Board Examinations Research Articles

Associations of Internal Medicine Residency Milestone Ratings and Certification Examination Scores With Patient Outcomes

Despite its importance to medical education and competency assessment for internal medicine trainees, evidence about the relationship between physicians' milestone residency ratings or the American Board of Internal Medicine's initial certification examination and their hospitalized patients' outcomes is sparse. To examine the association between physicians' milestone ratings and certification examination scores and hospital outcomes for their patients. Retrospective cohort analyses of 6898 hospitalists completing training in 2016 to 2018 and caring for Medicare fee-for-service beneficiaries during hospitalizations in 2017 to 2019 at US hospitals. Primary outcome measures included 7-day mortality and readmission rates. Thirty-day mortality and readmission rates, length of stay, and subspecialist consultation frequency were also assessed. Analyses accounted for hospital fixed effects and adjusted for patient characteristics, physician years of experience, and year. Certification examination score quartile and milestone ratings, including an overall core competency rating measure equaling the mean of the end of residency milestone subcompetency ratings categorized as low, medium, or high, and a knowledge core competency measure categorized similarly. Among 455 120 hospitalizations, median patient age was 79 years (IQR, 73-86 years), 56.5% of patients were female, 1.9% were Asian, 9.8% were Black, 4.6% were Hispanic, and 81.9% were White. The 7-day mortality and readmission rates were 3.5% (95% CI, 3.4%-3.6%) and 5.6% (95% CI, 5.5%-5.6%), respectively, and were 8.8% (95% CI, 8.7%-8.9%) and 16.6% (95% CI, 16.5%-16.7%) for mortality and readmission at 30 days. Mean length of stay and number of specialty consultations were 3.6 days (95% CI, 3.6-3.6 days) and 1.01 (95% CI, 1.00-1.03), respectively. A high vs low overall or knowledge milestone core competency rating was associated with none of the outcome measures assessed. For example, a high vs low overall core competency rating was associated with a nonsignificant 2.7% increase in 7-day mortality rates (95% CI, -5.2% to 10.6%; P = .51). In contrast, top vs bottom examination score quartile was associated with a significant 8.0% reduction in 7-day mortality rates (95% CI, -13.0% to -3.1%; P = .002) and a 9.3% reduction in 7-day readmission rates (95% CI, -13.0% to -5.7%; P < .001). For 30-day mortality, this association was -3.5% (95% CI, -6.7% to -0.4%; P = .03). Top vs bottom examination score quartile was associated with 2.4% more consultations (95% CI, 0.8%-3.9%; P < .003) but was not associated with length of stay or 30-day readmission rates. Among newly trained hospitalists, certification examination score, but not residency milestone ratings, was associated with improved outcomes among hospitalized Medicare beneficiaries.

Predictors of Plastic Surgery Applicant Success: An Analysis of the Texas STAR Database.

Integrated plastic surgery residency is one of the most competitive medical specialties. Although previous studies have surveyed integrated plastic surgery residency program directors regarding desired applicant characteristics, there is a paucity of literature assessing detailed application characteristics and reported match outcomes from applicants in recent application cycles. This study examines application characteristics associated with matching into integrated plastic surgery residency from 2017 to 2023. The authors accessed the Texas Seeking Transparency in Application to Residency database, which contains survey information from graduating medical students nationwide regarding residency application characteristics and specialties/programs to which applications were submitted. Characteristics of matched versus unmatched applicants between 2017 and 2023 were compared using χ 2 and 2-sided, independent t tests. Univariate logistic regression models were used to assess predictors of a successful match. A total of 381 integrated plastic surgery residency applicants responded to the Texas Seeking Transparency in Application to Residency survey from 2017 to 2023. Mean United States Medical Licensing Exam Step 2 CK scores; the number of away rotations, interview offers, and honored clerkships; and Alpha Omega Alpha membership rate were significantly associated with and predictive of matching. Preference signaling of programs was associated with an increased interview offer rate. Higher board examination scores, increasing numbers of honored clerkships, away rotations, and Alpha Omega Alpha membership were identified as statistically significant predictors of matching into integrated plastic surgery residency. Prospective applicants should use this information to help guide their efforts in these areas that appear to be associated with a successful transition to residency.

