Precisely. When something rare walks into my clinic, I will consult a reference rather than rely on my memory and limited experience and make sure I'm doing it right and do a literature search to make sure I'm up-to-date. For run-of-the-mill prostate, breast, lung, most GI stuff, etc, I can do a chart review in 5 minutes and know what my plan's going to be, and can contour and review the plan without referencing anything.
But because I might not be able to whip out a pediatric DIPG re-irradiation plan off the top of my head, am I incompetent? Or even gray areas in breast, such as do I treat nodes with a couple of risk factors or not. I'm doing a literature search on that sometimes and looking for new data.
If this exam did what it's supposed to do, all of us competent physicians should just walk in, be presented with a case, given the tools and resources we normally have to generate a plan, such as reference books and the internet, and then present our plan (you know, what we do in our actual jobs). Instead, we play this game where we spend months cramming to memorize scripts and spit out specific case scenarios in a matter of seconds. Why not test us to see how we actually practice? Isn't that the point of the exam?
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