Special curriculum for surgery residents who fail the ABSITE

Abstract

PurposeThe American Board of Surgery In-Training Examination (ABSITE) documents surgical residents’ acquisition of surgical knowledge. From 1995 to 1998, after merging two general surgical residencies, 10 residents had ABSITE scores below the 30th percentile. A special curriculum was designed to address these knowledge deficiencies. The purposes of this study were to determine: (1) whether the special curriculum was effective, as measured by the next ABSITE, (2) whether the evaluation score for the special curriculum predicts the next ABSITE performance, and (3) how the special curriculum can help manage the knowledge-deficient resident. MethodsEach resident filled out a questionnaire and met with the program director. The special curriculum ran from May 1 until the following March. Each resident presented a basic science conference and took the Association of Program Directors in Surgery Basic Science Course. Each resident studied a surgery textbook and took 4 examinations. Each resident was placed on probation but promoted to the next year in July. Their continuation in the residency depended on their performance in this special curriculum, clinical evaluations, and the next ABSITE. ResultsThe questionnaire responses were: stopped studying: 10, surprised with low score: 9, no review of questions: 8, personal problems: 6, and test anxiety: 5. Basic Science conferences were above average or excellent. Conference attendance was 40%–80%. Evaluation scores were 57 to 95.The mean ABSITE percentile scores were initial = 18 (±8) and final = 48 (±35). The mean improvement was 31 (±29). The mean ABSITE standard scores were initial = 438 (±72) and final = 542 (±107) with a mean improvement of 104 (±61). Six out of 10 residents scored over 30% from 34%–97%. Four residents scored from 4%–23%. Six of the 10 residents were retained whereas 4 residents resigned. ConclusionsThe special curriculum provides an effective method with a due process for dealing with residents who have a deficiency of knowledge. The curriculum evaluation scores predicted the ABSITE outcome in only 70% of the residents and failed to correlate in 30%. This special curriculum separated the residents into two groups: one group passed the ABSITE with scores of 34% or above, and the other group failed, with ABSITE scores of 23% or below.