Thorns of Failures: Views of Non-Passers of Criminology Board Examination

Philippine Regulation Commission (PRC) records show that the national passing percentage in the Criminologist Licensure Examination (CLE) is deteriorating. The number of unlicensed Criminology graduates throughout the country is increasing. This study explored the lived experiences of non-passers of the Criminologist Licensure Examination (CLE) through a qualitative research method. The informants of this study were 10 board exam flunkers throughout the Province of Cebu. Four informants were used for the in-depth interview, and six were used for the focus group discussion. Eight (8) emergent themes described the positive and negative experiences of the informants before, during, and after the board exam. For the positive experiences, four (4) themes were developed, namely: Take a Trip Down Memory Lane, Licensure Examination: The Main Event, Acceptance and Moving Forward and Contingency Plan: Look for a Job. For the negative experiences, four (4) themes were formulated, namely: The Chronicles of Review, Test Anxiety: The Feeling of Taking the Licensure Examination, Board Exam Result: A Flunker’s Nightmare and Mission Unsuccessful. For the plights of the informants before, during, and after taking the licensure examination, eight (8) emergent themes were formulated, namely: Procrastination and Idleness, Indiscretion of Reviewees, Financial Struggle: A Dilemma to Board Exam Takers, Family Problems: A Heavy Load to Carry, The Answer Sheet: A Fragile Piece of Paper, Bad Luck: In the Wrong Place at the Wrong Time, Examinee’s Inability to Comprehend Questions: A Tough Assignment, The Fallen Leaves, and Disappointments and Failure to Meet Expectations: Adding Insult to Injury. For the reasons of the informants for not retaking the exam, two (2) themes were developed, namely: Age Limit in the Tri-Bureau: Crashing the Flunker’s Aspirations and Making a Fresh Start.

ChatGPT for use in technology-enhanced learning in anesthesiology and emergency medicine and potential clinical application of AI language models : Between hype and reality around artificial intelligence in medical use

The utilization of AI language models in education and academia is currently asubject of research, and applications in clinical settings are also being tested. Studies conducted by various research groups have demonstrated that language models can answer questions related to medical board examinations, and there are potential applications of these models in medical education as well. This study aims to investigate the extent to which current version language models prove effective for addressing medical inquiries, their potential utility in medical education, and the challenges that still exist in the functioning of AI language models. The program ChatGPT, based on GPT3.5, had to answer 1025 questions from the second part (M2) of the medical board examination. The study examined whether any errors and what types of errors occurred. Additionally, the language model was asked to generate essays on the learning objectives outlined in the standard curriculum for specialist training in anesthesiology and the supplementary qualification in emergency medicine. These essays were analyzed afterwards and checked for errors and anomalies. The findings indicated that ChatGPT was able to correctly answer the questions with an accuracy rate exceeding 69%, even when the questions included references to visual aids. This represented an improvement in the accuracy of answering board examination questions compared to astudy conducted in March; however, when it came to generating essays ahigh error rate was observed. Considering the current pace of ongoing improvements in AI language models, widespread clinical implementation, especially in emergency departments as well as emergency and intensive care medicine with the assistance of medical trainees, is aplausible scenario. These models can provide insights to support medical professionals in their work, without relying solely on the language model. Although the use of these models in education holds promise, it currently requires asignificant amount of supervision. Due to hallucinations caused by inadequate training environments for the language model, the generated texts might deviate from the current state of scientific knowledge. Direct deployment in patient care settings without permanent physician supervision does not yet appear to be achievable at present.

