Fallout from False Assumptions in Medicine

Under the stress of the event, we felt the soldiers’ true nature would reveal itself, and we would be able to tell who would be a good leader and who would not. But the trouble was that, in fact, we could not tell. Every month or so we had a “statistics day,” during which we would get feedback from the officer-training school, indicating the accuracy of our ratings of candidates’ potential. The story was always the same: our ability to predict performance at the school was negligible.⁸

A similar situation may be at play with MOC. Conclusions have been reached without confirming that the assessment tools being used are measuring the appropriate data. Is the entire theory behind MOC even valid? Could an illusion of validity be responsible for leading the MOC in the wrong direction? As physicians, we are committed to developing large, randomized trials to study controversial issues. Isn’t it time for the ABMS to design, implement and fund such studies?

Simon M. Helfgott, MD, is associate professor of medicine in the Division of Rheumatology, Immunology and Allergy at Harvard Medical School in Boston.

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