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• W4226156729 abstract "To the Editor: We are writing to offer a reasoned critique to Arnhart and colleagues’ article. 1 We object to the article’s conclusion, especially as stated in the abstract: This study offers support for licensure and practice standards to account for physicians’ USMLE [United States Medical Licensing Examination] attempts. The relatively small effect sizes, however, caution policy makers from placing sole emphasis on this relationship. We believe a conclusion supported by the data they presented might read, “This study demonstrated that there is a small but significant relationship between USMLE attempts and disciplinary action. However, there is still insufficient evidence to support limiting USMLE attempts for the purpose of reducing disciplinary actions.” The methods the authors describe do not account for the many confounding variables and factors that affect human behavior. We are particularly concerned that Arnhart and colleagues did not discuss the reasons for multiple testing attempts, which might include health issues, personal dilemmas, and other unexpected or uncontrollable life events. Nor did the authors offer any discussion of the possible reasons for disciplinary action that may be unrelated to the design and purpose of the USMLE Step exams. Disciplinary issues of incompetence, inappropriate behavior, substance abuse, fraud, and malpractice were all lumped together, thus obfuscating any attempt to make sense of the identified relationship. We are also troubled that the authors proposed policy while the results only indicated an association—the authors themselves cautioned their readers about inferring a causal relationship. Even with the caveats listed in the abstract (and the long list of limitations in the paper itself), it is incorrect, misleading, and therefore irresponsible to even hint that this study supports limiting USMLE attempts. Suggesting that we substitute the number of examination attempts for scores to estimate the likelihood of disciplinary action is unsupported by this study. There may be other justifications for such a policy, but limiting disciplinary actions is not one of them." @default.
• W4226156729 created "2022-05-05" @default.
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• W4226156729 date "2022-03-30" @default.
• W4226156729 modified "2023-09-26" @default.
• W4226156729 title "The Sky Should Be the Limit: USMLE Attempt Limits Will Not Reduce Disciplinary Actions Among Graduates of U.S. and Canadian Medical Schools" @default.
• W4226156729 cites W3171904565 @default.
• W4226156729 doi "https://doi.org/10.1097/acm.0000000000004580" @default.
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