Avrupa Meme Görüntüleme Diploması Çoktan Seçmeli Örnek Soruları: Büyük Dil Modellerinin Yeteneklerinin Değerlendirilmesi

Dear editor, In pursuit of a fresh outlook, my objective was to gauge the abilities of a multimodal large language model (LLM) against sample questions from the European Diploma in Breast Imaging (EDBI) test, an initiative by the European Society of Breast Imaging. Large language models are pushing the potential in radiology, from interpreting text and medical images to generating reports (Bhayana, 2024). Generative Pre-trained Transformer 4 (GPT-4) has notably passed a national mammography board exam with clarity (Almeida et al, 2024). As the latest version among multimodal LLM types, GPT-4 is capable of answering questions requiring both lower-order and higher-order thinking. Three written sample questions, where multiple choices could be correct, were evaluated. It was noted that there was no negative marking for incorrect answers (https://www.eusobi.org/european-diploma-in-breast-imaging-edbi/). The scoring system was adapted from the European Diploma in Radiology scoring guidelines (https://www.myebr.org/edir-scoring-faqs). Data was obtained from Google Gemini, GPT-3.5, and GPT-4 in March 2024. When assigning a value of 1 point to each question, GPT-4 reached an accuracy of 78%, GPT-3.5 achieved 50%, and Google Gemini scored 22.2%. This notable success in the sample questions from the EDBI particularly emphasizes GPT-4's potential in aiding clinical decision-making. Future studies may assess its performance in questions requiring medical image analysis, such as mammography, breast ultrasound, or breast magnetic resonance imaging.

Flipping the Classroom in Residency Didactics Leads to Higher American Board of Surgery in-Training Examination Scores

Didactic education in General Surgery (GS) residency typically follows a nationally standardized curriculum; however, instructional format varies by institution. In recent years, GS residents at our institution expressed discontentment with weekly didactics and were not meeting their goals on the American Board of Surgery In-Training Examination (ABSITE). We sought to develop improvements in our didactic curriculum to increase resident satisfaction and ABSITE scores of GS junior residents (Jrs). In a quality improvement project, we changed the weekly didactic curriculum format from hour-long lectures in the 2018 to 2019 academic year (AY) to a partially-flipped classroom in the 2019 to 2020 AY, involving a 30-minute faculty-led presentation followed by 30 minutes of resident-led practice questions. The outcomes measured were ABSITE scores taken in 2019 and 2020 and resident opinions via an anonymous survey. This study was conducted at the University of Minnesota (Minneapolis, MN). The cohort for this study included all GS Jrs in our GS residency program, including postgraduate year (PGY) 1 nondesignated preliminary, PGY1 to 3 categorical GS residents, and residents in their lab time. Senior residents attended a separate didactics session. After curriculum changes, the ABSITE percentile scores for GS Jrs rose from 52% ± 5% to 66% ± 4% (p = 0.03). No categorical GS Jr scored <30% in 2020, compared to 20% (6/30) of categorical General Surgery residents in 2019. All residents preferred the new format overall and reported greater engagement in and preparation for didactics. After changing didactic education from hour-long lectures in the 2018 to 2019 AY to a flipped classroom model in the 2019 to 2020 AY including 30 minutes of faculty-led lecture followed by 30 minutes of resident-led practice questions, ABSITE scores and resident satisfaction at the University of Minnesota General Surgery Program improved.

PARENTAL INVOLVEMENT IN PUPILS’ ACADEMIC PERFORMANCE IN FIVE SELECTED PUBLIC PRIMARY SCHOOLS OF KALAMBA SUBCOUNTY BUTAMBALA DISTRICT, UGANDA. A CROSS-SECTIONAL STUDY.

Background: The purpose of this study was to assess Parental involvement and Pupils' academic performance in five selected public primary schools of Kalamba sub-county Butambala district. Methodology: The study used a cross-sectional survey design where purposive sampling of 5 government aided and 5 out of 10 in Kalamba sub-county, as well as the intact classes of pupils from primary five to Seven taking four major subjects as per the Uganda National Examination Board guidelines, were included in the study. Thus 425 pupils and 45 teachers participated in the study. Questionnaires with close-ended and structured items were used to collect data on parental involvement. Results: The study enrolled 208 males and 262 females aged 18 and above. Findings revealed that parental involvement is low in pupils' academic performance and the relationship between parental involvement and pupils’ academic performance is significant. Close analysis reveals that all three concepts of parental involvement, namely, parent-pupil interaction, parent-moral guidance, and parent-teacher interaction, had positive r-values that are 0.145, 0.198, and 0.118. Conclusions: Due to social, political, technological, and economic changes in Uganda, in some parts of Uganda, some parents have abandoned their roles towards their children, many of them do not interact with them, morally guide them, and not interact with their teachers; that pupils in primary schools in Kalamba sub county Butambala district generally do not perform well academically and that academic achievement of the learner depends on many factors, Parental involvement is among these factors. The higher the Parental involvement, the higher the possibility of the pupils getting good results and vice versa. Recommendations: There is a need for parents in Kalamba sub-county to give enough time for their children to get highly involved with them, monitor them, guide them morally, interact with teachers, and support them financially and academically.

