Oral Boards to Go: Bad Idea

I am a psychiatrist trained rather traditionally in the 1970s and certified in 1977 in general psychiatry by the American Board of Psychiatry and Neurology (ABPN). I am astonished by the plan to eliminate the oral exam in psychiatry boards as described in the September 5 issue. I was aghast and dumbfounded to read that the reasons were the relatively low pass rate and the impact of language or cultural barriers and that “the crippling effect of anxiety” is suspected to be a “predominant reason” for the relatively low pass rate.

It is astounding that we would shift, to residency directors, the decision about whether the resident has “the ability to examine a patient [and] establish and maintain a relationship with the patient...” before leaving residency.

I cannot believe that this is occurring in a field where the relationship with a patient and communication in a clinical setting are so fundamental.

I had no problems with Part II of the ABPN examination, but knew some people who did. As I recall, most passed the second time. A few failed many times, some because they were in the wrong field. Some failed because their own issues, including anxiety, got in the way of the exam and their practice.

To compare a psychiatrist with a neurologist in this regard is not a good comparison, given the distinct differences in their roles and practices.

Perhaps we should do away with examinations altogether and just ask the applicant if he or she is competent.