Doctors 'Cheating' On Board Certifications 238
Maximum Prophet writes "After taking board exams, doctors have been routinely getting together to remember and reproduce as much of the exam as they can. These notes are then bound and reproduced. According to the American Board of Dermatology, the exams are protected by copyright laws, and any reproduction not approved by the board is illegal. While I have no doubt that the Board believes this, and pays lawyers to believe it as well, I don't think they understand copyright. Perhaps they should invest in better testing methods."
IT Certificate (Score:5, Insightful)
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Nah, they're protected by a very powerful union [uapd.com].
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Re:IT Certificate (Score:5, Insightful)
Uh, there's this thing called Residency, which is a big difference compared to IT work...
Re:IT Certificate (Score:5, Funny)
Hey man I was resident in my mother's basement for years to get this IT gig.
Re:IT Certificate (Score:5, Insightful)
Uh, there's this thing called Residency, which is a big difference compared to IT work...
Yeah, you get treated like children and work 80 hours a week and get little pay when doing residency.
IT interns get treated like slaves and workd 100 hours a week and often get no pay.
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I was lucky as an IT intern, I was unpaid but given $500 for gas for commuting. For the entire time I was working there. It comes out to about 9 cents per mile and I wasn't given any extra for driving I had to do on the job.
On the bright side, it was a small company so the president would bring in a case of Heineken to share with anyone else working late.
They had you drive on the job unpaid? (Score:3)
Lucky there was not a accident or stuff got stolen from your car http://it.slashdot.org/story/07/12/11/2144255/ohio-plans-to-encrypt-after-data-breach [slashdot.org]
Now having a unpaid intern driving there own car is a legal minefield for both sides.
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I was thinking you'd accept unpaid work if it was a massive company.. I don't know why you would accept that for being at a small company though. Hour-for-hour I got paid about 40% of what I do now when I was a student.
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I would think the opposite: a small company might give you something really meaningful to put on your resume, and a very personal recommendation when you go job hunting. A large company is generally going to have you run errands for coffee, and send a form letter if anything.
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Yeah, and we don't get the "prestige" of being called "Doctor".
Have you ever corrected them?
Comment removed (Score:4, Interesting)
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Now tell that to the young ITs today....
Re:IT Certificate (Score:5, Informative)
I'm not opposed to Doctors getting compensated well - I'm opposed to them knifing me in the dark.
A common occurrence - I go to a doctor who's performing a procedure. Before the procedure I ask for an estimated amount. Yes, I understand it can change. Yes, I understand my insurance must pre-approce. I go home, come back and have the procedure performed. After the procedure I ask for my FINAL BILL so that I can pay it. So, I pay the bill and go home.
NINE WEEKS LATER... I get a bill in the mail for 25... 50... sometimes more. There's always some "forgotten" thing that didn't get billed, or an insurance mistake. WTF? Did they not understand? They had insurance approval, they got paid right away. What's the problem here?
I won't pay them - we had a final bill and that's that. You don't get to gouge me a second time. I call them and inform them that my bill was final and paid immediately at great cost and sacrifice to other areas of my life.
If my auto mechanic did this to me I'd tell him off... but for some reason Doctors think they can. No no and no.
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After my wife's back surgery two years ago, we got a statement from insurance regarding her surgeon. He's great, did a good job, and was on our insurance because we made damn sure of that before we let him start cutting.
Then we got a statement from insurance regarding his "assistant". His "assistant" was the other doctor in his practice, helped during the three hour surgery, and wasn't on our insurance. They'd only cover him at 70% and with no "negotiated in-network discount" so we owed like $9,000 more
Re:IT Certificate (Score:5, Informative)
Your insurance company changes these prices each year, and does not make them available for ready viewing by physicians, as that is not to their advantage. Your insurance company also sets deductibles and copays, and doesn't tell us what they are or how paid up your are on them. When we try to call your insurance company to figure this out, we get put on hold for 20 minutes (just like you) and as often as not are told we need to fill out form 2204-09, available on their website hosted in North Korea, to get permission to access information about your particular plan in order to make some guess about how much you're going to owe based on the procedure we think you're going to need and the particular agreement your plan has with our office.
If your physician gets paid right away by your insurance company, s/he is truly blessed. The insurance folks have 30 days to mull over the payment, and then can contest this and that and claim the diagnosis code needs another procedure code and so forth, with several weeks turnaround each time on muddied fax; they have little incentive to pay promptly. I can assure you they make as many mistakes paying us as they do billing you. And then we get to send you revised bills based on their (often) capricious decisions.
When patients call our office complaining about a bill, my preferred response is typically "fine," since I'd rather not spend another 40 minutes on the phone with your insurance company asking why the $120 we charged to remove your pre-cancerous mole shouldn't be bundled into the $10 toenail removal we did 2 months ago, and the 3 pages of paperwork designed in Kyrgyzstan where I can try to justify our billing to some insurance company bureaucrat. So we can get the $43 your insurance company has negotiated the $120 procedure down to. For the work we already did. I expect if we made your auto mechanic go through this bullshit 20 times a day they might just kill themselves with an air compressor.
Re:IT Certificate (Score:5, Insightful)
Re:IT Certificate (Score:5, Insightful)
OECD data show that in 2008, the US paid 16 percent of GDP in total health care costs, public and private combined. This resulted in a life expectancy of 78.3 years, and the US is ranked 12th on the Inequality-adjusted Human Development Index.
