Physicians sanctioned in board exam cheating scandal

The American Board of Internal Medicine has sanctioned 139 physicians for allegedly exchanging test questions from the board's certification exam.

Five physicians also face complaints filed by the board in U.S. District Court for the Eastern District of Pennsylvania. The board is claiming copyright infringement, misappropriation of trade secrets and breach of contract.

The board's actions come five months after the organization sued Arora Board Review and its owners, claiming copyright infringement and theft of trade secrets. The 139 sanctioned physicians had participated in an exam preparation course offered by the New Jersey-based company and had disclosed to Arora officials actual board questions.

The ABIM and Arora Board Review have reached a settlement in that case, including a provision that the company's manager no longer can operate a live board review course, according to ABIM officials. Arora Board Review did not admit wrongdoing.

Christine K. Cassel, MD, ABIM president and chief executive officer, said board staff first learned of problems about a year ago, when they found copyrighted exam questions on Arora's website. The ABIM ultimately removed hundreds of compromised questions from its exam.

"At the Arora Board Review courses, [the manager] was not only bragging that he had ABIM questions but soliciting people who remembered questions to report them back to him," Dr. Cassel said.

Camille Miller, an attorney representing the Arora Board Review, said the organization objects to the ABIM's actions against physicians.

"Physicians routinely discuss examination content with others, and ABIM has not apparently enforced this consistently against other physicians," according to a statement by Miller, of the Cozen O'Connor law firm in Philadelphia.

Humayun Chaudhry, DO, president and chief executive officer of the Federation of State Medical Boards, said physicians bring "disrepute" on the profession by exchanging board exam questions.

"Cheating on a board certification exam is a serious matter which calls into question a physician's character," he said.

Dr. Chaudhry said he believes this is the largest case of organized physician misconduct. State licensing boards may choose to take further action.

"It could call into question the validity of their medical license," Dr. Chaudhry said.

Kevin B. Weiss, MD, MPH, president and chief executive officer of the American Board of Medical Specialties, said he was disappointed in the physicians involved. "I believe ABIM took the appropriate steps necessary to protect the public and other physicians in the profession."

The 24 member boards of the ABMS have rules and procedures to guard against cheating. Dr. Cassel said physicians must sign a "pledge of honesty" that appears in bold three times during the exam and says they will not disclose, copy or reproduce any of the material, and warns of severe penalties if they do.

The 139 physicians sanctioned by the ABIM were notified June 9. Their penalties include revocation of board certification or suspension of certification for one to five years, depending on the severity of the offense. Some noncertified physicians involved will have to wait a year or more before seeking certification.

Physicians can appeal the board's decision within about two months, after which the ABIM will begin notifying state medical licensing boards of its actions, Dr. Cassel said.

The ABIM plans to send warning letters to more than 1,000 other physicians who took the course and didn't report instructors' claims that they provided access to actual ABIM questions.