Tue, 22 Apr 2003
Earlier, I linked to Cem Kaner's skill-based final exam for a testing course. My wife is "board certified" through the American College of Veterinary Internal Medicine (ACVIM). That means she's an expert practitioner. I said I'd describe how such certification works. Here goes. (More details here.) I've highlighted the parts that jump out at me. If we must have certification, can it include things like these?
(Note: all this happens after you're already a veterinarian and have completed an internship.)
You must work (practice medicine and also take some courses) under the direct supervision of two board-certified "diplomates" (like my wife) for a portion of a three-year residency. You must also spend some time (not much) shadowing other specialists. For example, you might read radiographs (x-rays) with radiologists. (The software equivalent might be testers spending some time working with programmers.)
You must have one publication accepted to a journal. It could be a research report ("I did this experiment..."), a case report ("I treated this interesting case..."), or a retrospective study ("At U Illinois, we've fixed 543 LDAs over the past 15 years and...")
You must submit three case reports to an ACVIM review committee. Two out of the three must be accepted. Each case report describes your management of a challenging case. The writeups have to be your own work, without help from your supervisors. They will certainly include discussion of things you did but shouldn't have, and discussion of why you didn't do particular things. Dawn, who sat on the review committee one year, says that any writeup that didn't have such discussion would be "unbelievable". No case that demonstrates expertise goes smoothly.
(In food animal medicine, the reasons for not doing things are often economic: a farmer is only willing to spend X dollars on an animal, and you have to spend those dollars wisely as the case progresses and you learn more. Sound familiar? But case reports also include descriptions of flat-out mistakes, how you recovered from them, and what you now realize you should have done. That's only realistic.)
The written exam is taken in two parts (in different years). There's a general exam, multiple choice, that takes a day. Then there's a more specific exam (concentrating on your sub-specialty, like food animal medicine) that takes two days.
The two day exam has a multiple-choice part. It also has an essay question part. ("Compare and contrast these two diseases...", "Explain the physiology behind coughing.", "Here are some toxic plants. Explain what they do...")
There's also a patient management part that works in an interesting way. You are given a set of symptoms. You pick tests you'd run. You get back the results of those tests. You can run more tests or try some treatments. At each exam step, you try something and get results. This continues until you can't think of anything more to do. You never know if you got to the answer by the optimal route, or even if you've gotten a complete answer (since the animal may have more than one problem).
This is serious stuff. Testing certifications do not stack up very favorably, in my opinion.