HIGH-STAKES KNOWLEDGE ASSESSMENT AT ABFM: WHAT WE HAVE LEARNED AND HOW IT IS USEFUL

Clinical knowledge is fundamental to the social contract between medicine and society. As 1 of the 6 core competencies, appropriate clinical knowledge is effortfully acquired, constantly updated through practice and learning, and regularly assessed independently through board certification—and patients care a lot about it. It is thus important for ABFM to regularly review the validity of ABFM high-stakes knowledge assessments. In comparison with other common assessments of clinical knowledge—the ward attending who sees the medical student on rounds and asks some questions, patient satisfaction surveys, a medical school specialty advisor who writes a letter of recommendation—a well-constructed multiple-choice exam potentially provides a more standardized approach, greater reliability and scalability, and much less expense. In an age of increased understanding of structural racism, however, it is important to ask whether board certification exams are biased against certain racial and ethnic groups. In recent years, many standardized tests have been accused of bias