An Analysis of the Musculoskeletal Trauma Section of the Orthopaedic In-Training Examination (OITE)

Abstract

Since 1963, the Orthopaedic In-Training Examination (OITE) has been used to assess the knowledge of orthopaedic surgery residents1,2. Written and administered by the American Academy of Orthopaedic Surgeons (AAOS), the OITE is composed of approximately 275 questions that test residents’ knowledge in twelve categories: foot and ankle, hand, orthopaedic science, hip and knee reconstruction, orthopaedic diseases, spine, pediatric orthopaedics, medical-related issues, sports medicine, musculoskeletal trauma, rehabilitation, and shoulder and elbow. Although the OITE was initially intended to measure an individual resident's knowledge against a national standard1,2, recent studies have shown that scores on the OITE correlate with passing scores on the American Board of Orthopaedic Surgery (ABOS) Part-I written examination, which is taken at the completion of residency3,4. Prior to 2008, however, there were no analyses of the questions on the OITE. It seemed logical that an in-depth analysis of the test questions on the OITE would be a step toward improving OITE scores and, on the basis of the correlation between the OITE and the ABOS examination, might result in higher passing rates on the ABOS certifying examination as well. Analyses of the foot and ankle, pathology, sports, and hand sections of the OITE have previously been published, beginning in 20085-8. To our knowledge, however, there have been no publications related to the musculoskeletal trauma section. Using prior publications as an established model5-8, we focused on the musculoskeletal trauma questions on OITEs that were administered from the years 2005 to 2009 and attempted to provide a detailed analysis of these questions by analyzing the national performance data of residents at all levels of training, beginning with postgraduate year (PGY)-2 (completion of one year in training [YIT-1]), the references cited …