I first submitted a manuscript with these data to the New England Journal of Medicine and it was rejected immediately before the manuscript even reached the peer review process. (I even gave the editor access to a password protected webpage containing the infographic you will see below). They weren't interested. (Perhaps because this is a retrospective review?)
I then submitted a slightly revised manuscript to JAMA. The after a preliminary review, the editor of JAMA would not submit my manuscript for peer review, but thought the work might warrant review as a 600-word "Research Letter to the Editor" that allowed only one figure and one table and no more than 6 references. Needless to say, nearly a month later, I just learned that my "research letter" was rejected by both JAMA and JAMA Internal Medicine. The reviewers comments were helpful should I ever decide to re-submit these data to a peer-reviewed journal again in a different format. However, given the many changes occuring to the ABMS MOC program recently, I felt time is of the essence and elected to proceed with publishing my data here on this blog. I feel these data are too important to sequester behind a medical journal paywall and encourage physicians to use these data to question the credibility and reproducibility of the American Board of Medical Specialties' (ABMS) MOC secure examination and the remainder of the MOC program as a requirement for maintaining hospital practice credentials. By publishing my data on this blog, I can publish ALL of the data I collected and collated, not just a tiny fraction of it. Also, I have found that this blog's reach is equal to or larger than many medical journals, particularly when a post contains important and credible information.
METHODS: The ABIM's first-time MOC pass rate data were gathered from current and prior archived ABIM web pages for each subspecialty between 2000 and 2014 using the Internet Archive Wayback Machine (https://archive.org/index.php). (Only the past 5-years of pass rate data were available for Hospital Medicine and 10-years of pass rate data were available for Interventional Cardiology because they were "newer" internal medicine subspecialties). The number of physicians failing their examination each year was then calculated by subtracting the product of the total number of physicians who took the examination by the published pass rate from the total number of physicians who took each subspecialty MOC examination. Linear regression trend lines of annual pass rates with their correlation coefficients over time were calculated for each subspecialty. Historical volatility of pass rates was calculated as the standard deviation of the data range of year-to-year percent change of pass rate. For example, published pass rates for General Internal Medicine from 2000-2014 were 89%, 92%, 91%, 85%, 86%, 84%, 79%, 83%, 92%, 90%, 88%, 87%, 84%, 78% and 80% respectively. The percent pass rate change from 2000 to 2001 was calculated as 0.92/0.89 - 1 = 3.37%. The 14-value dataset of percent pass rate annual changes for the years 2000-2014 therefore was 3.37%, -1.09%, -6.59%, 1.18%, -2.33%, -5.95%, 5.06%, 10.84%, -2.17%, 2.22%, -1.14%, -3.45%, -7.14%, 2.56%. The historical volatility of pass rate percent changes for General Internal Medicine equaled the standard deviation of this dataset, or 4.93.
RESULTS: First-time ABIM MOC pass rate trends (and the raw data for each internal medicine subspecialty's first time MOC pass rate) with their linear regression trend lines can be displayed using the interactive infographic below (just click the specialty circle to display the detailed annual pass/fail data):
The total number of physicians who took the test over 15 years and the percentage of physicians who failed their MOC exam on the first try are shown by subspecialty in the table below. Year-to-year historical volatility of pass rates by subspecialty also shown (bolded historical volatility values exceed one standard deviation from the mean of all subspecialty volatilities):
| Subspecialty | Physicians Undergoing MOC Examination (n) | Number of Physicians that failed MOC exam on their first attempt (%) | Pass Rate Historical Volatility (Minimum/Maximum annual percent pass rate change) |
|---|---|---|---|
| General Medicine | 61,050 | 9,212 (15.3%) | 4.93 (-7.14 / 10.84) |
| Cardiology | 10,486 | 1,386 (13.2%) | 3.23 (-3.53 / 6.10) |
| Cardiac Electrophysiology | 1,398 | 113 (8.1%) | 4.33 (-7.45 / 5.49) |
| Critical Care | 5,596 | 552 (9.9%) | 4.62 (-7.69 / 8.33) |
| Endocrine | 2,308 | 310 (13.5%) | 7.48 (-10.4 / 13.16) |