Performance of ChatGPT on the Taiwan urology board examination: insights into current strengths and shortcomings.

To compare ChatGPT-4 and ChatGPT-3.5's performance on Taiwan urology board examination (TUBE), focusing on answer accuracy, explanation consistency, and uncertainty management tactics to minimize score penalties from incorrect responses across 12 urology domains. 450 multiple-choice questions from TUBE(2020-2022) were presented to two models. Three urologists assessed correctness and consistency of each response. Accuracy quantifies correct answers; consistency assesses logic and coherence in explanations out of total responses, alongside a penalty reduction experiment with prompt variations. Univariate logistic regression was applied for subgroup comparison. ChatGPT-4 showed strengths in urology, achieved an overall accuracy of 57.8%, with annual accuracies of 64.7% (2020), 58.0% (2021), and 50.7% (2022), significantly surpassing ChatGPT-3.5 (33.8%, OR = 2.68, 95% CI [2.05-3.52]). It could have passed the TUBE written exams if solely based on accuracy but failed in the final score due to penalties. ChatGPT-4 displayed a declining accuracy trend over time. Variability in accuracy across 12 urological domains was noted, with more frequently updated knowledge domains showing lower accuracy (53.2% vs. 62.2%, OR = 0.69, p = 0.05). A high consistency rate of 91.6% in explanations across all domains indicates reliable delivery of coherent and logical information. The simple prompt outperformed strategy-based prompts in accuracy (60% vs. 40%, p = 0.016), highlighting ChatGPT's limitations in its inability to accurately self-assess uncertainty and a tendency towards overconfidence, which may hinder medical decision-making. ChatGPT-4's high accuracy and consistent explanations in urology board examination demonstrate its potential in medical information processing. However, its limitations in self-assessment and overconfidence necessitate caution in its application, especially for inexperienced users. These insights call for ongoing advancements of urology-specific AI tools.

Clinical Knowledge and Reasoning Abilities of AI Large Language Models in Anesthesiology: A Comparative Study on the American Board of Anesthesiology Examination.

Over the past decade, artificial intelligence (AI) has expanded significantly with increased adoption across various industries, including medicine. Recently, AI-based large language models such as Generative Pretrained Transformer-3 (GPT-3), Bard, and Generative Pretrained Transformer-3 (GPT-4) have demonstrated remarkable language capabilities. While previous studies have explored their potential in general medical knowledge tasks, here we assess their clinical knowledge and reasoning abilities in a specialized medical context. We studied and compared the performance of all 3 models on both the written and oral portions of the comprehensive and challenging American Board of Anesthesiology (ABA) examination, which evaluates candidates' knowledge and competence in anesthesia practice. Our results reveal that only GPT-4 successfully passed the written examination, achieving an accuracy of 78% on the basic section and 80% on the advanced section. In comparison, the less recent or smaller GPT-3 and Bard models scored 58% and 47% on the basic examination, and 50% and 46% on the advanced examination, respectively. Consequently, only GPT-4 was evaluated in the oral examination, with examiners concluding that it had a reasonable possibility of passing the structured oral examination. Additionally, we observe that these models exhibit varying degrees of proficiency across distinct topics, which could serve as an indicator of the relative quality of information contained in the corresponding training datasets. This may also act as a predictor for determining which anesthesiology subspecialty is most likely to witness the earliest integration with AI. GPT-4 outperformed GPT-3 and Bard on both basic and advanced sections of the written ABA examination, and actual board examiners considered GPT-4 to have a reasonable possibility of passing the real oral examination; these models also exhibit varying degrees of proficiency across distinct topics.

