We appreciate Glaser's comments regarding board certification affecting medical student interest in internal medicine.1 While many senior students review residency program data regarding the passage of the American Board of Internal Medicine examination, we are not aware of students not choosing a career in internal medicine because of such concerns.
Although the overall passage rate in 1993 was 54%, when you review the statistics looking at US and Canadian physicians taking the examination for the first time, the passage rate for 1993 is much higher, at 75%, and this rate has been consistently maintained over the years.2 The American Board of Internal Medicine considers the examination for certification in internal medicine a standard of excellence rather than a standard of competence.
Certainly, there are outstanding internists who have difficulty with certifying examinations that, unfortunately, may limit their practice opportunities. However, we do not believe that the examination statistics,