You Think Your Doctor Orders Expensive, Unnecessary Tests?

Since I just got finished with a really obnoxious, expensive exam whose results won’t be used for anything but I was required to take it anyway….I’m thinking about standardized testing.

So that means you’re going to read about it.

Bwa-ha.

Okay! So!

I’ve gone through all the standardized exams I can remember paying for, from high school through the time when I will sit for my licensing exam. Whenever possible, I used the testing fees that were true around the year I took the exam.

Here’s what it costs to sit for the exams you have to sit for in order to become an Internal Medicine physician in the US. Starting in high school.

PSAT: $15

SAT : $41.50

SAT II (2 subject tests and the writing test): $50

MCAT : $225

Step 1 : $480

Step 2 : Clinical Knowledge section – $480; Clinical Skills section – $1007

Step 3 : $670

Internal Medicine Boards : $1365

So, let’s review. In order to get to the point where I can practice Internal Medicine in a board-certifiedly manner, I have to pay a grand total of $4333.50….JUST for the exams. Just so I have permission to walk into the room and sit down at a desk.

That doesn’t include the absurdly expensive preparatory materials that you basically have to use because otherwise you’re screwed (which are often FAR more expensive than the exams). That doesn’t include extension fees, in case you miss your appointment through extenuating circumstances. That doesn’t include travel costs (Step 2 CS is only offered in five cities IN THE WORLD). That doesn’t count the shelf exams whose costs are folded into med school tuition, or my in-service exams that are covered by my residency program but undoubtedly come out of my paycheck somewhere.

As of 2005, there were 67,000 people going through this process. Assuming a constant flow of people from medical school to residencies, that’s $290,344,500. Per year. JUST FOR ADMISSION TO THE EXAMS. NOTHING ELSE. And fees tend to increase as time goes on; I’ve never seen a fee for anything decrease, ever.

Someone figured out how to make an awful lot of money off this whole standardized testing thing, didn’t they.

Don’t even get me started on the test prep industry.

If these exams were all relevant, maybe I wouldn’t complain so loudly. But a good number of these tests are completely useless. The PSAT and the SAT cover the same material, if I recall correctly. The SAT II subject exams don’t really serve much of a purpose. Step 1 tests basic science, but that kind of thing can be left to the medical schools; they’re already paying for the nationally standardized shelf exams for each subject. Or we could throw some of it into the Step 2 CK exam. Scrap Step 2 CS entirely; it’s a swindle. Likewise Step 3, which covers the same material as Step 2, except they try to make it fancy so you don’t notice.

If we absolutely have to hammer learners into the ground with national standardized exams: Test high school stuff with the SAT, and use that score for admission to college. Test collge-level science with the MCAT, and use that score for admission to medical school. Test med school learning with the Step 2 CK exam (and mix in a little bit of Step 1 material if you seriously think that people can understand more advanced medical concepts without mastering the basics). Use Step 2 to screen residency applicants. And then let people learn the freaking material for their own freaking specialty, and make sure they learned it by giving them the Board Exam.

Maybe we could keep the PSAT (just because I got the National Merit Scholarship from that baby). That’s all. Nothing more needed.

Don’t students and trainees have enough debt already?

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Published in: on November 3, 2011 at 6:02 pm  Comments (1)  

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  1. Doctor Orders…

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