Poll Results & Post-Boards Weariness

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First things first:  last week’s poll results showed that the majority of individuals were wary of using physician “Pay For Performance” as a strategy towards increasing AV fistula placement rates.  Proponents of this strategy (see editorial by Hakim and Himmelfarb in a 2009 KI article) would argue that linking AV fistula placement to some type of financial reward (or linking lack of AV fistula placement to some type of financial penalty, depending on your viewpoint) is the surest way to increase the AV fistula rate in the overall dialysis population.  Potential arguments against using a physician “Pay For Performance” strategy would include penalizing doctors who take care of patients with a lower success of achieving working AV fistulas and encouraging the placement of unnecessary AV fistulas, to name a few.  

So I took the boards yesterday, and I’m eager to hear what others thought of the exam.  Fair?  Frustrating?  Piece of cake?  My own view:  it’s a hard exam, and not only because it requires 8 hours of concentration–like many of these ABIM exams, there are often 2-3 answers which seem like they could be right; the challenge comes in selecting the “Best Answer” according to whomever wrote the question.  Ever wonder how they come up with the questions?  Here is the ABIM’s stated policy on how all their exams are developed.  This week’s RFN Poll of the Week is Boards related.  


  1. The boards were tough, but I saw a few questions that I wouldn't have known had I not read your blog 🙂

    Wish I could have gone to your poster at the ASN, but I needed to fly earlier than I thought.

    Thanks for the good work,


  2. One important factor to keep in mind: apparently not all the questions on the boards "count"–that is, some are being "tried out" to make sure they are not ambiguously worded, and could potentially be used on future versions if they pass scrutiny. I think this is one of the major reasons they don't want test-takers discussing specific questions after taking the test. So if you are an optimist, you can potentially convince yourself that the questions which seemingly had multiple correct answers were just "test questions" which don't count…

  3. Good to know that there are others in the same boat.After taking the exam I had the same feeling.More than 50% of the questions I guess had more than one correct answer,leaving you to struggle to pick one.
    Thanks for the comments.

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