| Gastroenterology | 6,255 | 770 (12.3%) | 4.35 (-6.45 /4.71) |
| Geriatrics | 6,559 | 539 (8.2%) | 7.64 (-14.13 / 20.51) |
| Hematology | 2,427 | 338 (13.9%) | 7.11 (-9.76 / 13.51) |
| Hospital Medicine* | 829 | 113 (13.6%) | 1.09 (-2.27 / 0.00) |
| infectious Disease | 3,520 | 312 (8.9%) | 5.00 (-10.53 / 7.32) |
| Interventional Cardiology | 3,182 | 244 (7.7%) | 2.24 (-5.32 / 2.33) |
| Nephrology | 4,129 | 466 (11.3%) | 3.81 (-8.42 / 5.56) |
| Oncology | 4,568 | 456 (10.0%) | 3.87 (-8.79 / 6.90) |
| Pulmonary | 5,792 | 803 (13.9%) | 6.57 (-11.24 /13.92) |
| Rheumatology | 2,143 | 217 (10.1%) | 3.56 (-6.59 / 5.81) |
| TOTAL | 120,242 | 15,832 (13.2%) |
ABBREVIATED DISCUSSION:
- A very significant 15,832 physicians (13.2%) have failed their MOC secure examination on the first try. This has a significant impact on physician morale without justification and has affected patient access to their physician as a result.
- A large variation in year-to-year pass rates exists for many subspecialties, particularly Endocrinology, Geriatrics, Hematology, and Pulmonary suggesting inconsistent content, irrelevant content, and/or inconsistent setting of pass rate cut-offs year to year using the ABIM's modified Angoff method of determining pass rate cut-offs.
- First-time MOC failure rates vary by as much as 51% between subspecialties, with General Internal Medicine having the highest failure rate (15.3%) and Interventional Cardiology having the lowest (7.7%)
- Fourteen of 15 subspecialties had declining pass rate trends in this 15-year review of ABIM MOC pass rates (see infographic). Was this because the tested material is increasingly irrelevant to patient care? Or might there be another ulterior (financial?) motive for the decline? Or are most physicians simply unable to cram larger and larger amounts of information into their heads and regurgitate the proper answer in a limited time period thanks to the exponential growth of health care information over the last 15 years?
- Year-to-year first-time MOC pass rates could vary by as much as 20.5% (Geriatrics).
- The steepest pass rate decline was interventional cardiology (1.62% decline in pass rate per year), though low numbers of physicians took the exam the first several years it was offered.
- Since MOC participation is increasingly tied to hospital credentials as "board certification" became "time-limited" in 1990, what responsibility does the ABIM assume to patients when they fail a physician? How many physicians of each internal medicine subspecialty had to retake their examination (and how many times did each have to repeat)? What is the total cost to the doctor and the health care system for this unproven "quality" metric in terms of real dollars, patient access, and care delivery?
- Given the large number of physicians that have failed their MOC examination, why has the ABIM not studied the psychological, social, professional, and clinical impact their failure of physicians? Or don't they care?
A word of caution: the American Gastroenterological Association (AGA) has recently posted a video promising to bring an end to the MOC secure examination for gastroenterologists. Instead of ending the MOC program, however, (and after reviewing the full proposal about to be published in November) the AGA promises to replace MOC with an even more complicated "Continuous Professional Develppment" program "tailored to your needs" called "GAPP", the "Gastroenterologists Accountable Professionalism Pathway." This pathway promises to be an even more complicated 13-step program rather than MOC's 4-step program. It is a spin-off from the ABIM's similar "Continuous Professional Development" program used before by the ABIM that still has no proof of its value to patient care and without any disclosure of the cost this program for working physicians. It maintains the need to participate in their program for physicians to remain credentialed to practice medicine in their hospital. Before leaping for joy that the MOC examination is being phased out, realize that our specialty boards are reeling from the exposure of the financial reality of their "programs" to our health care programs and are creating new "programs" to assure ongoing financial and time-commitments from working physicians without proof that recertification is of any value to patient care over traditional self-directed Contining Medical Education. Worse yet: the AGA uses the term "Professionalism" in the title of their new re-certification proposal - a word defined via a "Task Force" of the corrupt ABIM Foundation.
