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My letter was not directed at types of examinations or their value in predicting the comparative or future competence or performance of physicians.I contend that there is an absolute level of competence, ie, knowledge, that patients and fellow physicians are entitled to expect a newly licensed physician or certified specialist to possess and that the purpose and design of a licensing or certifying examination should be to determinewhether a physician has that knowledge.Examinations that permit knowledge of esotrica to offset ignorance of facts essential to proper medical care and that merely compare the relative performance of examinees do not fulfill the aforementioned objective.
Harnes JR. Examinations and Competence-Reply. JAMA. 1981;246(18):2030. doi:10.1001/jama.1981.03320180022013