Same data for Norway show that in 2008, we paid 8.5 percent of GDP in total health care costs. We spent half as much! But our lives are 2.5% longer (80.2 years life expectancy), and we are ranked 1st on the IHDI.
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Re:Cry me a river. (Score:4, Insightful)
The entire point is that they are not. The US "health" system is really an insurance system. Now do you see why the rest of the world is laughing at those idiots in the USA that got sucked in by the PR campaign from the insurance companies about doing a tiny bit to shift it back to healthcare again. Leave the doctors alone and complain to those in politics that over the years colluded with insurance companies to take health care away from them. Vote out your local idiot that was bribed to help keep the insurance profits high.
This is SO WRONG in SO MANY ways (Score:5, Informative)
I'm almost at a loss as to how to be informative on this post because it's so lacking in facts or actual observation.
1. Doctors are primarily (with a few notable exceptions like Kaiser-Permanente and the military health system) small partnerships of under 5 physicians. They don't run "big operations with high margins."
2. Hospitals are generally not-for profits (again some exceptions) with net excess revenues less the 5-7%, about the cost of capital replacement.
3. Doctors do expect compensation for the 4 years of college, 4 years of medical school, and 3-8 years of internship, residency, and fellowship, since they give up 7-12 years of post-college years of income generation for the same life expectancy. However, huge salaries for a few do not equate to massive salaries for all. Just like baseball players, a few get the big bucks, but many more play in the minor leagues. Check out the National Bureau for Labor Statistics data.
4. Some doctors make lots (neurosurgeons, for example), but then they also pay millions of dollars (YES, MILLIONS) of dollars in malpractice insurance because people expect perfection from doctors, not acknowledging how complex and variable human biology is.
5. The most complex part of the healthcare system is the insurance system, which is completely out of the control of the medical professionals.
6. AMA is not a union, has no collective bargaining rights, and has as its membership AT BEST maybe 10-15% of all physicians. It's a voluntary professional membership society.
7. The major evolving complexity in the state of healthcare in the US is the federal government, which through tax laws, federal mandates, and regulatory actions, have created a never-ending chain of requirements, complexity, and frustration. The decades long effort at vilification of the medical profession and poor financial management coupled with government regulation will give you increasingly lower quality of medical care delivered by less trained salaried employees.
8. On the plus side, technology can assist in improvement in the application of scientific knowledge to the delivery of care, but not if legislated and dictated by Congress and political forces.
The IT profession (at least NOT YET) doesn't have state regulated boards, mandatory licensing, bureaucratic payment policies, and direct government intervention in almost every aspect of your professional career.
captcha: digits (At least a triple entendre)
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Doctors... could you perhaps ask your billing office to do a statistical analysis on how much you actually ended up getting paid for various procedures?
Larger organizations will actually do this regularly, and there are actually consulting agencies that can do the analysis for small offices. For an example of some aggregate data:
http://www.medscape.com/features/slideshow/insurerreport [medscape.com]
There must be some positive benefit to working with the insurance companies or you would have found a better way?
Insurance companies have the customers captive. If you don't work with them, you don't get the patients in their pool.
The old fashioned style of solo private practice is gradually going extinct due to the overhead and lack of negotiating leverage vs. insurance compan
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In the United States, nearly every practitioner would be forbidden from charging for a weight/height/BP check unless we also determine you've got a blood pressure problem requiring some sort of treatment.
Similarly, to charge for most any office visit, the government and private payers require vitals (including weight/height/blood pressure) in order to bill for most visits —in addition to checking whatever else you're being seen for. There is no additional charge to check your vital signs. It's like
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For the CISSP you sign an agreement that bars you from doing this, and can be used as grounds for revoking it. I'd imagine other certs do something similar.
Simply signing a form agreeing not to do something doesn't mean that the agreement is in any way valid. I'd gladly sign a form giving away my rights to free speech. What are they going to do if I then break the agreement? They can't sue - the constitution where I am guarantees freedom of speech no matter what.
MD degree is to long and the school mindset may (Score:2, Interesting)
MD degree is to long and the school mindset may be to much drilled in to people. Going to med school do they really need a full 4 year BA with all the filler classes before med school? Why not 2-3 years and then Med school? Now I can see what that setting in a class room for years with lot's of tests and some stuff that you will never use can do to your mindsets. Testes become more about craning for the test then studying the full topics. Now some of this comes from poor tests and the other part comes from
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I want to go to a doctor who studied a year of molecular biology as an undergraduate. I don't want him to get his education on the job from the drug company salesman.
I believe in a liberal education. I also want a doctor who took a few courses in English, poly sci, economics, history, etc. I want a doctor who can write a coherent sentence and read a well-organized article. I want a doctor who knows when the American Medical Association is trying to put one over on them. I want doctors who know when their po
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I want a doctor who knows when the American Medical Association is trying to put one over on them.
That's easy: they always are.
I want doctors who know when their politicians are trying to put one over on them.
That's easy: they always are.
I want doctors to know enough about IT to understand that.
Here is the usual physician response to IT: if you're making our lives simpler, it's great. But if anything has to be done on the computer, it's probably just saving the hospital money by making doctors (who don't usually work for the hospital) do the data entry job that used to be done by a clerk (who did work for the hospital).
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The only reason I can see for wanting a premed studen
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Re:MD degree is to long and the school mindset may (Score:5, Interesting)
As a molecular biologist I have to ask: how would that matter? The MDs that have patients don't really need to be thinking about ATPases or the Michaelis–Menten equation. The MDs that are taking basic research and putting it into the field seem to be getting their PhDs which can't be easily faked. And the just regular PhDs are in theory doing the really basic research that involves knowledge of mobio, we don't go to med school or see patients.
