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	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: We believe that several points in the Special Communication by Dr Brennan et al¹ deserve comment. First, the authors show that certification examinations correlate well with other measures of physician aptitude, but do not show that these examinations are more accurate or precise than other tests of physician quality. Tamblyn et al² demonstrated that while several indices of physician quality correlated with scores on a certification examination, these indices were also correlated with testing done during medical school. Other research indicates certification examinations add little to earlier testing.³ We question the value of measuring the same thing in multiple ways.

Second, while the authors point to research that shows an association between certification examination results and clinically relevant outcomes, this does not establish a causal link. Third, a poll indicating that patients believe board certification is important should not be considered supportive to their argument; physicians frequently . . . [Full Text of this Article]

Christopher Slatore, MD
cslatore@u.washington.edu

Scott Stuart, MD
University of Washington School of Medicine
Seattle

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