The revolt against ABIM and MOC

[Kakoy]

So, I was a a dinner last night and many of the private practicing physicians were talking about this current question about MOC and abim’s attempted expansion. Many of the private Rheumatology is pretty scathingly about it. Just wondered what everyone’s thoughts were.

I feel like this is the similar to the step CS thing ‘revolt’ which never had much momentum. This looks more promising.


www.newsweek.com/abim-american-board-internal-medicine-doctors-revolt-372723%3famp=1

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[Crayola227]

well of course a revolt led by fully licensed attendings who have completed an accredited residency program and likely are already credentialed wherever they are working, are likely to be more successful than students

I don't know how much more successful, but yeah

students can't get licenses without Step 2 CS, and changing that will be a hurdle

technically there's places that will hire attendings who are *just* BE

 

[Bobblehead]

That article is from 2015. The ABIM caved and the practice improvement requirements are still "suspended". There is now the option to do a knowledge "check-in" every 2 years that's open book or the 10 year secure exam. I think there was also some rumblings of being able to use resources during the exam such as Uptodate but that's not there yet either.

Regardless, unless there's a greater push for competition it's unlikely the ABIM will go away, there's just too much money at stake.

 

[Raryn]

technically there's places that will hire attendings who are *just* BE

Every place will hire attendings who are "just" BE. There is no employer I'm aware of who requires board certification to be hired. Otherwise new grads couldn't get jobs for six months until their results were out.

That said, many places will fire you if you dont get it within a reasonable time period. Three or five years is common.

The other caveat is that BE status is time limited. Without passing the test, 7 years after residency graduation you are no longer eligible to take it without repeating a year of residency. So at that point you're neither BE nor BC, and blocked from most of the nicer jobs.

 

[DoubleBogey]

That article is from 2015. The ABIM caved and the practice improvement requirements are still "suspended". There is now the option to do a knowledge "check-in" every 2 years that's open book or the 10 year secure exam. I think there was also some rumblings of being able to use resources during the exam such as Uptodate but that's not there yet either.

Regardless, unless there's a greater push for competition it's unlikely the ABIM will go away, there's just too much money at stake.

It’s uptodate- you can use throughout the knowledge check in exam

 

[jdh71]

Yeab ABIM got reasonable. No one had time for "practice improvement crap" and I suspect that will never come back. I'm currently fine with MOC especially since they starting counting the CME you get at accredited meetings towards your points. I wasn't about to spend extra time then doing ABIMs additional hours of nonsense. Now my CME is good for both my MOC and my state licenses. I'm going to try the every two year thing I think and see how it goes. I think I'll prefer that a big test every 10.

 

[DrMetal]

It’s uptodate- you can use throughout the knowledge check in exam

We used to have an old saying in college, "open book means open @$$"....ie, the professor would make the questions that much harder, or the test that much longer, so you didn't really have time to look up anything. You either new it or your don't.

So I ask: exactly how much time--and what's the utility of--do you have to look up something (in U2D, or any other resource for that matter). If you have roughly 75-90 seconds per question, 1/2 of that is spent reading the question and taking in the information. Another 1/4 of that time is spent looking at the answer choices and just thinking. What does that leave you with, ~20 seconds to look up something in U2D? Does that really help?

 

[Raryn]

We used to have an old saying in college, "open book means open @$$"....ie, the professor would make the questions that much harder, or the test that much longer, so you didn't really have time to look up anything. You either new it or your don't.

So I ask: exactly how much time--and what's the utility of--do you have to look up something (in U2D, or any other resource for that matter). If you have roughly 75-90 seconds per question, 1/2 of that is spent reading the question and taking in the information. Another 1/4 of that time is spent looking at the answer choices and just thinking. What does that leave you with, ~20 seconds to look up something in U2D? Does that really help?

Effect of Electronic Resources on Examination Performance Characteristics | Annals of Internal Medicine | American College of Physicians is the results of the assessment of open book. It takes significantly longer but reportedly acts just as well to discriminate between good and bad test-takers if not better.

 

[rokshana]

We used to have an old saying in college, "open book means open @$$"....ie, the professor would make the questions that much harder, or the test that much longer, so you didn't really have time to look up anything. You either new it or your don't.

So I ask: exactly how much time--and what's the utility of--do you have to look up something (in U2D, or any other resource for that matter). If you have roughly 75-90 seconds per question, 1/2 of that is spent reading the question and taking in the information. Another 1/4 of that time is spent looking at the answer choices and just thinking. What does that leave you with, ~20 seconds to look up something in U2D? Does that really help?

you get 2 minutes per question on ABIM board exams, so time is not really the issue.
and utilizing U2D is far more realistic of how we now practice...the goal is no longer how much info can you memorize...there is simply too much that changes too fast...and if you have to look up every single question, well then you probably should not have sat down to take that test...

I was involved with the testing the ABIM did with the open book test vs the std and overall I didn't feel the need to use U2D, but it helped with those "what the HECK??" questions that they put on there (and pretty much for me any derm pix i looked up!).

 

[DrMetal]

I was involved with the testing the ABIM did with the open book test vs the std and overall I didn't feel the need to use U2D, but it helped with those "what the HECK??" questions that they put on there (and pretty much for me any derm pix i looked up!).

So, could you roughly quantify, for what % of the questions did you use U2D? And when you did use U2D, did you find yourself getting solid answers for those "what the heck" questions, or were still asking yourself "what the heck" despite looking it up?

you get 2 minutes per question on ABIM board exams, so time is not really the issue.
and utilizing U2D is far more realistic of how we now practice...

2 minutes is still not a ton of time. Are the questions harder in the open book version?

More realistic of how we practice?! If they want to get truthfully realistic, they should ask us questions about SNF vs Hospice placement issues, in a patient that has no medicaid/medicare.

 

[Raryn]

2 minutes is still not a ton of time. Are the questions harder in the open book version?

I finished each block one hour early on the real thing. If you gave me uptodate access, I might have finished only 30 minutes early.

 

[gutonc]

I finished each block one hour early on the real thing. If you gave me uptodate access, I might have finished only 30 minutes early.

This. I left the exam room 2 hours early for the IM boards and almost 3 hours early for the Onc boards. Passed both comfortably (although IM less so). I had time to find the primary literature supporting each answer via PubMed, nevermind using UpToDate.

 

[rokshana]

So, could you roughly quantify, for what % of the questions did you use U2D? And when you did use U2D, did you find yourself getting solid answers for those "what the heck" questions, or were still asking yourself "what the heck" despite looking it up?



2 minutes is still not a ton of time. Are the questions harder in the open book version?

More realistic of how we practice?! If they want to get truthfully realistic, they should ask us questions about SNF vs Hospice placement issues, in a patient that has no medicaid/medicare.

i'm not one of those people that remember the details after taking these kinds of tests...but i probably used it more than i would have if i was taking the real thing...didn't study for the Mock test, but even then i don't think i used it more than 20%?
2 minutes for the questions is a lot of time...i think i was done with at least 2 hours left over when i sat for the real exams.

 

[PlutoBoy]

The ABIM test is an easy and fair test. You shouldn't need to look up the answers to more than 10% of the questions.

I was amazed by the simplicity of some questions (choose a HTN agent or patient has BPH pick a drug).

I didn't study for it and passed very comfortably.