Residents need to learn medicine, not how to pass a test

In his famous novel, Moneyball, Michael Lewis illustrates the phenomenon of professional baseball scouts focusing on all the wrong characteristics when looking at players. He describes how scouts focus on fastball velocity as a way to compare pitchers, despite the lack of correlation between fastball speed and the quality of a pitcher. As it turns out, the most important factor in a pitcher is deception, not a high-velocity fastball. The goal, after all, is to get batters out, not throw the hardest pitch. Lewis theorizes that because pitch speed is easy to measure, and easy to compare, it became overemphasized. The principle of overvaluing that which is easily measured is the same mistake made in graduate medical education in regards to test scores. Every year, emergency medicine residents take a multiple choice test known colloquially known as the in service exam. The exam is an excellent predictor of the ability of a physician to eventually pass the board certification exam. The Accreditation Council for Graduate Medical Education (ACGME) monitors each residency program’s scores, and they are felt to reflect the quality of each programs education. Their logic is that if a program has low test scores, it must mean they are not properly educating their residents. The ACGME requires residency programs to have an 80 percent first-time pass rate on the board certification exam. If a program does not have adequate test success, programs can be placed on probation, and eventuall...
Source: Kevin, M.D. - Medical Weblog - Category: General Medicine Authors: Tags: Education Emergency Medical school Residency Source Type: blogs