Having gotten my Ph.D in the basic research wing of a major medical school, I can concur that MD's typically have only a vague understanding of mechanistic biochemistry, and that the Ph.D's designing future treatments have only a vague understanding of human physiology. Exactly how is this a satisfactory state of affairs?
If you were ill with some condition that presented in an unusual way, (say, a borderline metabolic deficiency), would you prefer your M.D. to actually be able to figure out on their own what's wrong with you, or just blindly follow diagnostic recipes they memorized from the New England Journal of Medicine?
The only reason I can see for wanting a premed student to take molecular biology is to add another level of selection to deter the weakest students from becoming doctors.
You are aware that intro molecular biology is now taught in the second year of any standard biology major, or sometimes combined with biochemistry in your third year? My wife is an ecologist and she took it. Pre-vets take it. Nurses take it in nursing school. Heck, my dentist took advanced biochemistry as well. So why are you against pre-meds taking it? You think a doctor doesn't need to be as capable as a nurse, vet, or dentist? It's not exactly quantum physics, and it's extremely useful since you may only get the abbreviated "molecular medicine" type of crash course in med school since they assume you already took it as a premed.
Interestingly, I've heard that the major that scores the highest on average on the MCAT is actually not premed, biology, or chemistry. Philosophy majors do the best on the MCAT. Granted, there's a lot of self-selection going on there, they probably make up at most 1% of the MCAT takers, and the MCAT is not necessarily an indicator of who will be a good doctor.
You can see a list of the topics covered on the MCAT below which covers (surprise!) molecular/cell biology and biochemistry. Unless the philosophy majors are cheating, they must have at least self-studied the material to score so highly, but more likely than not they took a course or two. I'm really puzzled what you are trying to prove here.
https://www.aamc.org/students/download/85566/data/bstopics.pdf [aamc.org]
Re:MD degree is to long and the school mindset may (Score:4, Interesting)
MD degree is to long and the school mindset may be to much drilled in to people. Going to med school do they really need a full 4 year BA with all the filler classes before med school? Why not 2-3 years and then Med school? Now I can see what that setting in a class room for years with lot's of tests and some stuff that you will never use can do to your mindsets. Testes become more about craning for the test then studying the full topics. Now some of this comes from poor tests and the other part comes from the tech the test idea.
Well, it wasn't always this way. Used to be, you didn't need a B.A. to enter medical school. Heck, you didn't even need to have any contact with real patients before you set up your own practice (i.e. no residency or clerkships). Medical schools used to be giant diploma mills that would take any paying student. Accreditation and board certification were a complete joke.
Then the civil war came along, many of those doctors were drafted to help the army, and to the horror of wounded soldiers everywhere, it soon became clear that your chances of survival were often *better* if you were not treated at all than if you were allowed to be operated on by one of these diploma mill graduates with no real qualifications.
Since then, all medical schools have required a bachelor's degree.
I entirely agree one could theoretically teach all the relevant pre-med material in 2-3 years, nothing is stopping anyone from simply finishing a B.A. a year early if they want. Most pre-meds I knew could have too, they just chose not to because they wanted to live a little before going to med school, or buff their resume and get into a really good one.
And sure, you can always argue pre-meds are being weeded out with only slightly relevant material (yes, orgo II, I'm looking at you). But, you know what? I aced that class without really understanding it and all it took was applying a few key chemical concepts and a fair bit of rote memorization. If you can't hack that, I don't want you interpreting my MRI scan or prescribing me an immunomodulator that might or might not interact with my heart medication.
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Apparently, you and Maximum Prophet [submitter of TFA], are not too familiar with the medical establishment.
It is one of the more blatant examples of both the 'Good ole boy network', and the ' We have always done it that way/It was good enough for me and my pappy' crowd in action.
Institutional mentality run rampant....
Re:MD degree is to long and the school mindset may (Score:5, Insightful)
Bullshit is entirely subjective. I know engineers who are focused on engineering to the extent that they know (and care) nothing about anything else. So maybe you have a point. People like that do the bare minimum work necessary to pass their out-of-major courses and retain nothing. Maybe it's not worth teaching some people anything but what they will most predictably use in their career.
But a doctor is more than a technician. He or she is in the business of caring for people. A one-dimensional engineer might be competent and get the job done, but he might lack in creativity -- I know plenty like that. A one-dimensional doctor doesn't understand his patients. He doesn't understand that two patients with the same disease may express themselves in very different ways or that two patients that *say* the same thing about their condition may be describing different systems. He may not understand the psychological aspects of living with disease. Etc.
The more a doctor knows about PEOPLE, the better it enables him to practice MEDICINE.
To some extent, the same is true of engineers and programmers. You might know how to perform a certain task, but where do you learn to understand what customers want? They sure to hell don't teach that in your engineering classes and it damn sure is important to know.
Re:MD degree is to long and the school mindset may (Score:4, Insightful)
One of my high school friends is a doctor. He finally finished his last year of school/residency/fellowship/whatever and got a Full Time Job around when we were both 32.
His job is to look at slides of liver cells and decide if they are cancerous. That's it. Now, I understand that could be a very tough decision, and a huge one in many people's lives, and I'm sure making that decision earns him a doctor's salary.
