Solutions to Discourage Using Board Exam Recalls

There’s been a bit of chatter recently about the written radiology board exam. At the eye of the storm is the question of whether the common practice of studying recalled questions from previous examinees constitutes cheating.

I’m not going to get into the issue of debating whether it is or it isn’t. Mostly because everyone else already has and I have neither the time nor inclination to present a debate worthy of the issue. (Besides, the entity which most strongly contends that using recall questions is cheating just happens to be the same entity which gets to decide, every ten years or so, whether my time-limited board certificate continues to be valid. I better not say the wrong thing and annoy those folks.)

The problem with making rules that fundamentally define what is cheating and what is not is that he who makes the rules needs to have a plan of action to enforce them. If you make rules that proceed to get ignored, you risk appearing ineffectual. What’s the ABR to do? I mean, you can’t force examinees to forget all of the test material they’ve just been staring at for hours and hours, can you?

Maybe you can. The “Men in Black” movies have been running on cable a lot recently (next sequel is coming soon), and they’ve got me thinking that the ABR’s best approach might be to develop a Neuralyzer akin to that exhibited in the movies. For those unfamiliar, the Neuralyzer is a nifty little pocket-sized gadget, flashed in the eyes of someone who’s just witnessed something (aliens, oft-repeated test questions, etc.) that you don’t want them remembering. Just neuralyze examinees as they leave the testing room, and presto! No more recalled question banks.

Of course, the ABR probably doesn’t want to wait for such tech to come along. They’re being ripped off by examinees now. (That is, if you consider it being ripped off when someone pays you a few thousand bucks to give them the same product you’ve given to hundreds of other customers for years on end.)

Perhaps a lower-tech Neuralyzer will suffice. How about a smack on the head with a Louisville Slugger for each examinee, right as they’re leaving the testing facility? That’ll also discourage examinees from retaking the exam too many times if they fail. If such heavy-handed tactics seem distasteful, maybe some other amnesic treatments could be substituted - electroshock, perhaps, or various meds.

For the holdouts who maintain that exams should be a part of the learning experience, and that remembering the experience is a good thing, perhaps another approach: Aversive conditioning, a la “Clockwork Orange.” Strap examinees down and show them footage of radiology residents sharing recalled questions with one another while you administer noxious drugs, shocks, waterboarding, or whatever other unpleasant stimuli you choose. Eventually, the merest thought of passing on their examination experiences to future examinees will be behaviorally paired with echoes of the torture - er, “conditioning” - and watch those young whippersnappers police themselves.

If all of this seems like an unnecessary encroachment upon the civil liberties of the examinees, or merely an inordinate investment of additional time and resources, just consider the onerous alternative of ceasing the usage of repeated exam questions from year to year, and having to produce all-new ones. Now that would be unfair.