Medical Education Depravity

I recently completed the article-based continuing certification process required by the American Board of Psychiatry and Neurology to maintain my board diplomate status. The process involves reviewing journal articles selected by the ABPN and answering multiple-choice questions designed to demonstrate that you have absorbed the material. It is supposed to be an exercise in continuing medical education—a way for practicing physicians to stay current with advances in their field. What I encountered instead was an exercise in ideological indoctrination so brazen that it would have been unrecognizable to the physicians who trained me twenty years ago.

One question presented a scenario involving a seventeen-year-old boy in outpatient psychiatric treatment for depression who reveals that he has a boyfriend and that "disturbing" things are happening in the relationship—things he has not disclosed to his therapist because he "does not want to get him into trouble." The question asks what the physician should say first. The correct framing of the question—that a minor is being sexually abused by an adult male—is never stated. The word "abuse" does not appear. The word "crime" does not appear. Instead, the question is constructed entirely around the concept of therapeutic confidentiality, as though the central clinical issue were how to make the boy feel safe enough to keep talking, rather than how to protect a child from a predator. Another question describes a fifteen-year-old boy who "identifies as bisexual" and is being pressured by a same-age male partner to lose weight, with threats of "outing" him. Again, the framing centers entirely on confidentiality and the psychiatrist's legal obligations regarding disclosure—not on the pathology of the relationship itself. These are not questions about medicine. They are questions designed to normalize aberrant and illegal sexual behavior involving minors by embedding it within the sterile language of clinical ethics.

These questions were not drawn from articles flagged as diversity, equity, and inclusion content—articles that also constitute a large and growing share of the required literature. The DEI articles address subjects like "intergenerational trauma," "anti-racism," and "transphobia"—neologistic constructs that have been medicalized despite having no basis in clinical science. They are purely political concepts dressed in the language of psychiatry, and they are now part of the formal recertification process for practicing physicians. But the questions I described above came from what is presented as mainstream clinical literature. The ideology has metastasized beyond the DEI label. It is now embedded in the baseline assumptions of the material itself.