Abstract

BackgroundThe American Board of Internal Medicine Certification Examination (ABIM-CE) is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME) core competency for graduating internal medicine residents. With recent changes in graduate medical education program directors and internal medicine residents are seeking evidence to guide decisions regarding residency elective choices. Prior studies have shown that formalized elective curricula improve subspecialty ABIM-CE scores. The primary aim of this study was to evaluate whether the number of subspecialty elective exposures or the specific subspecialties which residents complete electives in impact ABIM-CE scores.MethodsABIM-CE scores, elective exposures and demographic characteristics were collected for MedStar Georgetown University Hospital internal medicine residents who were first-time takers of the ABIM-CE in 2006–2010 (n=152). Elective exposures were defined as a two-week period assigned to the respective subspecialty. ABIM-CE score was analyzed using the difference between the ABIM-CE score and the standardized passing score (delta-SPS). Subspecialty scores were analyzed using percentage of correct responses. Data was analyzed using GraphPad Prism version 5.00 for Windows.ResultsPaired elective exposure and ABIM-CE scores were available in 131 residents. There was no linear correlation between ABIM-CE mean delta-SPS and the total number of electives or the number of unique elective exposures. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures (143.4 compared to 129.7, p=0.051). Repeated electives in individual subspecialties were not associated with significant difference in mean ABIM-CE delta-SPS.ConclusionsThis study did not demonstrate significant positive associations between individual subspecialty elective exposures and ABIM-CE mean delta-SPS score. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures suggesting there may be an “ideal” number of elective exposures that supports improved ABIM-CE performance. Repeated elective exposures in an individual specialty did not correlate with overall or subspecialty ABIM-CE performance.

Highlights

  • The American Board of Internal Medicine Certification Examination (ABIM-CE) is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME) core competency for graduating internal medicine residents

  • The primary aim of the current study is to evaluate the impact of individual subspecialty elective exposures on resident ABIM-CE scores within a university based residency program

  • Of the 152 residents enrolled in the MedStar Georgetown University Hospital (MGUH) internal medicine residency who were first-time takers of the ABIM-CE from 2006–2010, 131 had paired elective exposure and ABIM-CE score data available

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Summary

Introduction

The American Board of Internal Medicine Certification Examination (ABIM-CE) is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME) core competency for graduating internal medicine residents. Scores on the American Board of Internal Medicine Certification Examination (ABIM-CE) are one of several methods used to assess medical knowledge in graduating medical residents. To assist programs in evaluating resident performance, the ACGME has defined a toolbox of methods for assessing the six required competencies, including medical knowledge. Many programs have adopted these methods which include the Internal Medicine InTraining Examination (IM-ITE), the American Board of Internal Medicine Certification Examination (ABIMCE), standardized patients, objective-structured clinical examinations (OSCE), 360 multi-source evaluations, program director medical knowledge score, patient surveys, portfolios, oral exams and checklists [5]. It is important to assess the factors that impact resident performance on the ABIM-CE

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