To the Editor.
—The study by Ramsey et al1 was well conceived and implemented, but the results beg a larger question, which is how well American Board of Internal Medicine scores correlate with performance as an internist. While no one will argue that having more knowledge in one's brain contributes to better performance as a physician, this is only one dimension of physician competence. Equally important skills include the ability to know when one does not have the required information in one's memory to make a clinical decision, as well as the capacity to obtain that missing information elsewhere. Perhaps a better indicator of physician competence would be to have physicians take examinations (especially recertifying examinations) in their own office or library, surrounded by the very resources (ie, journals, books, and computers) that are integral to their ability to provide quality medical care.These letters were shown to the
Hersh W. Examination Scores Fall With Time: But So What?. JAMA. 1992;267(3):366. doi:10.1001/jama.1992.03480030044032