Please feel free to share this post with interested journalists, friends, and colleagues. If you have further questions or ideas about these data, feel free to leave a comment or send me a note at wes - at - medtees dot com.
-Wes
25 comments:
Good work Wes. It is high time to start considering the UNINTENDED CONSEQUENCES of this useless test, just like we must do daily with clinical testing. Applying a test with such high false positive (15% failure rates) to a population of physicians where the likelihood of true positive ("incompetence" Less than 0.03%, 1/42000 per year) occurs, is simply BAD MEDICINE and a waste of time, far beyond the $5 billion this costs internists each decade as was also recently published!
A Cost Analysis of the American Board of Internal Medicine's Maintenance-of-Certification Program
Alexander T. Sandhu, MD; R. Adams Dudley, MD, MBA; and Dhruv S. Kazi, MD, MSc, MS
[+] Article, Author, and Disclosure Information
Ann Intern Med. 2015;163(6):401-408. doi:10.7326/M15-1011
Wes,
The American Gastroenterological Association (AGA) is offering its plan to ABIM as an alternative to MOC. They're doing this because the membership has requested AGAs involvement in MOC and this was their first thought. AGA has pledged to make this an open process.
What you failed to mention is that AGA President, Michael Camilleri, and AGA President (elect), Timothy Wang, will also be publishing an editorial on MOC. In the accompanying editorial, the AGA leadership states clearly that they think the onerous exam should be eliminated. The editorial also states clearly that "While board certification was initially designed as simply a mark of distinction, it has grown, in some instances, to be required for hospital privileges, and thus the re-certification examination has evolved into a high stakes assessment." They continue: "The fact that board certification has become a requirement for privileges at many hospitals is surprising, given the lack of evidence that MOC has led to improved patient outcomes".
From my reading it seems:
1) The AGA wants MOC improved for those members who find value in the ABIM credential.
2) The AGA has said quite clearly the ABIM exam should go and that ABIM’s current MOC process has little value.
3) The AGA states that it is surprised that some hospital would require a credential without outcomes data that show it has any value.
4) The AGA editorial acknowledges NBPAS; though they did not specifically endorse it.
The AGA is mainly a scientific body that also focuses on education. They also try and give gastroenterologists a small voice on the hill. I don't think, under normal circumstances, the AGA would ever get involved in other societies much less hospital politics. Still, the MOC controversy is everywhere, and AGA is trying to sort through it based on surveys of its membership.
The fact that AGA acknowledges that there is no science behind hospital credentialing, implores the ABIM to reform, and acknowledges NBPAS, is telling.
Michael Gilbreath
Startling, cold face-splashing results!
We have seen the pass/fail data before and analyzed the negative consequences of such dysmal numbers and the implications for patients and physicians. Of course, it means in our times of universal shortages, fewer doctors for a growing patient population. Less time for patients.
It is absurd for the ABIM and ABMS not to have responded to this bleeding need for doctors and time. It us unacceptable if this problem is not corrected immediately. It's insanity to not break out of the shell and speak of these things together to fix them.
We have been engaged in wars for years with an overtaxed Veterans' Administration. To not acknowledge these heavy, burdened times of overpopulation, aging, death, horrendous maiming and digital change and other trying systemic changes is simply irresponsible madness and laziness on the part of our bureaucratic officers.
It is another example of negligence. To not see need and respond in a time of need is unconscionable.
I think the ABIM officers have spent more time focused on lobbying, false professionalism, wild bull rides with equities, and politics than on the nature of testing and its harsh societal consequences. That is troublesome.
It is not surprising that (J)AMA did not let your study out of the chute to 'put to the test' this brutal up and down ride of the ABIM's sick version of a rodeo.
Maybe we need some alternatives to these highly subjective journals as well.
What other cold cases lie buried beneath the basement tiles of that dark building on Walnut Street?