But... did he really need 15 years of education to make that decision? I know his last two years of education were in a fellowship just for liver cancer, and I assume some previous amount of his training covered cancer and livers, but all the rest is sort of wasted. Isn't there an option for those that want to specialize to learn less and be licensed for less?
I'm an electrical engineer. I know that I could never design a safe bridge (unless there's a good application note I could read). If engineering was like medicine, I would have been expected to go to school for 15 years to become an "engineer" capable of doing civil/electrical/mechanical/software/materials science/etc. and I would need to be paid drastically more to cover the staggering loan payments. But instead engineers figured out how to specialize and keep costs low.
Why can't doctors?
Re:MD degree is to long and the school mindset may (Score:4, Interesting)
Yes, but did the guy reading the slide HAVE to do all those other things?
I got an ECG a few years ago and it was interpreted by an MD (a cardiologist). No doubt a hospital generates so many of these in a day that you could easily employ somebody full-time to do nothing but interpret them. However, instead of giving somebody a year of training and turning them lose for $60k/yr they instead send them to a team of cardiology MDs each taking maybe 10% of the load and being paid $200k/yr easily.
No doubt the MD who read my ECG could have done a holistic evaluation of my situation and provided all kinds of recommendations, and they no doubt do that for other patients all the time. However, they weren't doing that for me. What they did do is render a few sentences of opinion purely based on the test, perhaps with a recommendation for follow-up. I'm not convinced that this couldn't have been done FAR less expensively by a technician.
Now, we'll always need generalists, and we'll always need the occasional House for the 0.1% of cases that truly boggle the mind. However, the problem with our medical system is that we make everybody a generalist and we don't triage cases well. Everybody who wants to gets to see House, and House is so busy that he probably doesn't get to spend adequate time on the cases that really do demand his expertise. I know a diabetic who was treated by a well-respected endocrinologist and it took the guy two years to get her blood sugars under control, and then only poorly with a bunch of side-effects. It took another two years to really get things working well, and in the meantime there were numerous cardiovascular complications (you name it). The problem was that the guy was so popular that he was overbooked, and he didn't spend more than a single 15-minute appointment per quarter dealing with her. So, he'd prescribe something, then review numbers 3 months later (maybe fasting sugars have dropped from 250 to 220), then adjust medications, and repeat. If the guy had handed things off to a nurse who followed-up one week after a medication switch they could have probably titrated her meds in a few months at most. I'm sure reimbursement structures don't help - doctors don't have much incentive to do things between periodic appointments unless you're in a hospital.
A triage-based system with less doctor involvement would greatly reduce costs and potentially increase access to care. A nurse who can check in on a patient biweekly is probably a lot more useful for the average patient than a doctor who can check in twice a year. Sometimes the simple stuff matters most when it comes to things like compliance and spotting problems.
Doctors are an important part of the system, but right now they're a one-size-fits-all solution.
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Your essay has three basic premises. All of which I disagree with: 1) Doctors caring for people, 2) creativity stems from education, 3) engineers are technicians (by extensions: technicians are uneducated fools).
1) A doctors job is to diagnose and correct my condition, if possible. I will agree to the extent that people do not always state their symptoms precisely, but I'm fairly certain that Shakespeare isn't going to boil "I feel nauseous" into nausea, vertigo, sour stomach, etc. You work with people, you
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Great. But I went to school to learn engineering to learn something specific, and to get a degree saying that i had a level of proficiency at it so that I could get a return on the rather large investment. I was not there to be well rounded, or exposed to the fine arts, that is someone else's agenda. If that someone else wants to pay my tuition, I suppose I'd have to accept it, but when asked for cash this person was mysteriously absent.
I'm glad your liberal arts have paid off for your PhD thesis and you ar
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you should view them as an opportunity to not only try and expand your capabilities and views, but also bring a fresh perspective to those fields that may end up being of use to others.
Except that I don't want to waste a colossal amount of time memorizing (and then forgetting) things that I likely won't even need. If it turns out I need it, I'll try learning it when the time comes.
As it stands, you have to pay for all of these classes, and they use up your time. Time you could be spending to learn more about the things that are the most important to you.
I'm not very worried that there is a minuscule chance that I may need these skills, or that they'll benefit me slightly. I don't see eith
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I'm all for forcing doctors into organic chemistry and ME's into thermodynamics. And, contrary to popular belief, as an EE I use electromagnetism all the time when drawing lines on schematics or devising solutions to new problems. In fact no part of a EE program taught me to draw lines, or even how to design hardware for reals, it was all theory. And bring it on. The technical portion (including the pure science) was what I went there for.
But most of that degree is pure bullshit, realistically forced on us
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That might have been true if there weren't such a thing as a residency. Residency is the true limiting factor in the amount of certified doctors in the workplace, not the board certification test. While there are a small percentage of doctors who go through residency and fail boards repeatedly, the majority pass without further incident... even without cheating.
On a slight tangent, what is a cause for concern is that doctors are retiring faster than they're being trained. With the Boomer population aging
that happens on all sort of examination (Score:3, Informative)
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This doesn't work for performance based for profit examination system. The oral on exams required experienced doctors to test and probe for knowledge weaknesses, in order to properly gauge the expertise of the new doctor.
For profit performance based tests are all about "BEING CHEAP". Here the glaring example is asking the exact exam question again and again, to cheap to even rewrite the exam or for example writing 10 to 20 times exam questions as required and randomly changing the exam within each exam p
From An Insider (Score:4, Interesting)
Speaking as an MD, and posting anonymously through more proxy jumps than you can count, I can tell you that the ABR is a disgrace.
