A reader highlights the disconnect between the ivory tower academics and real-world physician when it comes to board exams:

. . . the boards are costly and time consuming. They have spawned a whole industry of CME that feeds on doctors’ fears of not being up-to-date. I get a constant stream of advertisements for board reviews and courses throughout the year which makes me believe that the boards have become a profitable business . . .

. . . If the administrators of the boards would come down from their ivory towers they would get rid of the pass/fail mindset, and make it known to healthcare organizations that boards should not be used to threaten a doctor’s livelihood.