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Apologies for Thinking Boards Were Logical

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  • #16
    Originally posted by G View Post

    wow, that is a pretty big drop by organized medicine if it truly not being followed (in my specialty, we do a lot of behind the scenes stuff that doesn't make a very good story until things are either done or looking ominous). my knee jerk response was "let them take breast and the associated liability" but I know that misses the point.
    They will take it until a malpractice suit. Then they turn into a pumpkin who doesn’t know anything with a joke malpractice coverage. The lawyers will hone in on any docs involved including their primary because that’s where the money is.

    “Well doctor why did you allow your patient to have their mammogram interpreted by an incompetent boob?”

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    • #17
      It is, and worse all boards do it differently because it makes sense. In the end almost everyone who takes them passes, and it means nothing regarding practices going forward, everyone is on edge for the collection period and plays to the test so to speak...but this is the game.

      The game is of course regulatory capture.

      At least there is a transparent scoring system here, I've never even heard of such a thing, our boards barely instituted a script recently to keep examiners on track and stop them from just skewering examinees for no actual useful info and wasting time.

      Oral boards are a total farce. They sound like an appropriate thing but the correlation between passing written at some percentile score and orals is like 100%. Further, it brings into play a bunch of interpersonal dynamics that can really affect things that have zero to do with what you did.

      Our board doesnt even let someone in your own state be an examiner, cuz we cant be trusted to not sabotage the competition (and its a good rule because we cant).
      Last edited by Zaphod; 08-16-2020, 07:27 AM.

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      • #18
        Originally posted by zlandar View Post

        They will take it until a malpractice suit. Then they turn into a pumpkin who doesn’t know anything with a joke malpractice coverage. The lawyers will hone in on any docs involved including their primary because that’s where the money is.

        “Well doctor why did you allow your patient to have their mammogram interpreted by an incompetent boob?”
        Nice choice of words

        Comment


        • #19
          I’m not sure why there’s hate for boards in general. I took the radiology oral boards, passed them and moved on. It was sort of a rite of passage in some ways. It also made you study like a motherf8cker for months cause you didn’t want to look like an idiot to the examiner. Overwhelming majority did just fine.

          It seems to me, the right and responsibility to practice medicine is granted by the state, not the boards. But the states depend on the boards to sort of tell them who is competent. So having the boards is a good thing for those who want to ‘protect the turf’. Otherwise, anyone with some brain can learn to do medicine and ask the state to grant them a license. So what the process is a little vague or there is lack of transparency. Maybe it isn’t wise to let everyone in the world know the process. It isn’t like the can somehow tell just the physicians. If they tell the majority of the physicians, that’s basically telling the whole world. Just like we don’t need to know all the ‘black ops’ the government does to protect all of us.

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          • #20
            Originally posted by STATscans View Post
            I’m not sure why there’s hate for boards in general. I took the radiology oral boards, passed them and moved on. It was sort of a rite of passage in some ways. It also made you study like a motherf8cker for months cause you didn’t want to look like an idiot to the examiner. Overwhelming majority did just fine.

            It seems to me, the right and responsibility to practice medicine is granted by the state, not the boards. But the states depend on the boards to sort of tell them who is competent. So having the boards is a good thing for those who want to ‘protect the turf’. Otherwise, anyone with some brain can learn to do medicine and ask the state to grant them a license. So what the process is a little vague or there is lack of transparency. Maybe it isn’t wise to let everyone in the world know the process. It isn’t like the can somehow tell just the physicians. If they tell the majority of the physicians, that’s basically telling the whole world. Just like we don’t need to know all the ‘black ops’ the government does to protect all of us.
            I think the hate is there for the same reason it's there for MoC. It's a money grab. I would argue that board transparency and government black ops aren't in the same universe.

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            • #21
              I dunno, I have both opinions of oral boards. Part of me thinks it's dumb and not realistic of actual practice. Some say it's designed to just make sure you're not dangerous. Also, despite all the check marks you're supposed to hit or say, it's still potentially subjective depending on the examiner. I was supposedly talking to someone on reddit that gave oral boards. I mentioned the possible use of retention sutures for a difficult closure about some random thing. They then said that if anyone ever mentioned retention sutures that would be an automatic fail of the oral boards which is pretty dramatic.

