January 18, 2012

CNN: Many docs admit to cheating on radiology boards

Daily Briefing

Many physicians nationwide have cheated on the radiology board certification exams by memorizing test questions and providing those questions to others taking the test, according to a CNN investigation.

To become board certified, residents must pass two written tests and one oral exam during their five years of residency training. According to CNN, half of the exam is the same every year, while the other half changes. 

Although radiology residents are required to sign a document that prohibits them from sharing test materials, many contribute to "sophisticated banks" of recall questions that provide that year's test questions to future test takers.

The American Board of Radiology (ABR) considers contributing to and using the recall banks cheating. "Accumulating and studying from lists of questions on prior examinations constitutes unauthorized access, is inappropriate, unnecessary, intolerable, and illegal," says ABR Executive Director Gary Becker.

For its investigation, CNN interviewed dozens of radiology residents who had promised to memorize certain questions and record them after the exam. CNN obtained at least 15 years' worth of recall test questions and answers, which were available on a radiology residents' website and on a shared military computer server.

Some professors in the past have encouraged the use of recall questions to study for the test, CNN reports. After failing one of the written radiology exams, Army captain Matthew Webb's program director at the San Antonio Uniformed Service Health Education Consortium told him to use the recall questions to pass the test. Webb filed a complaint about the recalls, which launched an ABR investigation into the practice.

Although ABR considers the practice cheating, many radiologists consider the recall questions a "gray area." Radiologist John Yoo says the recall questions are used primarily as a study guide. Meanwhile, radiologist Joseph Dieber says the test itself makes the recalls necessary. "Part of the problem is the test and the questions that they ask," he says, noting that "some of the questions are so obscure, that unless you know that they like to ask questions about that topic, you're not going to study it."

ABR revises exam to reduce cheating
In response to the widespread use of recall questions, ABR is adopting a new testing procedure that relies more on concrete skills testing and less on memorized facts. According to an ABR fact sheet, the new board exams will "assess the doctors' abilities to actually interpret imaging studies and perform image-guided procedures." The new questions will be drafted by radiology experts. The test will continue to include some of the older test questions.

In addition, the new procedure eliminates the oral component, which had been criticized for being too subjective (Zamost et al., CNN, 1/13; Walker, MedPage Today, 1/17).

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