By Warren R. Heymann, MD*
The mission of the American Board of Dermatology (ABD) is: “To serve the public and distinguish the profession by certifying that diplomates have the knowledge and skills to provide high-quality, safe, and effective dermatologic care.”
We believe commitment to professionalism and ethical conduct are just as important as knowledge and skills when it comes to treating patients effectively.
The ABD expects diplomates and dermatology trainees to demonstrate a commitment to fulfilling professional responsibilities, adhering to ethical principles, and being sensitive to diverse patient populations. This includes exhibiting respectful, compassionate, and honest behavior in interactions with patients and colleagues as well as providing care that adheres to the specialty’s highest standards.
These are the reasons why every trainee signs an honor code before each exam, and why every diplomate signs a similar honor code before designing their CertLink each year.
Violations of ethical standards and ABD policies are not unheard-of on board examinations.
Some of you may recall the “airplane notes” scandal in radiology and dermatology reported by CNN in 2012:
“CNN has confirmed the practice also exists with dermatology [in addition to radiology], where the recalls are known as ‘airplane notes,’ because residents write down as much as they can remember on the plane after taking the test… So-called ‘airplane notes’ are well known to dermatology residents and are compiled, typed up and quietly distributed among residency programs across the country.”
Such transgressions are a breach of professionalism in any residency program. Not adhering to the basic principles of honesty and integrity essential in practicing medicine may result in the loss of the privilege of being certified by the ABD.
Why is cheating so critical?
For residents, signing and adhering to the honor code is required not only to protect the integrity of the exams and prevent candidates from gaining an unfair advantage, but, more importantly, to support candidates and protect patients.
Passing the certifying exams is an accomplishment to be proud of because it shows that each trainee has acquired the skills and knowledge measured by these exams. Remember, though -- passing an exam is the beginning of your professional journey.
The ABD also emphasizes the importance of lifelong learning and continuous skill development for its diplomates throughout their careers. That is the point of the Continuing Certification Program.
When I started my dermatology residency in 1980, standard therapies such as acyclovir and isotretinoin were not yet available. Biologics were a pipe dream. If I practiced dermatology today by 1980 standards, I would not deserve my certification. We all know that providing quality care to our patients mandates continuous learning by approaching that challenge with personal integrity to strive to be our best. We must be honest with ourselves and others about what we know, what we do not know, and what we need to do to acquire new knowledge and skills.
By signing an ABD honor code before taking an ABD exam, a promise is made not to copy, disclose or discuss questions or answers.
There are no shortcuts. AI will not do it for us. We need to do it ourselves. That is the only way we will reap the benefits of answering the CertLink questions and studying the rationale. Beginning in January 2026, diplomates must correctly answer 73% of CertLink questions after four years. We believe that nearly all diplomates who actively participate will pass. That is intentional on the Board’s part. Passing is not the point – learning is.
Let’s not cheat ourselves and our patients by violating the honor code or ignoring our code of ethics as physicians. It matters.
*About the Author
Dr. Heymann is the ABD President. He practices at HMGS Dermatology in Marlton, NJ. Additionally, he is a Professor of Medicine and Pediatrics, and Head Emeritus of the Division of Dermatology at Cooper Medical School of Rowan University. He is a Clinical Professor of Dermatology at the Perelman School of Medicine at the University of Pennsylvania.