              On the other hand, one of my friends was nice enough and squeaked through residency after being held back a year. I wouldn't let them operate on my loved ones and know they wouldn't pass boards and is doing something else now. So without something to screen candidates, if they wanted to, they could've been out there taking general surgery call and possibly operating on your loved ones until hospital administration catches on.

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              • #22
                If you look at the “scoring system”, very little weight is given to the skills necessary to actually being evaluated. A broken finger, did you treat it properly and have the skill demonstrated to fix it.
                A crappy surgery can get a great score. Great job on the health history and the consent was signed. It moves (kind of and did not get infected). C at best. Congratulations, you are now certified. Little of the scoring is based on measuring how skilled of a hand surgeon are you. I was simply surprised at the scoring system used. The plus is, at least they have results of actual surgeries included. Saving grace.

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                • #23
                  Originally posted by Nysoz View Post
                  I dunno, I have both opinions of oral boards. Part of me thinks it's dumb and not realistic of actual practice.
                  What do you mean? The first thing I think of when a trauma rolls into the ED is 'I wonder if their tetanus is up to date?'.

                  Originally posted by Nysoz View Post
                  On the other hand, one of my friends was nice enough and squeaked through residency after being held back a year. I wouldn't let them operate on my loved ones and know they wouldn't pass boards and is doing something else now. So without something to screen candidates, if they wanted to, they could've been out there taking general surgery call and possibly operating on your loved ones until hospital administration catches on.
                  That's on the residency. A residency should be a good enough gate keeper to discern those who can practice independently and those who simply cannot. Taking a written test with relatively outdated questions and an oral exam that is basically trying to hit subjective checkmarks is not what I want to screen doctors.

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                  • #24
                    Thank goodness IM and my subspecialities don't have this nonsense called oral boards.

                    Comment


                    • #25
                      Originally posted by CordMcNally View Post

                      That's on the residency. A residency should be a good enough gate keeper to discern those who can practice independently and those who simply cannot. Taking a written test with relatively outdated questions and an oral exam that is basically trying to hit subjective checkmarks is not what I want to screen doctors.
                      I agree it should be on the residency, but unfortunately all residencies aren't the same. Graduating residency/passing boards doesn't make a safe physician either though. I'm sure we all know some board certified docs we wouldn't let touch/see our family unfortunately.

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                      • #26
                        Originally posted by STATscans View Post
                        I’m not sure why there’s hate for boards in general. I took the radiology oral boards, passed them and moved on. It was sort of a rite of passage in some ways. It also made you study like a motherf8cker for months cause you didn’t want to look like an idiot to the examiner. Overwhelming majority did just fine.

                        It seems to me, the right and responsibility to practice medicine is granted by the state, not the boards. But the states depend on the boards to sort of tell them who is competent. So having the boards is a good thing for those who want to ‘protect the turf’. Otherwise, anyone with some brain can learn to do medicine and ask the state to grant them a license. So what the process is a little vague or there is lack of transparency. Maybe it isn’t wise to let everyone in the world know the process. It isn’t like the can somehow tell just the physicians. If they tell the majority of the physicians, that’s basically telling the whole world. Just like we don’t need to know all the ‘black ops’ the government does to protect all of us.
                        Because they dont actually serve a real purpose. They are a money suck, and now they have the ability to control if you can work or be contracted with insurers to be employable. All for something that basically everyone has, everyone passes, etc...Its a useless, worthless extra hoop, except for the people selling it.

                        If it was just written boards once and done, shoot, even every so often I dont think people would care too much. Its that theyve inserted themselves into our lives and wallets so much.

                        Oral boards are no fun at all and of course little like real life. Its a game, we're the marks.

                        Tell us what purpose they actually are needed for, and how they actually are serving it and performing that function? If it wasnt there already and basically something we have always expected, what would you think of a private company test that existed "just to make sure we know what we're doing", you know, the whole purpose of residency and all the tests you have to take then. If you're incompetent to the point of danger, you shouldnt make it out of residency.

                        I mean, the pass rates alone show they serve no purpose, and if we should all pass, again, circuitously, they arent necessary. There are zero logical arguments that arent based in "its the tradition I know and came up with and believe in, for no actual reason". After that its pure justification and rationalization.

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                        • #27
                          Originally posted by CordMcNally View Post

                          That's on the residency. A residency should be a good enough gate keeper to discern those who can practice independently and those who simply cannot. Taking a written test with relatively outdated questions and an oral exam that is basically trying to hit subjective checkmarks is not what I want to screen doctors.
                          So much this.