Google Gemini and Bard artificial intelligence chatbot performance in ophthalmology knowledge assessment.

With the popularization of ChatGPT (Open AI, San Francisco, California, United States) in recent months, understanding the potential of artificial intelligence (AI) chatbots in a medical context is important. Our study aims to evaluate Google Gemini and Bard's (Google, Mountain View, California, United States) knowledge in ophthalmology. In this study, we evaluated Google Gemini and Bard's performance on EyeQuiz, a platform containing ophthalmology board certification examination practice questions, when used from the United States (US). Accuracy, response length, response time, and provision of explanations were evaluated. Subspecialty-specific performance was noted. A secondary analysis was conducted using Bard from Vietnam, and Gemini from Vietnam, Brazil, and the Netherlands. Overall, Google Gemini and Bard both had accuracies of 71% across 150 text-based multiple-choice questions. The secondary analysis revealed an accuracy of 67% using Bard from Vietnam, with 32 questions (21%) answered differently than when using Bard from the US. Moreover, the Vietnam version of Gemini achieved an accuracy of 74%, with 23 (15%) answered differently than the US version of Gemini. While the Brazil (68%) and Netherlands (65%) versions of Gemini performed slightly worse than the US version, differences in performance across the various country-specific versions of Bard and Gemini were not statistically significant. Google Gemini and Bard had an acceptable performance in responding to ophthalmology board examination practice questions. Subtle variability was noted in the performance of the chatbots across different countries. The chatbots also tended to provide a confident explanation even when providing an incorrect answer.

I-WARM: Development of a Board Examination Reviewer Web Application for Filipino Pre-Service Physical Educators Utilizing the Unified Spaced Repetition and Hypercorrection Techniques

One of the major parameters by which college graduates' productivity is gauged is their board examination performance. Relevantly, the development and utilization of sophisticated tools and technology to facilitate reviews are encouraged and worthy of such exploration. The study aimed to develop an integrated web application reviewer for MAPEH (music, arts, physical education, and health) (i-WARM) with the use of unified spaced repetition and hypercorrection techniques. This descriptive research and development (R &amp; D) design was used and employed a nine-step process in which functions were built for effective learning and retention of concepts. The evaluation was conducted by 106 graduating Bachelor of Physical Education students from a teacher education institution in Central Luzon, Philippines. Results revealed that the i-WARM is easy to use and easy to learn as it was viewed as clear and understandable, accessible, and has a flexible feature and interface. Pre-service physical educators perceived that the services provided by the web application are useful for their review as it was rated functional and informative. Frequent problems such as crashes and downtimes were not observed by the user during their exposure to the web application. The i-WARM could be explored as a potential aid in assisting learners to acquire concepts easily through an interactive interface. This may likewise assist teachers and students in establishing retention of significant concepts for future licensure examinations.

Holistic Review of Applicants by the United States Postgraduate Training Programs Is Not Associated With the Percentage of Female Residents.

Introduction Given the underrepresentation of female physicians in most specialties and the aim of holistic review in residency applicationsto improve the diversity of matriculating resident physicians in the United States (US) postgraduate medical training programs, we examined the association between holistic review and female resident representation among US postgraduate training programs. Methods We conducted a cross-sectional survey of US postgraduate training programs to inquire about their use of holistic review for resident applications (independent variable). The primary outcome was the percentage of female residents in each program, which was obtained along with other program-level characteristics from the Fellowship and Residency Electronic Interactive Database Access (FREIDA) catalog in April 2023. We limited the analysis to the 10 specialties with the most training spots in 2022, including anesthesiology, emergency medicine, family medicine, internal medicine, neurology, obstetrics and gynecology, orthopedic surgery, pediatrics, psychiatry, and surgery (general). We also examined the interactions between holistic review and specialtyand the percentage of female facultyusing model comparison and simple slopes analyses. Results Of the 3,364 total programs surveyed from the 10 specialties, 222 (6.6%)responded. Responders and nonresponders had similar program-level characteristics, including program type (e.g., university, community), specialty, and reported minimum board examination scores. Of the 222 responders, 179 (80.6%) reported performingholistic review. The percentage of female residents was 49.0% (interquartile range 37.5 to 66.7) in the no holistic review group and 47.8% (35.4 to 65.0) in the holistic review group (median difference 0.9%, 95% confidence interval -6.7 to 8.3). Furthermore, there was no evidence of interaction between holistic review and either the specialty or the percentage of female faculty on the outcome of the percentage of female residents. Conclusions Holistic review of residency applications in this limited sample of US postgraduate training programs was not associated with the percentage of female residents. The role of holistic review in addressing the imbalance of male and female physicians in the healthcare workforce, particularly between specialties, remains unknown.

