Abstract
Background:Multiple tools including Accreditation Council for Graduate Medical Education (ACGME) standardized milestones can be utilized to assess trainee and residency program performance. However, little is known regarding the objective validation of these tools in predicting written board passage.Methods:In this retrospective study, data was gathered on n = 45 Wayne State University Obstetrics and Gynecology program graduates over the five-year period ending July 2018. United States Medical Licensing Examination (USMLE) scores, Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training scores and ACGME milestones were used to predict American Board of Obstetrics and Gynecology (ABOG) board passage success on first attempt. Significance was set at p < 0.05.Results:Written board passage was associated with average CREOGs (p = 0.01) and milestones (p = 0.008) while USMLE1 was not significantly associated (p = 0.055). USMLE1 <217 (Positive predictive value (PPV) = 96%). CREOGs <197 (PPV = 100%) and milestones <3.25 (PPV = 100%), particularly practice-based learning and systems-based practice milestones were most strongly correlated with board failure. Using a combination of these two milestones, it is possible to correctly predict board passage using our model (PPV = 86%).Discussion:This study is the first validating the utility of milestones in a surgical specialty by demonstrating their ability to predict board passage. Residents with CREOGs or milestones below thresholds are at risk for board failure and may warrant early intervention.
Highlights
The success of a residency program relies upon ensuring that residents who are in the program are learning the necessary clinical skills and academic knowledge to successfully practice and pass the specialty board examination
Written board passage was associated with average CREOGs (p = 0.01) and milestones (p = 0.008) while USMLE1 was not significantly associated (p = 0.055)
CREOGs
Summary
The success of a residency program relies upon ensuring that residents who are in the program are learning the necessary clinical skills and academic knowledge to successfully practice and pass the specialty board examination. To ensure that residents are developing appropriately over the course of their training and developing competence appropriately, several tools have been implemented over the years. In the early 20th century William Halstead established the foundation of the American surgical residency at the Johns Hopkins School of Medicine [2]. Abraham Flexner uncovered that many training programs were of substandard quality [3], which lead to accreditation as the method of establishing uniform standards. The Accreditation Council for Graduate Medical Education (ACGME), which accredits post-graduate training programs, is tasked with “improving healthcare and population health by assessing and advancing the quality of resident physicians’ education through accreditation” [4]. Multiple tools including Accreditation Council for Graduate Medical Education (ACGME) standardized milestones can be utilized to assess trainee and residency program performance. Little is known regarding the objective validation of these tools in predicting written board passage
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