                          Comment


                          • #28
                            Originally posted by Nysoz View Post
                            I dunno, I have both opinions of oral boards. Part of me thinks it's dumb and not realistic of actual practice. Some say it's designed to just make sure you're not dangerous. Also, despite all the check marks you're supposed to hit or say, it's still potentially subjective depending on the examiner. I was supposedly talking to someone on reddit that gave oral boards. I mentioned the possible use of retention sutures for a difficult closure about some random thing. They then said that if anyone ever mentioned retention sutures that would be an automatic fail of the oral boards which is pretty dramatic.

                            On the other hand, one of my friends was nice enough and squeaked through residency after being held back a year. I wouldn't let them operate on my loved ones and know they wouldn't pass boards and is doing something else now. So without something to screen candidates, if they wanted to, they could've been out there taking general surgery call and possibly operating on your loved ones until hospital administration catches on.
                            The amount of insane practicioners with insane views that are also board examiners is downright scary. Frankly there are too many of them with those kind of dramatic views in academia and the world that is board examiners. Its just plain toxic.

                            Like, thats just your opinion man.gif

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                            • #29
                              Originally posted by Zaphod View Post

                              Because they dont actually serve a real purpose. They are a money suck, and now they have the ability to control if you can work or be contracted with insurers to be employable. All for something that basically everyone has, everyone passes, etc...Its a useless, worthless extra hoop, except for the people selling it.

                              If it was just written boards once and done, shoot, even every so often I dont think people would care too much. Its that theyve inserted themselves into our lives and wallets so much.

                              Oral boards are no fun at all and of course little like real life. Its a game, we're the marks.

                              Tell us what purpose they actually are needed for, and how they actually are serving it and performing that function? If it wasnt there already and basically something we have always expected, what would you think of a private company test that existed "just to make sure we know what we're doing", you know, the whole purpose of residency and all the tests you have to take then. If you're incompetent to the point of danger, you shouldnt make it out of residency.

                              I mean, the pass rates alone show they serve no purpose, and if we should all pass, again, circuitously, they arent necessary. There are zero logical arguments that arent based in "its the tradition I know and came up with and believe in, for no actual reason". After that its pure justification and rationalization.
                              Every passing is a good thing. We all learn the same anatomy and treatment. It isn’t like Harvard has some secret way of teaching their medical school versus state medical school X.

                              Again, I would argue that it is a good thing to have a certain standard we all must pass. If not you can’t justify charging so much money. So they take a few thousands dollars. Big deal. We make plenty of money. Do you want just anyone to say, they can practice medicine? Or treat you? Should simply getting into medical school be enough? And having to take boards, force you to learn and study a lot. If not people would simply do the bare minimum to get the residency years over with.

                              Me personally, I studied [language] off knowing that I didn’t want to fail the boards the first time. And if there was no big pressure to study hard, I may not have the knowledge I have now. Most of the day to day stuff we do can be learn from a few years of residency. What separate the physicians from the nurses and students and other ‘health care providers’ is the board.
                              Last edited by Peds; 08-18-2020, 07:06 AM.

                              Comment


                              • #30
                                Originally posted by STATscans View Post

                                Every passing is a good thing. We all learn the same anatomy and treatment. It isn’t like Harvard has some secret way of teaching their medical school versus state medical school X.

                                Again, I would argue that it is a good thing to have a certain standard we all must pass. If not you can’t justify charging so much money. So they take a few thousands dollars. Big deal. We make plenty of money. Do you want just anyone to say, they can practice medicine? Or treat you? Should simply getting into medical school be enough? And having to take boards, force you to learn and study a lot. If not people would simply do the bare minimum to get the residency years over with.

                                Me personally, I studied knowing that I didn’t want to fail the boards the first time. And if there was no big pressure to study hard, I may not have the knowledge I have now. Most of the day to day stuff we do can be learn from a few years of residency. What separate the physicians from the nurses and students and other ‘health care providers’ is the board.
                                Are you talking about both oral and written boards?

                                Written boards do make you study for the trivia, although in my specialty, they are irrelevant, a waste of time, and money. I just recertified last week; I can vouch that neither my review nor the test have improved my doctoring. (The annual tests which cover current literature however do make a difference in my practice.)

                                Oral boards have as much merit as situps under a parked car.
                                Last edited by Peds; 08-18-2020, 07:08 AM.

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