In Reply: We agree with Dr Keller that the availability of Web-based references prevents physicians from relying solely on recall of factual information as they care for patients. However, these tools are a supplement to the strong working memory of medical practice and efficient information-gathering skills that are needed to provide high-quality patient care. Medical education research shows that expert diagnosticians are more focused and efficient in both diagnosis and information gathering.1 Because testing time is precious, the ABIM examinations are purposely designed to test working memory and not just factual recall, so the most important facts relevant to answering questions correctly are already provided in the clinical vignettes. Accordingly, the expert physician item writers assert that a look-up process is unnecessary to arrive at the correct answer.
Lipner RS, Lucey CR. Allowing Resources During the Certification Examination—Reply. JAMA. 2011;305(1):40-41. doi:10.1001/jama.2010.1891