The ABIM demonstrates with their avoidance of cold hard facts that they practice a strange head game with physicians. That head game they play can only be called "intellectual malpractice!" It is the result of decades of "laziness" and "self-absorption" on the part of the ABMS. The ABIM is its child; for years it's been allowed to run wild out of control. Why? It profits the ABMS as well.
Conflicts of interests have the ABIM's thoughts and passions engaged the rest of the time. MONEY!
We have fallen into the abyss!
God help us (anybody) to get through this trough of resistance. We need a real response!
Real response is change. Real response is addressing the needs;
addressing the nagging complaints that will otherwise never go away.
Consider publication in PLOS medicine.
Hopefully the Abim or the AGA will follow the lead of the American Board of Anesthesiology.... on line questions only.
Its so damn easy to end this.
on line questions every year.
No secure exam.
I do wonder how much money the abim collected from failing more and more physicians.
The bottom line so far... The ABIM is not the internists friend.
Oh well, some will suffer. Physician casualties are considered acceptable collateral damage by the ABIM as it joins with other tax-exempt non-profit organizations, most notably hospital systems, to gain total control of the medical profession.
From the perspective of hospitals and medical boards (most notably the ABIM), physicians serve a higher purpose other than merely providing patient care. That purpose is to generate income that feeds the nonprofit so that it can further its own agenda.
From their perspective, the ideal physician is a compliant, nonquestioning, RVU-generating machine. A useful cog.
This phenomenon is similar to the Stalinist-era deprofessionalisation of medicine, where neo-Weberian power relationships among administrative bodies crushed and controlled physicians to further collectivist policies.
Not a surprising development as our own governing administrative bodies are populated with chardonnay-sipping marxists who dream of perfecting what Stalin started.
Is there any way to separate out the pass rate for those MDs that recertify at 10 years, and then re-recertify at 20 years. My guess is that the more years out of residency/ fellowship training, the more unlikely it is to pass an exam that covers lots of minutia that is not clinically relevant. Are the MDs that are 20 years out over represented in the recent failure rates?
MCJ -
"Is there any way to separate out the pass rate for those MDs that recertify at 10 years, and then re-certify at 20 years."
The answer is no, for several reasons. First, the ABIM does not publish these details. Those data are closely held specifics. Secondly, the secure examination in its present (secure, mandatory format) was first offered in 1996.
he ABIM states pass rate data web page that 96% of physicians pass "Assuming at least three subsequent exam administrations, not necessarily three retakes." How does one interpret such a statement? What is the difference between a "repeat exam administration" and a "retake?" How many physicians lost employment because they failed? (Isn't that the number that matters?) What responsibility did the ABIM have to physicians they failed? We can't tell. We also don't have these data by specialty.
Since the exam has not been offered for 20 years, we have no idea how many took the examination at 10 vs 20 years nor how many took the examination early vs those that failed to take the examination altogether. What is clear that at least 13.2% of physicians had to retake their examination if they wanted to remain "board certified." That is a VERY significant number. No doubt several of those physicians had to take the test three or more times to pass. The costs of additional preparation courses and time involved (including time away from work) are also not considered.
My initial ABIM certification exam was in 1993, it was a secure exam administered at a Hotel. I then had a secure Recertification exam 10 years out in 2003 (possibly also at a hotel) and then re-recertification 20 years out in 2013 at a testing center. All of these were high stakes exams, proctored one way or another. As is true of everyone who has been certified, I have had the same ABIM identification number throughout all this time. It would not be that difficult for ABIM to put together the data for failure rates of those who are 10, 20, or more years out from their initial certification. I suggested this to ABIM, and was never given an adequate answer as to why this can not be done.
Harsh Criticisms and Suggestions for the ABIM/ABMS and Related Organizations.
(Certification/licensure of Professional Medical Bureaucrats)
The professional medical bureaucracy needs to have its own "certification/licensing process" established with strict ethical rules reintroduced, and strictly enforced.
The testing process and legal process will weed most of them out when strict enforcement of ethics and criminal activity is enforced.
Conflicts of interest should not be the "acceptable norm" but a criminal punishable offense, also strictly enforced, as it is for any other high official in government or corporate America.