They have elected to ELIMINATE the oral exams. Whats next, calling us providers?
Humans are not computer problems, and solving computer questions is not an appropriate screening method for certification.
Bottom line: Oral Examiners should be PAID, CAREFULLY TRAINED, GRADED and only the BEST kept year after year... like NFL REFS !
Of course, the overpaid ABR administration might* have to take a pay cut to achieve this.... AND THEREFORE, THIS WILL NEVER HAPPEN.
A DISGRACE UPON MEDICINE
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Speaking as an MD, and posting anonymously through more proxy jumps than you can count, I can tell you that the ABR is a disgrace.
They have elected to ELIMINATE the oral exams.
Did they give a justification for this? I can think of two reasons.
The first is cost, which you seem to blame, where the written exams are cheaper to administrate.
The second is CYA (Cover Your Ass), that for something like licensing, if someone complains about your decision (you fail someone, or you pass someone who later gets involved in a malpractice suit), it's a lot easier to defer blame to a written test. (of course they probably wouldn't admit this reason)
Mouth doctors and deaf doctors (Score:2)
They have elected to ELIMINATE the oral exams.
I thought oral exams were the whole point of, say, becoming a doctor of dental surgery. Even if (as I suspect) you meant the other meaning of oral exams, are oral exams offered in a sign language, or (as I likewise suspect) is hearing considered a bona fide occupational requirement?
Oral Examiners should be PAID
And I do so twice a year, so that I don't have to brush, brush, brush all the floors in Hyrule [youtube.com].
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The oral exams were available in ASL.
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A high school friend (not the one I mentioned in another post) is a doctor of internal medicine and is completely deaf. (Though he can read lips.)
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hm; arrogant and paranoid. yeah, you probably really are a doctor.
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I'm torn... (Score:2)
On the one hand I don't want doctors to cram for the exam or to "learn the test".
On the other hand, I've taken standards tests myself for technology subjects, and there's often a lot of inane questions that don't really apply to the actual day-to-day job.
I guess that many organizations are guilty of this. There are probably a half-dozen test-prep organizations for high school students, technical learning, non-technical government licensing, and the like.
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And they pay to use test prep materials sold to them by the copyright holder.
Bad teachers always seem to assume (Score:2, Interesting)
That if they just ensure they collect the exams at the end, and forbid copies, and forbid anyone talking about the exam, that they'll never have to write a new exam.
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A chem prof and an econ prof were discussing how to prevent cheating. The chem prof said she was having a hard time coming up with original questions every year. The econ prof said she just gives the same test every year - she just changes the answers.
What a racket!
this is a sign that the overall school / testing n (Score:5, Insightful)
this is a sign that the overall school / testing needs change and new ways to learn / test people. We need more apprenticeships / trades learning system and less end less classroom with test that people who can cram can pass and get rid of tests that have little to do with the real job.
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more apprenticeships / trades learning system
More than 80 hours/week in residency? Of that, no more than about 5 hours/week is direct didactic learning.
Why the scare quotes? (Score:5, Interesting)
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I was going to post the exact same things. If getting information about previous exams is cheating, it's cheating. The people designing a test get to define the parameters of what's cheating and what's not. On some tests you can use a calculator. Some tests are open book. For others tests you aren't allowed to look at previous administrations.
Now, the question of what's legal is a separate issue. You can cheat on an exam without falling afoul of the law. Depending on the exam, you could follow the ru
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If getting information about previous exams is cheating, it's cheating. The people designing a test get to define the parameters of what's cheating and what's not.
I'm sorry, but I disagree with you strongly there. The people administering the test do get to decide what is allowed and what isn't allowed in the examination room, during the test. That includes, as you point out, allowing or disallowing calculators, text books, or whatever else they wish to prohibit or allow. But that authority stops at the exam room door. What you do on your own time to prepare for the exam, or who you talk to and what you talk about after the exam is your own business. There are o
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If getting information about previous exams is cheating, it's cheating. The people designing a test get to define the parameters of what's cheating and what's not.
I'm sorry, but I disagree with you strongly there. The people administering the test do get to decide what is allowed and what isn't allowed in the examination room, during the test. That includes, as you point out, allowing or disallowing calculators, text books, or whatever else they wish to prohibit or allow. But that authority stops at the exam room door. What you do on your own time to prepare for the exam, or who you talk to and what you talk about after the exam is your own business.
I disagree - they are allowed to set the parameters of the test - it's a simple contract between the person taking and the organization giving the test. If they don't want previous exams to be leaked, then they have the right to say that violates the terms you agreed to to take the exam and is cheating. Of course, as the article pointed out, proving that is next to impossible.
There are of course exceptions to this rule pertaining to especially egregious conduct, like breaking into a professor's office before an exam to steal a copy, which is clearly cheating, but nothing like that was going on here.
I've taught at both the university and high school level, and the rule of thumb that is generally followed is that once an exam is given to a group of students, and they leave the examination room at the end, that exam becomes public information, and if we assume otherwise, we give some future students an unfair advantage over others. I photocopy and hand out previous years exams (which I have created) to students, both as a study aid, and as way to level the playing field. I think these medical exams should be run the same way, in the interest of fairness.
While I agree with what you say here, the point is you have the right to decide the testing parameters. I worked for an organization
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And I don't see why the tests themselves can't be copyrighted. The answers and ideas might very well be ideas and facts, but the questions used to illicit said answers can be unique/original enough if sufficiently verbose to qualify.
