Doctors who fail the American Board of Surgery written exam are no longer allowed to review their tests privately after one man wrote down the answers to dozens of questions and offered them for sale on the Internet.
The board found out last summer that 86 questions used on its 290-question multiple-choice exam were listed on eBay.
Board officials said it took just a few anonymous e-mail exchanges with the auctioneer to reach the doctor who had obtained the questions.
"These are the actual certifying general surgery board questions with correct answers, guaranteed to improve your test score," the auctioneer wrote in August 2004. "A friend of mine failed this written exam, paid the $100 sitting fee and flew to Philadelphia to review his test. ... Why take the chance at failing, getting a year behind your peers...? Get an advantage now!"
Craig Edward Amshel, a rectal specialist from St. Augustine, Fla., failed the 2002 exam. But, as was the practice at the time, he was later allowed to review his test, alone, at the board's offices in downtown Philadelphia for several hours.
Amshel sold two or three sets of questions for $180 to $300, said his lawyer, David R. Dearden.
"I was able to take notes very quickly and wrote down about 100 questions with the correct answer," Amshel wrote in an e-mail to a person posing, on the board's behalf, as someone preparing to take the 2004 exam. "Believe me, I was quite thrilled when I took the test last year as some questions were verbatim."
He agreed to pay $36,000, the estimated cost of assembling teams of surgeons to go through the process of creating and testing new questions.
"This is a sad incident — first, because it's so bizarre, but also because it says so much about the person's disregard for the rules and ethics," said the board's lawyer, Gabriel L.I. Bevilacqua.
Amshel is now focused on restoring his certification through the board's appeals process, his attorney said.
"He didn't believe what he was doing was wrong," Dearden said. "He's a young surgeon just getting started, well-regarded, and just trying to put this behind him."
In addition to passing the all-day exam, a surgeon also must complete five years of training, get a recommendation from a mentor and complete an oral exam.