IS THE PUBLIC BEING PROTECTED - PREVENTION OF SUBOPTIMAL MEDICAL-PRACTICE THROUGH TRAINING-PROGRAMS AND CREDENTIALING EXAMINATIONS

Governments have traditionally looked to the medical profession for le adership in health planning and have charged the profession with the r esponsibility of establishing and monitoring standards of medical prac tice. Training Program accreditation and licensure/certification exams have been used as the primary methods of preventing unqualified indiv iduals from entering medical practice. Despite the critical nature of the decision made at the time of licensure/certification, there is no information about the validity of these examinations for predicting su bsequent practice and health outcome. In this article, the assumptions implicit in the current use of licensing/certifying examinations are identified, the relevant evidence is reviewed, and the implications of this evidence for current methods of measurement are discussed.