We set the ethical and legal standard internationally and enforce it globally. Why not enforce it here at home where it is needed.
Conflict of interest laws enforced
--for those professional bureaucrats entrusted with "quality measurement"--
--for those entrusted with the wellness/lives of the public--
--for those who are entrusted with the well-being and success of their highly valued professional medical providers, namely their client physicians--
The above mentioned idea of enforcing violations of conflicts of interest should include most organizations that fall under the medical "quality assurance" umbrella.
Even the conflicted areas of medical education like the ACGME, and so on, with their revolving door practices of hiding the violations and the perps by shuffling them off to an associate organization need to be monitored and given some oversight.
Baron, Wachter, and Cassel say we don't want government involved.
Why? They are the government, obviously. And they are the medical corporation.
I believe we do need some uncompromising independent commission to look into the whole racket of "quality assurance" and make recommendations on how to get it to work properly for the public phycians and not the government or corporate America, but first and foremost how to clean it up.
If we ignore the severe conflicts of interest we will never have any change. It is unfortunate, but the house needs to be cleaned at the ABMS and elsewhere.
I could point out several professional medical bureaucrats who have been egregious offenders over the years and several currently involved at the ABIM/ABMS in high positions. Some of these folks should have faced a judge already but have not.
Why? We have a double standard in law enforcement and criminal prosecution. The elite get off. Not this time. Not anymore.
Anyone who thinks these organizations and foundations are not corrupted by conflicts of interest and big money is fooling themselves.
Weed the corrupt bureaucrats out of "quality assurance", medicine, politics and corporate America altogether.
Stop playing around.
Do it! Then you will get a fair "lifetime certification" and test with nearly 98%-100% percent pass rate at a nominal cost of time and money to physicians and society. As it was in the beginning...
CME is the abandoned gold standard. Go back to it. Make it better and even more valuable.
The ABMS?NQF gold standard is...well you know very well how much wealth the officers hold and continue to amass!
According to Rich Baron the first ABIM certification test was an 8-question essay. ABIM record tell us there were 27 physicians certified by the ABIM the first year.
There were nine founding members in the club. They certified themselves essentially into the club, but it was a decent club.
Now it is corrupt. Rich Baron and Bob Wachter could have changed it all back to the way it was (and should still be today) by correcting past deviations and corruption with the simple stroke of a pen.
The ABIM knows this very well that they have erred. Money is too tempting and other financial compensation outside the ABIM serving on lucrative corporate boards. It is a situation that could be easily changed now by Baron and Braddock if they had the moral will to do it.
Restore the bylaws, which corrupt officers like Thomas Brem and others altered over time. It is as simple as that to make ABIM certification and its officers free of the smack of financial corruption--with the honest stroke of a pen.
A lifetime certificate once more. Not tied to employment or anything except an honest day's work serving the public in good faith again.
There is no way the ivory tower, non clinicians will ever allow these data to be published. It would tear down their funding and their organizations will collapse under the weight of their own corruption. The era of the ABIM is essentially over. There are legions of folks hoping the ABIM continues its arrogant insensitive course of action because ever misstep will mean that the impending Class Action Lawsuit will be airtight.
How is it that Rich Baron is still employed as the head of the ABIM?
Double Standards and Lack of Oversight at the ABIM.
Outrageous! An organization (ABIM) which dictates to physicians that they keep up with medical knowledge and changes without acknowledging that physicians are doing just that and more to keep up on their own.
Yes, the ABIM does engage in the practice of double standards. And their officers make a pile of cash doing it.
Measurement for everyone else and no oversight for themselves.
But they do once in a blue supermoon "assess" themselves to get the news media distracted and the legal system off their backs.
The ABIM is clearly comprised of lazy, but enterprising medical bureaucrats who abuse power, inure themselves to high heaven, and engage in intellectual malpractice to manipulate the system and cover up wrongdoing.
The ABIM has a history of helping themselves to 'dirty corporate cash' using their ABIM positions and influence to get 'set-up' with prestigious corporate board positions without disclosing the nature of the conflict and how it affects the "rapidly evolving enterprises of medicine." Or they have taken money to state to our government officials that cigarettes don't necessarily cause cancer.
