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ABIM Sanctions Physicians for Ethical Violations

Unprecedented action reflects ongoing commitment to protect the integrity of the medical board certification process

Philadelphia, PA, June 9, 2010 – The American Board of Internal Medicine (ABIM) took formal action today to sanction 139 physicians for soliciting or sharing confidential examination questions used to certify doctors in internal medicine and its subspecialties. ABIM has also initiated legal action in the U.S. District Court for the Eastern District of Pennsylvania last week against five physicians who were among the most egregious offenders.

The sanctioned physicians participated in Arora Board Review, an independent, New Jersey-based test-preparation course that purported to help physicians prepare for board certification exams. Participants in the course were encouraged to relay questions from memory to the company immediately after they took an ABIM examination. They were also provided with questions obtained by other physicians who had completed ABIM examinations.

Through an extensive investigation, ABIM established that the physicians being sanctioned shared or solicited actual ABIM examination questions – a significant breach in the professional standards ABIM requires of all of its board-certified physicians and any physician taking the exam for certification. Hundreds of questions were compromised and immediately removed from the ABIM exam question pool.

Each physician who signs up for an ABIM examination is directed, in writing, not to discuss exam content. In addition, before each test, physicians sign a ‘pledge of honesty’ to not disclose, copy, or reproduce any portion of the material contained in the examination and are warned that ABIM will impose severe penalties on any physician involved in efforts to provide examination question content to others.

“Physicians are – and should be – held to an exceptionally high standard of clinical skill and ethical behavior,” said Christine K. Cassel, MD, ABIM's president and CEO. “Board certification provides patients with assurance that the physicians they choose are competent and knowledgeable in their chosen field of practice. Through the actions we are taking today, we are telling patients that they can trust this process; and we are sending a very clear message to physicians. Anyone who seeks to compromise the integrity of our examinations will face swift and serious consequences.”

ABIM's board certification process evaluates the knowledge, skills, and clinical judgment of participating physicians and assures that those who are certified have demonstrated the requisite expertise to deliver excellent patient care in internal medicine. Questions on ABIM's examinations are developed through extensive work by physician experts in practice and academia and are validated according to testing industry standards to ensure that the scores are fair and valid indicators of a physician's knowledge and judgment. The test questions are copyrighted property of ABIM, and unauthorized dissemination of them is in violation of copyright law and professional ethical medical standards.

“The ABIM certification process relies on a rigorous test that challenges physicians to demonstrate high levels of competence in their specialty. Because of this, patients know that they can trust doctors who achieve certification,” said Dr. Cassel. “We take this trust very seriously, and we will take every step possible to ensure that the examination is protected and that anyone who engages in efforts to compromise the exam will be punished.”

Among the actions announced today:

  • Physicians who disclosed ABIM exam questions or solicited them from Arora Board Review were notified today by ABIM that their board certification has been suspended for up to five years, based on the extent and egregiousness of their offense.
  • Physicians who have not achieved certification and who disclosed ABIM exam questions or solicited them from Arora Board Review were notified today by ABIM that they will not be admitted to sit for a certification exam for a term of one year or more based on the extent and egregiousness of their offense.
  • Certification will be revoked for any physician who systematically sought to undermine certification through the organization, collection, and distribution of ABIM exam questions.
  • The investigation revealed that course operators repeatedly told participants that they were receiving actual ABIM questions and requested participants to send questions to the course operators after their exam. As a result, any physician who ABIM has reason to believe took the course will receive a letter expressing ABIM's concern about their failure to notify ABIM about the questionable activities in the course.

ABIM may impose additional sanctions, or escalate sanctions included in today's notification, based on any new evidence obtained in the ongoing investigation.

“Sharing test questions from memory is a serious problem that threatens the integrity of all standardized testing. Test takers need to know that this kind of ‘brain dumping’ is grossly unethical,” said Dr. Cassel. “Ethics are critical to the practice of medicine and are the foundation of a successful doctor-patient relationship. We will not tolerate unethical behavior from physicians seeking board certification.”

For Media Inquiries contact Lorie Slass at 215-399-4005.

About ABIM
For more than 75 years, certification by the American Board of Internal Medicine (ABIM) has stood for the highest standard in internal medicine and its 20 subspecialties and has meant that internists have demonstrated – to their peers and to the public – that they have the clinical judgment, skills and attitudes essential for the delivery of excellent patient care. ABIM is not a membership society, but a non-profit, independent evaluation organization. Our accountability is both to the profession of medicine and to the public. ABIM is a member of the American Board of Medical Specialties. For additional updates, follow ABIM on Facebook and Twitter.