Board Pass Rates Research Articles

What Predicts Residency Accreditation Cycle Length? Results of a National Survey

To determine whether residency program baseline characteristics, program director characteristics, and the date of the most recent Accrediation Council for Graduate Medical Education (ACGME) site visit would affect program accreditation cycle length. A survey asked about cycle length as well as program and program director characteristics. The survey was sent to all 391 accredited internal medicine residency programs registered with the Association of Program Directors in Internal Medicine in March 2005. Bivariate and multivariate regressions were performed to find factors independently associated with cycle length. The mean cycle length was 3.8 years among respondents (70% response rate). Program characteristics associated with longer cycle length included having a higher three-year American Board of Internal Medicine (ABIM) board pass rate. Program characteristics associated with shorter cycle length included being reviewed by the Residency Review Committee in Internal Medicine (RRC-IM) shortly after the July 2003 ACGME program requirement changes, being a university-based program, and having a large percentage of voluntary teaching faculty. Program director characteristics associated with longer cycle length included time spent in clinic. Other program and program director characteristics had no effect on cycle length. Several program and program director characteristics are associated with RRC-IM cycle length. Programs should be wary of the dates of their Residency Review Committee site visits in relation to ACGME programmatic rule changes. The percentage of voluntary faculty at each program, the ABIM board pass rate, and the amount of time the program director spends in clinic also affect a program's cycle length.

Outcome Measures of Triple Board Graduates, 1991-2003

To describe program outcomes for the Combined Training Program in Child and Adolescent Psychiatry, Pediatrics, and Psychiatry (Triple Board Program). All Triple Board Program graduates to date (1991-2003) were asked to participate in a 37-item written survey from February to April 2004. The response rate was 80.7%. Most graduates go on to careers in child and adolescent psychiatry, spending a mean of 72.3% of their time in the field; however, 24.8% of respondents spend at least one fourth of their time in pediatrics and 8.0% spend one fourth of their time or more in general psychiatry. Many graduates are involved in academics, teaching, and research. Board pass rates (including repeat attempts) were highest for general (95.8%) and child and adolescent psychiatry (91.4%) and lowest for pediatrics (77.2%), and a minority (36.3%) of graduates are fully "triple boarded" (i.e., have completed oral and written boards in all three fields). Of graduates, 93.8% stated they would re-enroll in the Triple Board Program, and satisfaction with the curriculum was high. The Triple Board Program is successful in terms of career outcomes, involvement in academics, boards pass rates, and graduate reported satisfaction. These data may help determine the future of this combined program in addressing workforce issues in child and adolescent psychiatry.

Incorporating the Fourth Year of Medical School into an Internal Medicine Residency: Effect of an Accelerated Program on Performance Outcomes and Career Choice

Background: To counter declining student interest in general internal medicine, New York Medical College and Saint Vincent's Catholic Medical Centers of New York implemented an experimental accelerated internal medicine curriculum that was provisionally approved by the American Board of Internal Medicine. Description: This accelerated program allowed selected 4th-year medical students to obtain credit for their 1st year of an internal medicine residency while completing requirements for the MD degree. Evaluation: Career and performance outcomes for trainees in the accelerated and traditional internal medicine residency programs were compared for 6 classes of graduates. There were no statistically significant differences between the 2 groups in mean scores on the Intern Clinical Evaluation Exercise, standardized in-service exam, monthly attending evaluations, or in Board pass rates. However, graduates of the accelerated program were more likely to be in general internal medicine practice on completion of residency. Conclusions: The accelerated program successfully increased the number of trainees entering generalist practice a year earlier, and maintained academic standards.

Surgical caseload in army general surgery programs: A 10-year retrospective

PURPOSE: Over the past decade, the Army Medical Department (AMEDD) has been affected by a military-wide drawdown. The volume and acuity of patients appears to be declining, raising questions regarding quantity and quality in Army surgical training programs. The purpose of this study is to examine the caseloads of Army general surgery programs compared with national averages, and to compare the board examination performance of Army residents with national pass rates. METHODS: The program directors of all 6 Army training programs were requested to submit resident caseloads and performance on qualifying and certifying examinations from 1990 to 2000. The Accreditation Council for Graduate Medical Education (ACGME) and the American Board of Surgery (ABS) provided resident statistics summaries and board examination statistics, respectively, for the same period. Total caseloads, chief resident cases, performance in defined categories, and board pass rates of military residents were compared with national averages. RESULTS: Four of the 6 programs submitted the requested data. The average caseload for Army residents, both total and chief residents, has been lower than the national average over the past decade. Nationally, total case numbers have gradually increased while military changes have been variable. The number of chief resident cases has trended steadily downward in Army programs at a rate exceeding the national average. The volume of procedures in endoscopy, thoracic, and breast surgery in the Army generally exceeds those recorded outside of the military. Despite the decline in surgical cases in the military, the pass rates in both the certifying and qualifying examinations among Army graduates have been consistently higher than the national average. CONCLUSIONS: Residents who train in Army programs perform fewer operative cases than do their counterparts in civilian programs. The downward trend in the number of chief resident cases over the last 10 years is likely reflective of the changes in military medicine. Despite these trends, Army residency graduates continue to exceed national performance averages on the ABS qualifying and certifying examinations.

Benchmarks of support in internal medicine residency training programs.

To identify benchmarks of financial and staff support in internal medicine residency training programs and their correlation with indicators of quality. A survey instrument to determine characteristics of support of residency training programs was mailed to each member program of the Association of Program Directors of Internal Medicine. Results were correlated with the three-year running average of the pass rates on the American Board of Internal Medicine certifying examination using bivariate and multivariate analyses. Of 394 surveys, 287 (73%) were completed: 74% of respondents were program directors and 20% were both chair and program director. The mean duration as program director was 7.5 years (median = 5), but it was significantly lower for women than for men (4.9 versus 8.1; p =.001). Respondents spent 62% of their time in educational and administrative duties, 30% in clinical activities, 5% in research, and 2% in other activities. Most chief residents were PGY4s, with 72% receiving compensation additional to base salary. On average, there was one associate program director for every 33 residents, one chief resident for every 27 residents, and one staff person for every 21 residents. Most programs provided trainees with incremental educational stipends, meals while oncall, travel and meeting expenses, and parking. Support from pharmaceutical companies was used for meals, books, and meeting expenses. Almost all programs provided meals for applicants, with 15% providing travel allowances and 37% providing lodging. The programs' board pass rates significantly correlated with the numbers of faculty fulltime equivalents (FTEs), the numbers of resident FTEs per office staff FTEs, and the numbers of categorical and preliminary applications received and ranked by the programs in 1998 and 1999. Regression analyses demonstrated three independent predictors of the programs' board pass rates: number of faculty (a positive predictor), percentage of clinical work performed by the program director (a negative predictor), and financial support from pharmaceutical companies (also a negative predictor). These results identify benchmarks of financial and staff support provided to internal medicine residency programs. Some of these benchmarks are correlated with board pass rate, an accepted indicator of quality in residency training. Program directors and chairs can use this information to identify areas that may benefit from enhanced financial and administrative support.

Content, culture, and context: determinants of quality in psychiatry residency programs.

Content, culture, and context: determinants of quality in psychiatry residency programs.