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I thought prohibiting students from sharing past copies of tests was a standard and acceptable method. Is it because they are using copyright to attack the practice?
This is news to me. Maybe it's different here in Australia, but it's common practice for universities* to make the last decade's worth of exams available to students. Admittedly they are under copyright and not publicly accessible, but that true of most of the course content. It's rather beneficial as well, since hey constitute the main form of revision for most students once their done reading through their notes. Most lecturers even spend the last lecture or two going over the answers to the previous year
Rote learning is the tragedy we will always face (Score:5, Interesting)
The American method of 'learning' is mostly rote learning. This does not help. As Einstein once said, "Imagination is more important than knowledge."
How shall we as Americans be able to steer our future when what we mostly test is the ability to cram? As a former educator, one of my best times in class was when a student was 'teaching' me. Even when they were wrong, the dialogue enriched both of us and for the student, it was invaluable.
Multiple choice questions make matters worse. No wonder foreign kids beat us in math and science. It's not funny at all.
I had a chance to teach a group of refugees from an African country and it was amazing to see how they approached a problem. While our Americanized kids reached for their calculators, these kids internalized the problem in their heads, then wrote down the range of where they thought the answer would lie, then solved the question. 100% of the time, they were right.
I will ask my doctor what she thinks about this issue when I see her in a fortnight.
Re:Rote learning is the tragedy we will always fac (Score:4, Insightful)
in most subjects i would agree with you, but i don't think i would want an imaginative doctor (at least not at the expense of a strong level of basic competence). some things damned well should be done by rote, based on centuries of hard-won experience.
some people do have to come up with the new stuff, but most doctors don't and shouldn't be trying.
Re:Rote learning is the tragedy we will always fac (Score:4, Insightful)
The American method of 'learning' is mostly rote learning
Overall? No. I'd say the US has been much better in this respect than many other countries. (Though "No Child Left Behind" has done its damndest to screw that up by encouraging teachers to teach-to-the-test.) However, it is like this for premeds, and that's what matters!
Why? The stakes are too high. Push up the stakes high enough, and people don't think; they memorize. Indeed, when faced with very high incentives in psychological studies, people bomb IQ tests. You can't think when something as important as a career as a doctor is on the line. (That's why classes need to be exactly as hard as necessary -- and no easier -- but also no harder!!)
It's also how biology is taught in college. "Go memorize this arbitrary chemical pathway. No, we won't talk about 'why.' Yes, you can forget it later. We all know this class is just for weeding, anyway." Partly because it's all premeds. (And partly because there's no helping the fact that, compared to physics, biology is much more about facts than principles. It's messier. Such is life.)
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The American method of 'learning' is mostly rote learning
Overall? No. I'd say the US has been much better in this respect than many other countries. However, it is like this for premeds, and that's what matters!
I have to disagree with you here, TerranFury.
It's not just premed that is taught in this fashion, it's everything up to and including premed.
The US education system was specifically designed to prevent the development of critical thinking skills and logical analysis.
Unfortunately, by the time students reach premed/grad school it is too late for them to start developing these skills.
You gave a perfect example yourself,
It's also how biology is taught in college. "Go memorize this arbitrary chemical pathway. No, we won't talk about 'why.' Yes, you can forget it later.
This type of education is not teaching the student anything other than how to
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Oh, to have mod points...
I don't think I'd be where I am now if I didn't excuse myself from group learning at primary and go do my own thing (which was usually lots of reading, playing with numbers, craft materials or involved the computer in some way). When everyone around me is stuck for what to do next, I'm already nearly finished. I'm glad I was one of the very few students who had both the brass neck and the foresight to do this instead of sitting there and chanting out multiplication grids to 12...
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I went to school in Austria (Alps, not kangaroos) for a year after having grown up in the US school system (Wisconsin, so a good part of it), and I have to say I disagree with your assertion that the US is more about rote learning than Europe. And my wife (Hungarian) was amazed at how much better the university experience (grad school) than anything she saw at home. And her limited experience with grade schools really amazed her at how interactive the classes were.
It is not that we here in the US fall back
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Teachers Colleges are badly organized, and heavily weighed towards liberal arts. So of course their graduates tend to have less skills in math/science. There are a lot of people in those organizations who want to do better, but the spark still has not been lit of a renaissance there.
Canadian here, so I'm not sure if this applies to the US, but here our teachers' colleges select largely based on university grades with no consideration to major. At the university I went to 50% was a pass pretty much school-wide, but most science/engineering students required a 60-65% minimum average to stay in their program, while most arts students required a 75%, and the class averages reflected this. That is, the arts averages were about 10-15% higher than the rest of the school because the require
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#2 I have normally seen that applied to college professors. I haven't seen it applied as much to lower-level teachers.
#3 That is the key.
#5 Most conservatives I know, would STRONGLY disagree here. Maybe disagree with Evolution, but don't discount ALL science because of that. Especially the ones that are atheists. I would say the fundamentalist nut-jobs fall under your broad stroke, but not main-stream social conservatives.
# 6 You write what you know... With a very limited scope... well, you see what happens
Re:Rote learning is the tragedy we will always fac (Score:5, Interesting)
The American method of 'learning' is mostly rote learning. This does not help. As Einstein once said, "Imagination is more important than knowledge."
Really? As a Canadian living in Romania, I have to strongly disagree. The education system here appears to be heavily based on rote learning (much moreso than I saw in Canada or attending American schools in my childhood). The folks I have hired have had excellent imagination, in spite of, not because of, their education (and have generally been the ones who skipped a lot of classes at university and taught themselves the required material).
