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The author collected completed questionnaires from 52 psychiatrists who had failed to pass the examinations of the American Board of Psychiatry and Neurology (ABPN) on their first try. He quotes from the responses of 6 of these psychiatrists, showing the profound emotional impact of their failure. He recommends that the ABPN explain its low pass rate, supply feedback on the exam results, provide the specific criteria by which competence is judged, allow candidates to take the written exam on a trial basis, and drop the oral exams if their reliability cannot be documented. He also recommends that the profession of psychiatry take responsibility for the certification procedure.
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