years to get the ABR and the ACR (the group that creates the In-Service) to do a very simple analysis to determine if performance on the in-service correlates with success/failure on the real test. Despite begging the principals this has not been done and as a PD for nearly 2 decades I cannot answer the residents' question "If I do well on the in-service does that mean I should do well on the real test".
This is one of those questions that neither group wants to answer.
In other disciplines there is abundant information on how in-service predicts board success. We are once again the outlier.

 

[VulgarDisplayOfPower]

Despite begging the principals this has not been done and as a PD for nearly 2 decades I cannot answer the residents' question "If I do well on the in-service does that mean I should do well on the real test".
This is one of those questions that neither group wants to answer.

I can answer that for you:
No.
I scored over the 90th percentile on the in-service radiation biology section but failed the ABR's "radiation biology" exam.

 

[Tony&lisa]

Exactly. If that is our only way of knowing how well we are doing as we go through residency, then that demonstrates a serious flaw in the testing because it isn't testing what we are learning. The problem with this situation created by the ABR is only exacerbated when they then don't provide a study guide!

 

[MadamCurie]

I have tried for years to get the ABR and the ACR (the group that creates the In-Service) to do a very simple analysis to determine if performance on the in-service correlates with success/failure on the real test. Despite begging the principals this has not been done and as a PD for nearly 2 decades I cannot answer the residents' question "If I do well on the in-service does that mean I should do well on the real test".
This is one of those questions that neither group wants to answer.
In other disciplines there is abundant information on how in-service predicts board success. We are once again the outlier.

I think I might know part of the reason behind this, and that is that the ABR and ACR – in theory at least – are supposed to be completely separate entities that by design don't interact. But given that very few people are willing to devote the time to writing good questions or even know how to do so (not an easy task, despite what many think), there has always been at least some overlap. In one sense, the overlap has been a good thing in that it allowed the In-Training exam to go from a complete laughingstock 20 years ago with seemingly no relevance whatsoever to the actual ABR exam, to today when it not only largely follows the ABR guidelines (such as they are), but also allows residents to keep each year's exam as a study aide. None of which applies to this year's ABR debacle, mind you.

That said, I seriously doubt that either organization is going to cooperate with the other to answer your very simple and relevant question, because there'd be too much at stake, e.g., if the ACR exam doesn't predict for ABR exam success, then what good is it? Likewise, no way is the ABR going to share their precious exam data, or even a sense of the breadth and depth of their super secret questions, with the ACR, especially seeing as they won't even do this with their own "constituents" (PDs and educators in particular).

 

[Tony&lisa]

I now of specific examples of PDs and even chair speaking to Dr. W and him basically nit budging an inch, backing the validity of the test 100% and placing all the onus on the shortcomings of the teaching of the material and the prepararion of the residents. I think the only hope lies in the larger groups like ARRO and ADROP that may have more of an impact than any individuals have had.

 

[radbioistheworst]

I now of specific examples of PDs and even chair speaking to Dr. W and him basically nit budging an inch, backing the validity of the test 100% and placing all the onus on the shortcomings of the teaching of the material and the prepararion of the residents. I think the only hope lies in the larger groups like ARRO and ADROP that may have more of an impact than any individuals have had.

The ADROP will meet with representatives from the ABR at ASTRO. Not sure it will yield anything but at least they’re trying.


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[RadOncLazers]

I now of specific examples of PDs and even chair speaking to Dr. W and him basically nit budging an inch, backing the validity of the test 100% and placing all the onus on the shortcomings of the teaching of the material and the prepararion of the residents. I think the only hope lies in the larger groups like ARRO and ADROP that may have more of an impact than any individuals have had.

That’s shameful and shortsighted. Why is this not surprising? Each time I think that at least half of the current residents failed, I am repulsed. There should be swift action taken, and if not this should be publicized widely.

 

[RadOncLazers]

Agreed. We cannot let this issue die down and quietly go away without significant action for this year's PGY-5 residents, which I suspect ABR leadership is doing. And I'm hoping that our chairs, PDs, and ARRO can somehow come together as a unified voice and make headway on this at ASTRO which is still a month away. This very unfortunate occurrence is not just a test-taking issue, but an issue that significantly impacts the PGY-5 year for residents and entry-level careers.

I would like some sort of form for us to gather and discuss outside of SDN. With involvement of PDs, chairs, and residents. I understand this unmasks our mutual identity, but frankly it’s half of the residents. I know we are all intelligent and capable. I respect each one of you. And I think we need more solidarity outside of posting messages. Thoughts or ideas?

 

[RadOncLazers]

I'd also be willing to join a group seeking to take this to litigation for a refund of money. This is an embarassment. We paid money to be assessed by the only body in our field created for that purpose. That was not delivered (for whatever reason...someone fell asleep on the job, a political message wanted to be sent, there was a computer glitch...whatever it was, you dont go from 90%, 90%, 90% to 70%). If not for the internet, they would not have even released the pass rate. This "cover-up culture" has no place in medicine, and it starts at the top. It starts all the way on the top.

I agree completely. The question is that we need to figure a way to take this “offline” and gather the voices. I’m not sitting silent after spending years of hard work to have this absolute mockery of a certification exam dictate our immediate future. So again I pose the question to anybody on the forum - how should we go about coalescing our efforts?