That said, I previously worked (in Canada) as a physics researcher in a hospital, and we would regularly "joke" about the MDs not being "real doctors" (in contrast to how most people view PhDs), since their main skill appeared to be rote memorization. (See also Richard Feynman's story about his diagram of cat anatomy when he gave a presentation to some med students.) Of couse, as a sibling post says, most medicine comes down to reproducing what is already known (as it should be).
I now look at doctors the way I look at lawyers. To get in, you don't need to be creative (and in fact, you probably shouldn't be, or should suppress it until you've already proven yourself), you just need to know the existing "case law" very very well. Mostly, your job is to identify stuff that has been seen before (taking into account quite a lot of subtle data) and go directly to the most successful known solution. If you want to be imaginative as a doctor, you can go the MD/PhD route (which, in my opinion, makes you a superstar), I suppose, or run the risk of losing your job by doing something no one else has done before (and hence is not "approved").
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Rote learning used to be very important. Knowing something could save a lot of time looking things up, which is important when you're a doctor in an emergency room ("it it one leach or two to cure whooping cough?"). And testing knowledge is much easier than testing ability so guess which one got tested. These days finding information quickly is a solved problem so keeping raw information in your head is less important (although that's not an excuse to keep your head empty :)
I'm curious why you are a "former
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well we need tech trades to take the pressure off (Score:2)
well we need tech trades to take the pressure off of the old higher education system.
Now the tech schools are a good start but they need to be better / offer apprenticeships.
I say a real apprenticeship and not just interns no a mixed classroom / apprenticeship system. with a real counting education system that higher education is poor at offering.
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Why did you choose the name Joe_Dragon? Is it because "Idiot Obsessed With Apprenticeships" was already taken?
Why not an NDA? (Score:4, Insightful)
Copyright is a dumb way to protect a test.
A much simpler and easier way would simply be for the AMA to have test takers agree to a very simple NDA. You agree not to share specific questions from this test with anyone. Covers the actual problem, is enforceable, doesn't require twisting copyright law in crazy ways. What's the downside?
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Because under an NDA you have no control over the information once it's leaked. An NDA only lets you punish the person who leaked it; the person they leaked it to is free to do whatever they want with it because they haven't signed an NDA. So if someone leaks it and does a halfway competent job in the process, the leak will never be traced back and other parties will be to pass around the information without restriction.
A copyright on the other hand allows you to reign in on the information and whoever has
Summary fails copyright law (Score:5, Insightful)
Mod parent up. (Score:2)
> /. needs to avoid publishing nonsense...
Half the articles would vanish (and 3/4 of the comments).
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Not so sure about their "airplane notes" reasoning (Score:4, Informative)
The first 2 times I ran into this, at about the same time, was for FAA & FCC (Federal Aviation Admin., Fed. Comm. Comm.).
You used to have to have at minimum a 2nd Class Radio Telephone license from the FCC to be a broadcaster in radio. You could actually have a 3rd class only to talk if the station had someone else on duty with a 2nd class to actually run the equipment. The stations often didn't want to pay for a 2nd person with the higher level license, so...
For FCC testing back in the 60s & 70s, there used to be outfits that came to cities periodically that would guarantee passage after a weekend course (12 hrs per day) during which you would be taught the answers to the test questions. The way they got the answers is what is talked about here. It had likely been going on for some time already when I found out about, but the 70s is when I was working on my FAA & FCC licensing, so that when I knew about it.
There was the same thing for FAA written tests and I seem to remember hearing that the FAA stuff came first. This may be the actual reason for calling them "Airplane Tests".
A more global, widespread issue (Score:5, Informative)
This also happens for NCERT, Medical Entrance Examinations, Engineering Entrance Examinations among several others. No Legal action has been taken in the recent past to stop such recollection, despite the fact that it merely promotes rote learning, textual recall or fundamental pattern matching. Interestingly, in India, no one has referred to this practice as cheating, although it is. It is only in the past two years that Computer Aided Tests which shuffle questions and stagger timelines are being introduced to avoid this practice. Enforcement of legal sanctions in India especially across Educational boards, Varsities and Corporate Testing groups have not been easy.
Question papers, by themselves for any test are never copyrighted officially. Most Board question papers in India, Pakistan, Sri Lanka, Bangladesh and Nepal do not come with any Copyright notices. Boards and Academic members have until recently been in the dark about 'Copyright Law' and have little idea as to how it is enforced. A vast number of books published are not registered for copyright, nor do they have ISBN assigned to them.
Part of the issue is the inability to enforce exclusivity on 'recalled' or 'reproduced' testing material. Another part is ignorance of the full extent of 'Copyright Law' itself, though this is significant in nations like India and China where their implementation has only now begun.
As an RN, I can tell you.... (Score:3)
"How did you answer that question about disseminated intravascular coagulation?"
"Ohhhhh".
If there was something of note, one of us would make a note about certain questions where our line of thinking was incorrect to go over later in study group. This sounds more formal than what we did, but I don't think there is really anything different about it aside from the level the MD students take it to, then again, with the level of knowledge required, a couple of notes here and there probably just doesn't cut it.
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If the exam questions are any good, then this is good preparation and has a good learning effect. Nothing wrong with that at all.
