Help me understand how the Internal Medicine medical boards are scored.
August 17, 2010 10:41 AM   Subscribe

My little brother is re-taking the internal medicine medical boards and I'm trying to get a better understanding of how much he needs to increase his score.

So my little brother is re-taking the internal medicine medical boards in a week. He didn't pass the first time due to some pretty extenuating family circumstances that more or less prevented him from studying. I'd like to set his mind at ease that he'll fly by this time. But there's one problem... for the life of me neither of us (or any other doctor's we've spoken to) understand how the test is scored. Here's what we *do* know:

It's graded on a curve and to pass, you need to NOT be in the bottom decile. So 90% of those who take it pass. (Which is pretty scary in its own right.)

He got a breakdown of his decile by various topics (cardiology, neurology, psychiatry, etc.) and while he was 7th decile in his specialty, and 2nd decile in a few other topics, he was 1st decile in most.

That he was in 2nd and 7th decile in a few topics but overall averaged into the 1st decile tells me that he *really* bombed some of those other topics. Or am I missing something?

Unfortunately there's no indication of how close he was to making it into the 2nd decile. Was he 1 question away? 3? 10?

He also got a score of some sort that was approximately 260. (The letter with all these details is MIA) and it said that to pass you need a score of approximately 360.

What this 260 and 360 is based on is a mystery. There are not that many questions and no apparent point value assigned to questions.

So my question is this. How much does he have to improve? Do the 260 and 360 indicate that he needs to get approximately 50% more questions correct? It's seems unfathomable that he could have missed *that* many questions -- especially when ranking in the 7th decile in category and 2nd decile in 2 others -- it would almost mean that the other 10 categories or so were 100% wrong.

Any insight into the arcane scoring system would be much appreciated.

P.S. As a bit of political commentary: the system seems a little broken. I know he's smart and a good doctor. He went to an ivy league undergrad and ivy league medical school. He did his residency and now fellowship at the best hospital in NYC. His patients love him and his co-workers love him. And yet he might not be a doctor because of this one test. I know we want to make sure our doctors know what they're doing, but he's a better doctor than 90% of the doctor's I've run across in my 45 years.
posted by petestein1 to Grab Bag (1 answer total) 1 user marked this as a favorite
(I recertified in internal medicine and in a subspecialty 3-4 years ago, having originally certified 10 years before that). I don't think there's any value in thinking about the numbers. Right now, he should focus on being in the right frame of mind for the test (i.e., get enough sleep). After my last test, I thought I had done horribly; I passed.

90% of those who take it pass. (Which is pretty scary in its own right.)

For one thing, the people who sit for this exam have been through an extremely rigorous, accredited, 3 year training program. In addition, the questions have little to no bearing on what a physician needs to know. 90% of the questions are things that don't have to be remembered; they can be looked up if needed. Or a question might ask you to pick the supposedly best choice of four or five perfectly reasonable courses of action; I call these "guess what I'm thinking" questions.
posted by neuron at 3:11 PM on August 17, 2010

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