The American Board of Pediatrics (ABP) offers a general pediatrics board examination and is the gatekeeper for pediatric board certifications in the Nation. 

I am writing this as a partner of a pediatrician who has experienced the ramifications of a test failure. I have watched my partner put her blood, sweat, and tears into preparing for this exam. She has made so many sacrifices in her social and professional life so that she can just get over this hump in October. We found out this week that by a difference of one question, she did not pass her board examination. 

This has been devastating for us. With the anxiety and stress, the test preparation has put us through this year, we do not see ourselves getting through the next year without therapy. The shame and imposter syndrome effects she will experience over a difference of one point or even one question is utterly demoralizing. The fact that next year we will have to again pay you 2500 dollars, in addition to paying for additional preparatory material, will put us under financial stress. Worst of all is the time that she will lose from pursuing her career, her passions, her hobbies, and her life. 

The purpose of board certification is to ensure that the pediatricians that serve us are knowledgeable and have demonstrated the ability to care for children, from infants to young adults. This can be done in a way that does not make new pediatricians suffer, and I know we can greatly reduce the stress and anxiety of this process with creative techniques that do not compromise the competency of our pediatricians. 

Painless Re-examination

There is no need for test takers to wait another year to retake the full board examination. For test takers who just missed a passing score, I strongly believe a supplemental test can be given (with reasonable advance notice) that is personalized to the content domains that their scaled score fell below passing for. 

There are many reasons why this suggestion is much more palatable for test-takers. The first is that they have already demonstrated their competency in most content domains, and there is mercy in not putting them through the broad preparation process once again. The second is that this process would greatly lower the stress and anxiety of candidates heading into their initial board certification. Finally, this would provide candidates with an avenue to gain certification without delaying their life and plans for an entire year. 

I believe that ABP can create question banks that cover each section of the content domain and administer a supplemental test in a fair and personalized way based on their initial certification exam results, which gives test takers a chance to obtain certification w/o putting themselves through a grueling year of preparation. 

Transparency

To the American Board of Pediatrics. You openly claim one of your core values is transparency. Test takers have no avenue or access to understand her score - a flat number score next to a subsection - but nothing to truly learn from. That is not transparency. Transparency is identifying the exact content that was missed so that the next time around, test takers can improve and do better. 

You publish a content outline that has not changed since 2017. It is woefully vague. Your guidelines for psychosocial issues are as follows: 

A. Family (eg, divorce, death, adoption, foster care)
B. Impact of illness (eg, chronic illness/disability)
C. Societal issues

• Socio-economic
• Violence (eg, bullying, physical violence)
• Cultural differences (eg, language barriers, alternative medicine)
• Immigration

This leaves so much room for interpretation. Without transparency, test takers are forced to scour every possible resource (sometimes futilely) and enter the test with only the hope that they have covered the material and that they haven’t wasted their time studying something the ABP never intended to test. 

Summary

To the ABP. Please respond to our request for transparency and for an avenue for quick and painless re-examination.