Before you go nuts... (Score:5, Informative)
When a physician is described as "board-certified", that means that s/he has taken a specialty examination given (in almost all cases) by a member of the American Board of Medical Specialties. In some fields, this only has a written component; in others, especially surgical fields, oral examinations are standard as well as the writtens. These examinations serve to certify that you know that particular specialty. They are not required to practice medicine, and physicians are not limited by law to practice only in areas of medicine for which they have received formal training. Insurers providing coverage and hospitals allowing privileges outside of your area are a different matter, but as a matter of law, a general-practice MD can perform neurosurgery in his office.
A permanent, unrestricted medical license in the US is predicated on passing the US Medical Licensure Examination Steps 1, 2, and 3 (unless you're an osteopath and you take the COMLEX, but that's a small number of people and in any case the principle is very similar). Furthermore, you will have to do at least an internship (the first year of residency after medical school) in order to be granted a permanent, unrestricted medical license. (Graduates of non-US/Canada medical schools may have to do two or even three years of residency.)
So yes, people do get together and discuss things. In particular, memorizing questions serves the purpose of identifying what the question-makers think is important. This is not always trivial; as medical specialties have moved their written examinations onto computers in recent years and K-type (Choose A if 1 and 3 are right, B if 2 and 4 are right, C if 4 only is right, D is 1, 2, and 3 are right, and E if all are incorrect) questions have been eliminated, there has been a significant influx of new questions from younger examiners. Like all examiners, they tend to submit questions from their own interests rather than just covering a broad enough base to be sure that the examinee is capable of practicing safe medicine. The line between pass and fail has to fall somewhere, and if you're academically relatively weak, knowing the likely subject matter (or the likely rare association between two things) can make the difference between pass and fail.
The USMLE 1/2/3 all have prep courses and study books with sample questions, just like the SAT. If you don't study how the questions are asked, you are unlikely to do your best. However, the base of knowledge is just immense - Step 3 considers anything that you might encounter in a general practice to be fair game. To pass the test, you're going to need to know the stuff.
The specialty board examinations don't take anyone who couldn't 1) get a residency in that specialty and 2) pass their way through it (which is not a given - people fail out of residencies all the time). Dermatology, the subject of this article, is populated exclusively by people who gradated in the top 5-10% of their med school class. Their intelligence and drive to study isn't really in question. What's happening is mostly a matter of pride; even though only a vanishingly small percentage of people who take the test will fail, it is incredibly embarrassing to be the one who does.
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To be clear: the ABMS specialty board examinations are completely different from the "medical boards" (which is how most laymen refer to USMLE Steps 1/2/3, because those are exactly analogous to the nursing boards, bar exam, CPA exam, etc. - they are a prerequisite for practicing in the field rather than a certification of special further training).
Cheating on Board Cert (Score:2)
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Indeed. But looking at old exam questions is not cheating at all, it is reasonable preparation. Any examiner that does not take this source of material into account is lazy and irresponsible and should be fired.
I don't think submitter understands copyright (Score:4, Insightful)
Paraphrasing is paraphrasing. Copying is copying. And tests are valuable only when they test what they are designed to test, and not rote memorization(*)
(*) Apologies to any pharmacology majors who have to memorize more than most people memorize in their life.
This is standard (Score:2)
Any halfway intelligent students in any field will contribute to such efforts. The task of the examiner is to know this and make new exam questions every time. In fact, as an examiner, I have bought such collections to get an idea what kind ow questions and difficulty level the students actually expect. Very helpful.
Now, that said, examiners that do recycle exam questions unchanged or, worse, use "test-banks" from textbook makers are lazy scum and should be fired.
Simple solution (Score:2)
...those with the best scores have the best opportunities. This means they can't have vastly varying tests or the results would vary creating an unfair advantage.
There is a very simple solution to this: make the test pass or fail. If medicine is similar to research then, once you get over a certain level of competency it is motivation and interest that is most important not whether you scored 80% or 90% on an exam.
Even if you want to keep public scores you can build up a large question bank of previously asked questions for which you know the difficulty and then randomly choose a few of these questions to put in an exam, along with new questions. This lets you
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We have a competitive application system in the US by which residency slots are allocated to medical students. Just as there are more applicants to med school than there are admission slots, there are more applicants to highly-competitive specialties than there are slots. Having clear, nationally-comparable test scores is much more meritocratic than reserving all the [CHOOSE HIGHLY COMPETITIVE SPECIALTY HERE] slots for graduates of the top ten med schools.
But it has been shown time and time again that (a) test scores have uncertainties in their results by at the very least a few percent, so there is no justification in ranking a 91 ahead of an 88, for example, and (b) test scores are only loosely correlated with future success and overall abilities once beyond a certain minimum - the people with 75 are not significantly less successful than those with 90s. Filling the [SPECIALTY] slots based solely on test scores does all a huge disservice by filling those s
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It may be binding contract law, but it's still simply not contract law "as well" (as well as copyright, I infer, since that's what the article summary says). "Something written down is involved" is not the same as "copyright is involved". "Somebody made notes we don't like" is not the same as "Sombody violated our copyright", etc. The problem here seems to be that one type of law may be being broken, but the exam people are hollering about a completely different type of law. For just one, any contract is pr
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Binding maybe, but it's a contract of adhesion. Contracts of adhesion are not automatically invalid, but you generally need to make a very strong case for them if you want them to stick in court. Of course, I am not a lawyer.
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I also find that old exam questions make good exercise questions, so not all the effort I put into the exam questions is wasted. Creating new exam questions every time is a lot of effort, but it is effort that must be spent in order to have reasonable exams. Looks to me the problem here is lazy examiners, not anything else. Fire them, but don't blame the students for doing things the right way.