The specialist examination in internal medicine: a qualitative andquantitative analysis of minutes from memory

Abstract

The specialist examination entitles to independent professional conduct and is therefore of great significance for the quality of medical care. It should cover the contents of the continuing education regulations. So far, little is known about the actual content of the exam. In this study, the question was, which content and which structural characteristics do specialist examinations in internal medicine in Germany contain. 100 randomly selected protocols from nationwide specialist examinations from the years 2013-2016 were quantitatively recorded and descriptively evaluated with regards to their main content as well as the various types of questions. The results were compared with the blueprints of the medical examinations in Switzerland and the USA. In each exam, an average of 27 (SD = 10) questions are asked. The questions can be categorized into three categories: (1) subject-specific questions, (2) case-related questions, and (3) diagnostic-oriented questions with visual material. Cardiology and Gastroenterology, each with 17 %, and Endocrinology with 11 % are the most frequently requested internal medical topics. For 50 % of the questions, the examinee must reproduce knowledge, while for the other 50 %, concepts and procedures must be understood and used. In comparison with the American and Swiss blueprints, a similar percentual distribution of question contents was found. With regards to the American blueprint, it is noticeable that there are more questions from other specialist areas such as Urology, Neurology and Psychiatry in comparison to Germany. The Swiss blueprint covers a wide range of interdisciplinary aspects such as ethics, prevention and economics which are not subject to examination in the German specialist examination. In the oral specialist examination in internal medicine in Germany as many topics as in foreign specialist examinations are examined. However, the variance between the individual exams is relatively large. A standardization of the exam is important to create equal exam conditions for all candidates.