Paradocs 157: The Testing Industrial Complex Strikes Again with Dr. Basavana Goudra

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Whether you are in medicine or not, you are affected by the board certification and board recertification process. The certification and recertification process is not only expensive but also stressful contributing to burnout with physicians. After completing a specialty residency training, candidates for board certification have to jump through a number of tests to become board certified. These include a written exam and then possibly other components like oral exam, case review or something else. That something else is the subject for today’s show – the Objective Structural Clinical Examination (OSCE).

What is the OSCE?

The OSCE is a new addition to the board certification process by the American Board of Anesthesiology whereby the trainees are subjected to various tests with ‘standardized actors’ to see how they can perform various personal skills like informed consent, canceling cases with surgeons, etc. This type of extremely subjective exam (despite the title) is ripe for interpretation that puts residents at the whim of cultural, personal, and acting disadvantages. The further question would be does this actually add anything to the skills of the physician?

What do Residents (And Program Directors) Think of OSCE?

The study conducted by Dr. Goudra looked at what residents thought of the value of OSCE was not good. In fact, 90% felt that it was a useless component that provided no benefit to determining whether someone was a good physician or better clinician. A previous study conducted by the ABA actually found that a majority of program directors also thought the exam was not worthwhile – yet it was implemented and still exists. This is about as good an example of the specialty boards’ complete lack of accountability and focus on revenue. We’ve talked about all their problems with recertification here, here, and here.

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