You know that sad story of corporate influence and tampering with sound scientific evidence for personal profit. We are talking about ABIM's past Chief Thomas Brem. You know this story by now from Dr Wes and Kurt Eichenwald.
But the current times at the ABIM are filled with even bigger money and egregious conflicts of interest.
I am talking about the fabulous corporate money, the extra few helpings and garnishes heaped on their personal plate, which to the average physician is the equivalent of winning the big Las Vegas cash jackpots repeatedly. And that's not all because behind door number two is the magic and excitement of getting coveted stock distributions and options. It's like being in the dot.com Wall Street bubble all over again when you get the stock in your hands and watch it grow.
To be very clear I am talking about ABMS officers seeking additional money to the money the ABIM pays for being an officer or executive of the specialty boards.
They sit on corporate boards outside ABIM where political power is obviously used to their personal advantage and the benefit of the corporate entity they assist or direct.
'They' profit, grow, merge and gain even more power in their industry and power over physicians and the public.
To the average American this practice of officers of a non-profit humanitarian organization abusing their power for even greater financial gain is sickening and disgusting.
When will the ABMS get the message about their history of past and present corruption? And that it is not acceptable! Nor can it or should it be considered legal.
The United States prides itself on being a champion and bastion of upholding honesty and fair legal practice in business and politics. We bend over backwards to stamp out this kind of corporate bribery and granting of favors around the world.
Why?
It gives an unfair advantage over others financially and politically. We should frown upon such behavior and not allow it to be tolerated.
How long before the next big scandal breaks in the news over more ABIM officials with egregious conflicts of interest?
Any reporter could have a field day at the fair grounds winning many prizes with these professional medical politicians.
They are 'sitting ducks' at the revolving-door penny-arcade just waiting for a reporter to pull out his camera and take a few snapshots for the public to see.
About spotting bureaucrats involved in medical industry corruption: they are as easy to spot as a fish in water.
They are the bright one being driven from the airport by a chauffer to the door of the ABIM's multi-million dollar condo.
Here's your headline: Fishy Political Ducks Spotted at the Penny Arcade.
Finally, we see an objective measure of whether board certification really matters.
http://www.medscape.com/viewarticle/851401#vp_1
Surprise, surprise. There is no difference in the two groups (board certified vs. non-board certified). Objective evidence that board certification does nothing other than enrich the ABIM and all the courstitudes who peddle their teach to the test mentality. What an absolute waste of time and money!! I thought physicians where scientific to the core. Why would any physician participate in activity that makes no difference to patient outcome?
Ignore the joker in the story who cites the ten extra deaths. He was on the writing committee of the Choose Wisely campaign that recommended doing the absolutely wrong thing in patients with STEMIs by not revascularizing the non-culprit vessel(s). The hypocrisy and audacity of these clowns sees no bounds. How many Americans died because interventional cardiologists followed fraudulent guidelines by ABIM/ACC that to this very day have not been publicly renounced. One could even say that the ABIM/ACC just bury their mistakes.
Congrats on your NEJM rejection! You remind me of my childhood mentor who was continuously turned down for medical professorships because of his radical ideas--crazy stuff, like keeping folks healthy without gouging them of all their life savings. Stay wild.
@lisa30092
Ok - many physicians are upset with these " guys " ! So - where is the action ? What is being done to restructure , take down, fire, replace , discredit formally , sue ?? Great works by doc Wes & Newsweek ,,,but, when do we see the other shoe fall !?? Petition ? Web page for legal action donations ? Letters to all hospital executive groups ?? Support for so called ' failed ' test takers !? BTW -- here here ,,, a rejection my several of these so called Med journals ( especially JAMA) is a badge of courage and a sign of ' the correct path is being pursued '! Suggestion : an audit of the editorial boards of these journals is long overdue ( other Boards , payments , associations ).
Again -- congrats to authors & commenters -you are helping the front line talent who take care of patients !! --- Now is the time for an action plan !!
Yes, it is overdue.