 

[RO28]

I agree completely. The question is that we need to figure a way to take this “offline” and gather the voices. I’m not sitting silent after spending years of hard work to have this absolute mockery of a certification exam dictate our immediate future. So again I pose the question to anybody on the forum - how should we go about coalescing our efforts?

I would also be up for joining to continue our efforts. I’m fired up and want to make this right. Is there a way we could exchange contact information via a private message on here and set up a google document or forum that requires some sort of password validation?

 

[RadOncLazers]

Two ideas:

1. We stage a protest at ASTRO. Any and all resident/program participation would be valuable. We make signs, distribute flyers. Make sure our entire field knows what’s going on, and what happened this year. I think this would be highly effective.

2. If legal action is desirable we can set up a Go Fund Me.

 

[radbioistheworst]

Two ideas:

1. We stage a protest at ASTRO. Any and all resident/program participation would be valuable. We make signs, distribute flyers. Make sure our entire field knows what’s going on, and what happened this year. I think this would be highly effective.

2. If legal action is desirable we can set up a Go Fund Me.

Protest sounds cool in theory but I think you should be careful here guys. Unless you get an overwhelming majority to join (and you won’t because those that passed have no real incentive and half of us who failed probably want to remain anonymous) it may not be as effective as you think. It’s a small field and it takes just 1-2 influential docs who disagree with you to potentially hurt your career... moreso than a failed qualifying exam in a year in which nearly half failed. Again, I also think we overestimate how much current practitioners, particularly non-educators, will care about this. On this very thread the (shortsighted) sentiment from some PP docs have been “wellp you kept expanding what did you think would happen.”

With all that said I do think awareness is important, though much more for the educators and leadership. Maybe we should first let ARRO and the ADROP speak for us, and from what I’m hearing it should be a pretty unified message. Perhaps whatever content and requests/“demands” you would make on signs or pamphlets you could turn into a consolidated letter for ARRO/ADROP to use. I’m working on something like that and would be happy to share w/ others to get feedback prior to handing it over to ARRO.

Just my opinion, might be in the minority here.



Sent from my iPhone using SDN mobile

 

[multitudes]

A protest? Come on, guys. The optics are terrible. The ABR wrote a garbage test and can't walk it back because doing so would undermine their ultimate authority. That's just the way it is. They aren't going to automatically pass people. They (probably) aren't going to offer a mid-year exam. Besides, a protest requires a big turn out, and I doubt many residents who failed this year will want to show up. I know I wouldn't -- I want to be interviewing for jobs.

I think ARRO and ADROP can figure this out. I'm certain they are better connected and better received by the ABR people. Just my two cents.

 

[RadOncLazers]

A protest? Come on, guys. The optics are terrible. The ABR wrote a garbage test and can't walk it back because doing so would undermine their ultimate authority. That's just the way it is. They aren't going to automatically pass people. They (probably) aren't going to offer a mid-year exam. Besides, a protest requires a big turn out, and I doubt many residents who failed this year will want to show up. I know I wouldn't -- I want to be interviewing for jobs.

I think ARRO and ADROP can figure this out. I'm certain they are better connected and better received by the ABR people. Just my two cents.

Well, I’m not willing to just sit and not actively pursue additional measures. I have emailed and provided ARRO with my thoughts. I’m open to other ideas and thoughts. I hope the ABR thinks about the situation following discussion with ARRO and ADROP, but the current “no fault” stance begs to differ.

 

[RadOncG]

An article describing the resident experience with this exam and questioning it's utility was written and accepted on KevinMD. It will be published online and distributed through social media channels in 1-3 weeks. Writing emails to all those acronyms may be helpful but the outcome is that they will get some study guides out and it will be over.

The ABR responds to public criticism. If you want more answers from them in future communications then attach this article and ask for their comments. When it is published it will be important to comment and share on social media. This will increase the reach throughout the mostly physician community that follows his content.

Thank you to the test takers that have contributed to writing of the article. There is no reason to be scared into silence. The ABR answers to us, we do not answer to them.

 

[KHE88]

It is fantastic that KevinMD will publish this. This is a great start. Thank you.
The problem with a protest and our field is that everyone is so used to keeping their head down and not making waves lest they jeopardize getting their carrot dangling at the end of this 10 year journey. And once people are on the other side, they don't care anymore because they got theirs already.

I don't understand why Paul Wallner gets to act as the gatekeeper for us and judge us with his own personal opinions and biases about larger programs vs. smaller programs. How do we fix this? Where is the oversight? How do we protect against a surprise unfair exam from someone with an agenda? If he is speaking about this at ASTRO, I will be the one in the audience booing loudly. Hopefully you all will join me.

 

[firewicket]

I think the sooner everyone accepts that ARRO/ASTRO/the ABR doesn't care at all about you...the sooner you will accept these circumstances. Its not worth your anguish...just accept it and move on.

 

[RadOncLazers]

I think the sooner everyone accepts that ARRO/ASTRO/the ABR doesn't care at all about you...the sooner you will accept these circumstances. Its not worth your anguish...just accept it and move on.

Your post is completely useless. No field in medicine has these sorts of fail rates. Historically residents and professional organizations have forced change. My department is very active in fighting the situation. And I am not about to keep my head down as our field is driven into the ground.