- http://www.cnn.com/2012/01/13/health/prescription-for-cheating/index.html
- http://www.cnn.com/2012/02/03/health/doctor-cheating-dermatology/index.html
Provide names of other journalists involved.
Scott Zamost, Drew Griffin, Azadeh Ansari
List date(s) this work was published or aired.
Jan. 15 and Feb. 3, 2012
Provide a brief synopsis of the story or stories, including any significant findings.
The investigation showed how radiologists have cheated to pass the mandatory written board certification exam. After the story aired, the medical group that oversees all board certifications announced it was cracking down on cheating. The second story also revealed that dermatologists have used similar techniques to cheat on their board exams for years. What made this even more interesting was that the whistleblower himself was a doctor. He claimed that widespread cheating was wrong and believed his complaints about it had been ignored. The cheating even had a name: “Recalls.” Over a period of six months, we investigated the practice of residents in the radiology program at the San Antonio Uniformed Services Health Education Consortium (SAUSHEC), which contains the Brooke Army Medical Center in San Antonio, Texas using “recalls” to prepare for their board exams. We were able to obtain years of questions and answers to the exam; some even compiled as Power Points. Residents who took the exam agreed to memorize as much as they could, then immediately after completing it, wrote down the questions and answers that they remembered. It was so prevalent that, as we would learn, some faculty in the military’s program even encouraged the residents to use the recalls. If this were so widespread, we wondered whether it existed in other programs. We began calling radiologists around the country. All told us that they were familiar with the recalls. We also began investigating various resident blogs for clues. Finally, we approached the American Board of Radiology, which we learned, had already expressed concern over the long-time use of the recalls and was in the process of changing its exam. But it wasn’t until we sat down with the board’s director that he acknowledged this practice constituted cheating. Our investigation soon expanded to other radiology programs around the country. When we attended a worldwide convention of radiologists, we found that residents readily admitted using the recalls. If this were true, then we had a story about decades of cheating by radiologists not only at one military hospital, but at the most prestigious programs in the country. Most were afraid to go on camera, but two radiologists agreed to talk to us, defending the use of the recalls and adamantly denying that it was cheating. At the same time, radiology board officials insisted the practice was wrong and violated board policy.
Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?
We obtained at least 15 years of the recalls, which were stored on a shared military computer server. The Army also responded to a series of FOIA requests. To get a broader handle on the story, we reviewed lawsuits, as well as official actions taken against doctors in other specialties for misuse of test material.
Explain types of human sources used.
Radiologists, dermatologists, doctors around the country who work in various specialties, medical board officials, military doctors, radiology program administrators.
Results:
The story resulted in a nationwide crackdown on potential cheating by doctors in all specialties. For the first time, the American Board of Radiology acknowledged the long-time use of “recalls” was cheating and violated its exam policy. The board, which already had been revamping its testing procedures, warned doctors that anyone caught using recalls could be subject to disciplinary action. In addition, the military removed online access to the recalls and warned residents that use of the material constituted cheating. Our follow-up prompted the board that oversees dermatology to also warn residents that use of so-called “airplane notes” was cheating and would not be tolerated.
Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.
Our original investigation aired as a two-part story on CNN Presents. The follow-up story on AC 360 revealed that similar use of recalled test materials has been a serious problem in dermatology. The dermatology board issued warnings that the cheating violated its “professionalism and ethical standards.” And in the wake of the story, the group that oversees 24 medical specialties issued a statement condemning the use of the recalls. There were no corrections or clarifications to the story.
Advice to other journalists planning a similar story or project.
It’s important to understand how these board exams work and the ethical standards established for radiology and other specialties. What kinds of questions do these tests contain and why would a doctor need to study a “recall” to pass? We knew it would be challenging to get anyone to talk about cheating on camera. Look for conferences or gatherings of doctors that are open to the public. It was very difficult to get any radiologist to talk about the use of recalls on camera. We spoke with dozens of doctors by phone who confirmed the practice, but it wasn’t until we attended the Radiological Society of North America’s annual convention that we were able to confirm the extent of the cheating. At the convention, we learned there was an area where residents hung out and had lunch. We began by speaking with residents about the story in this informal setting. All of them were familiar with the use of recalls, but none would go on camera. That was until we met several residents who believed the recalls were not cheating, and in fact, necessary to pass the exam. We convinced them to go on camera immediately. We also found program directors attending the convention. One spoke to us candidly about the use of recalls around the country. By the end of the convention, we had confirmed this practice was widespread.