MCJ said, "It would not be that difficult for ABIM to put together the data for failure rates of those who are 10, 20, or more years out from their initial certification. I suggested this to ABIM, and was never given an adequate answer as to why this can not be done."
I tried to get in advance of an initial certification test a copy of the lab values used for a particular subspecialty exam in 2010. They told me they could no give it out in advance. I ask why not?
They could not answer me after lengthy consultations with higher powers there; but still they would not say why they could not give the lab values out in advance like they do on the USMLE's.
Maybe they were just lying to me. I persisted and finally they told me to put the question in an email and they would get back to me. They did not respond. Why not?
Talking with the ABIM has always been unpleasant. Heavy. Getting them to answer anything that matters is like pushing back against a powerful river or like trying to ford a stream that you cannot ever cross.
I know it sounds like a bad dream or the myth of Sisyphus over and over, but all I have to say is that any other business would have consumer lawsuits and be out of business pronto.
Answer to the question about not giving me the lab values in advance to memorize.
It comes from personal experience about the questions and how old they were. The tests were a joke, like paying for a new car and then you are frisked and printed only to find out you drove off the lot with an old junker. The computer was slow and could not keep up with me. It is far from anything one could call an objective testing process.
The computer pre-test drive was meaningless as well.
I believe that the ABIM and others from what I hear have been cheating physicians for years with their lies about producing questions that are supposedly real gems and relevant in real life practice. Just not true.
Anyone who takes their test becomes a worse physician for wasting the time that could have been spent learning something useful, which is required everyday.
Ok, the real reason the lab values could not be given in advance at the time, which I believe they do understand they give out now, was because the lab values were all over the map.
Questions were uselessly out of date; to cover that many decades of changing ranges of lab values, and to give it out in advance would show what a scam test it was.
You can thank Arora probably for the ABIM finally retiring those old gems and getting some new questions and finally publishing their lab values online in advance. Maybe I'm wrong about this, but I can attest that 2008 and 2010 were not their best vintage years in my opinion for that high quality test they boast about.
As I said, they produce cardboard cars for us and call them a vehicle of learning. what an affront to the intelligence to claim it means something to ride in their outdated junky test car while those arrogant smiling frauds ride in a limo.
It makes me sick the more I learn about ABIM lying, cheating and apparent tax fraud. No credibility left.
I see the ABIM is suing someone in Puerto Rico now. And that person is counter- suing Cassel, Langdon, Holmboe, Baron, and company. It's over copyright again.
It cost ABIM close to a million dollars to sue von Muller. ABIM, had to pick up the bill, because the court rightfully would not make von Muller pay very much, thank goodness. And they really could not prove that the questions even met the standard to be considered original enough. Just science rehashed.
Judge said the ABIM was trying to ruin von Muller and he would not allow it. I looked at the court transcript because I wanted to know more about those old test questions which the ABIM was so concerned about being shared with candidates and diplomates.
I understand some of the old questions are sealed in another lawsuit against the ABIM for discrimination concerning the fairness of the test. If my experience is accurate that the questions are really outdated by the time you take the test, a plaintiff could ask to see the questions and have them evaluated by an expert. I hope that happens in the Puerto Rico case. Von Muller's lawyer screwed up procedurally and did not have the chance, therefore, to bring in a scientific team of experts to evaluate if ABIM's questions met the test of originality, etc, in order to be copyrightable.
Sarah should have won and could have got a lot of money from those self-righteous prig noses in a fair legal system. Her first lawyer goofed somewhat and the judge was telling von Muller's attorney that he had no patience for him. Judge considered him less than adequate for the task, it seems.
In today's court the ABIM might have much less power, because everyone knows they are the real cheaters. Always have been.
Civil liberties for all Americans died the day a judge gave ABIM the right to seize private property, have complete custody at ABIM offices over Arora's personal belongings, physician lists and addresses with phone numbers, and other personal information as well as business information about the board prep courses.
Did the ABIM have some legal power to seize property which they should not have been granted, especially seeing what the ABIM did with the seized property that had physicians' personal information contained in it.
If you ever think that the ABIM is a nice friendly organization, wake up and smell the blood on their teeth. All main officers currently with the ABIM were involved in the persecution of physicians during the von Muller pogroms.
