Passing ABPN Exam to be Based on Total Test Score

“When the oral examinations were eliminated for neurology candidates and the new three-part neurology certification examination was developed, the Neurology Council decided to go to a single pass/fail score,” Faulkner said. “The Psychiatry Council decided not to do so immediately and wanted to see a few years of examination results first. Based upon the results of recent new certification examinations, it has become apparent that few candidates fail only one of the three examination sections.”

Faulkner added that combining the three sections of the new certification examination into a single-section examination with many more questions will make it much easier to achieve higher examination reliability.

Linjun Shen, Ph.D., M.P.H., vice president for test development and core competencies at ABPN, said the change in the passing standard can be beneficial to candidates in the sense that, theoretically, good performance in one area can compensate for poorer performance in other areas. “However, our data repeatedly demonstrate that performance in one area typically is highly correlated with that in other areas,” Shen said. “In other words, if a candidate is good in one area, it is likely he or she is also good in other areas. Similarly, if a candidate is weak in one area, it is not likely he or she can get too much help from performance on other areas. Therefore, regardless of how the standard changes, the best strategy of test preparation still is to be ready for all the content areas specified in the test content outlines. Betting on stronger areas to rescue the overall test outcomes can be risky.”

Shen said the “cut score” for passing the exam will be established by a Standard Setting Committee that is to meet in October and will use established psychometric methods to establish the new passing standard.

Also of critical importance to candidates taking the exam is the plan for conversion to DSM-5 criteria and terminology. Importantly, written examinations administered this year will continue to use only DSM-IV classifications and diagnostic criteria.

However, for years 2015 and 2016, the board will be phasing in the use of DSM-5. In those years, diagnoses and diagnostic subtypes from DSM-IV that are obsolete with the publication of DSM-5 will not be tested. As an example, substance-induced mood disorder is a subtype from DSM-IV that is obsolete.

At the same time, diagnoses and diagnostic subtypes that are new to DSM-5 will not be tested in 2015 and 2016. As an example, cannabis withdrawal is new to DSM-5 and so will not be tested.

Finally, diagnoses that are “exactly or substantially the same” in both DSM editions will be tested in 2015 and 2016 using terminology from both editions. According to ABPN, “substantially the same” includes diagnoses that have had a name change only, those that have been expanded into more than one new diagnosis, and those that have been subsumed or combined into a new diagnosis.

Examples of diagnoses that have changed in name only are phonological disorder (DSM-IV), which in DSM-5 is called speech sound disorder, and factitious disorder (DSM-IV), which in DSM-5 is called factitious disorder imposed on self.

An example of a diagnosis that has been expanded into more than one new diagnosis is hypochondriasis (DSM-IV), which in DSM-5 has been expanded into two diagnoses: somatic symptom disorder and illness anxiety disorder.

Examples of DSM-IV diagnoses that have been subsumed or combined into a new diagnosis are alcohol abuse and alcohol dependence, which in DSM-5 have been combined into alcohol use disorder. (For an example of an exam question using the dual listing of DSM-IV and DSM-5 terminology, see box, below left.)

By 2017, the ABPN exams will exclusively use DSM-5 diagnostic criteria and terminology.

At the AADPRT meeting, Faulkner and Shen said steps are being taken to make the conversion process during 2015 and 2016 as clear and seamless as possible for candidates, and they emphasized that questions will be designed to test knowledge of the concepts behind the diagnoses, not the correctness of their knowledge about the converted terminology.

“There will be instructions at the beginning of every 2015 and 2016 computer-delivered examination to explain the format of the dual listing of DSM-IV and DSM-5 terminology in the examinations,” Shen said. “Instructions will also state that it is not the intention of the examinations to test the correctness of the conversion.” ■