ABIM had a well connected law firm; but even after all the (false) victory claims released on the ABIM website, they lost millions and recovered nothing; they lost face in public and in private, because there were no vicious ringleaders or cheaters.
Where are we now? Von Muller is a folk hero free of the ABIM hypocrisy and lies. The ABIM is living in moral and financial shambles.
A corrupt hypocrite advises hospitals about patient safety after being reckless and negligent in her past job as head of ABIM. Scandal-ridden NQF comes under fire and CEO, former ABIM head, has to give up lucrative board seats worth millions in cash and stock.
Arora got another certification elsewhere and shares grassroots wisdom and humor.
The ABIM Strikes Again
This time in Puerto Rico with a lawsuit against a physician who is passionately countersuing.
The flurry of documents, letters, briefs, accusations is hot and furious and the judge has expressed his impatience by limiting page count in the defendant's responses/attacks who is countersuing the named parties that are perhaps also considering countersuing the parties that are originally suing...
well it is very passionate and confusing so far, but...lot's of time, money, legal heat. Cassel's getting to old for this. Baron is occupied with keeping his head from falling off when he talks, and Langdon is looking forward to Hawaii or anyplace other than the cold dreary winter that is coming to Philly and Chicago...
What is the suit all about?
Believe it or not the ABIM has found from their treasure trove of seized property stolen or borrowed from Dr. Arora back in 2009 another vicious ringleader. It took them sixe years to trace the email account which was bounced around several million servers around the world, but they finally got the guy who is living outside the United States in San Juan.
Apparently the ABIM has not heard anything about jurisdictional complications involving all the other test sharing persons. No jurisdiction. And then there's the fact that it was like six years ago. Hello ABIM and your legal department. You are just now filing and spending more of the War Chest. Where are you getting the money? I thought your were broke and abandoned. Is it just a distraction or just need the attention.
We have gleaned that the ABIM has a branch of their infamous law firm "Sport and Sparring, Ltd"...I can't remember their name, but they are that big hefty below-the-belt hitter that went after Sarah von Muller in 2009 and dragging on and on getting only a big legal fee in the end...crushed many others with smear campaigns and lawsuits as well, and compromised everyone's civil rights in America with the infamous 2700 letters of reprimand which went out mostly to FMG's that would/could not fight back.
What is the ABIM thinking? 2009 e-mail from an anonymous email server to Dr. Who that they seemed to have just now traced back to Puerto Rico. The ABIM has entered more compromised questions into evidence, which I have examined, and they are certainly not any test questions that I can remember...from the same time period. Are they nuts putting themselves at risk to be kicked around again by public opinion for more examples of their negligent use of client funds--which are drying up fast. It could cost them another million dollars in fees and this physician seems to be popular among some well-connected people in his own turf. This is not Philly, boys and girls. ABIM turf. No it's different players and different judges...
I vote to pull out if you can. But it may be too late. Everyone with some heart wants to have a chance to make the ABIM their personal piñata.
Wow, CONGRATS to Dr Wes Fisher for this excellent REPORT on "ABIM MOC Pass Rates" by Specialty 2000-14. Anonymous and other commenters, thanks for your detailed insights. Truths will emerge in time, hopefully sooner than later. THE TRUTH WILL SET US FREE. Perhaps only by electing a PHYSICIAN PRESIDENT, like Dr Ben Carson, will US taxpayers, the public, and our patients be allowed to help us practicing doctors reform US healthcare and collapse the corrupt healthcare industrial complex, including the monopoly of the ABMS MOC (trademark) testing industry, wasting healthcare dollars. Again, congrats Dr Fisher!!! K Murray Leisure, MD, Infectious diseases, Plymouth, MA. 02360, USA. October 2 2015.
"Start ever day with a smile and get it over with."
- W.C.
Fields
was here.
Upper floor executive bathroom.
James Marino MD says the first time pass rate for MOC for May 2014 was 65%, that 35% failed.
http://medicaleconomics.modernmedicine.com/medical-economics/news/maintenance-certification-exams-have-dubious-value
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