Assessment of ChatGPT’s performance on Neurology Written Board Examination Questions (P5-7.002)

Assessment of ChatGPT’s performance on Neurology Written Board Examination Questions (P5-7.002)

Large Language Model Performance on Practice Epilepsy Board Examinations

This diagnostic study examines whether large language models are able to pass practice licensing examinations for epilepsy.

Comparative Performance of ChatGPT 3.5 and GPT4 on Rhinology Standardized Board Examination Questions

AbstractObjectiveAdvances in deep learning and artificial intelligence (AI) have led to the emergence of large language models (LLM) like ChatGPT from OpenAI. The study aimed to evaluate the performance of ChatGPT 3.5 and GPT4 on Otolaryngology (Rhinology) Standardized Board Examination questions in comparison to Otolaryngology residents.MethodsThis study selected all 127 rhinology standardized questions from www.boardvitals.com, a commonly used study tool by otolaryngology residents preparing for board exams. Ninety‐three text‐based questions were administered to ChatGPT 3.5 and GPT4, and their answers were compared with the average results of the question bank (used primarily by otolaryngology residents). Thirty‐four image‐based questions were provided to GPT4 and underwent the same analysis. Based on the findings of an earlier study, a pass‐fail cutoff was set at the 10th percentile.ResultsOn text‐based questions, ChatGPT 3.5 answered correctly 45.2% of the time (8th percentile) (P = .0001), while GPT4 achieved 86.0% (66th percentile) (P = .001). GPT4 answered image‐based questions correctly 64.7% of the time. Projections suggest that ChatGPT 3.5 might not pass the American Board of Otolaryngology Written Question Exam (ABOto WQE), whereas GPT4 stands a strong chance of passing.DiscussionThe older LLM, ChatGPT 3.5, is unlikely to pass the ABOto WQE. However, the advanced GPT4 model exhibits a much higher likelihood of success. This rapid progression in AI indicates its potential future role in otolaryngology education.Implications for PracticeAs AI technology rapidly advances, it may be that AI‐assisted medical education, diagnosis, and treatment planning become commonplace in the medical and surgical landscape.Level of EvidenceLevel 5.

Development of an Instrument for the Online Evaluation of Orthodontic-Treated Cases: A Pilot Study

Background: It is necessary to create a sound method for the optimal evaluation of treated cases of orthodontic board exam candidates. This cross-sectional study aimed to design and validate a new method for the national orthodontic board exam using a web-based program. Methods: Complete documents of 10 patients randomly selected from a pool of the previously presented cases at the national board examination were entered into a web-based program called "the Orthoboard". The documents were arranged according to the European Board of Orthodontist Standards, and 15 related questions were asked based on the index of complexity, outcome, and need index and the American Board of Orthodontics evaluation standards. A customized grading system was used for the finalized questionnaire. They were asked to be evaluated by 10 orthodontists (5 with less and 5 with more than 10 years of experience). The content validity of the questionnaire was analyzed by the content validity index and content validity ratio. The reliability of this questionnaire was measured using the Kappa statistical test. Results: Most evaluators do not consider it necessary to ask questions about the diagnostic resume, problem list, treatment plan, and treatment resume. Crowding after treatment and cross-biting before and after treatment had the best interexaminer reliability. The least agreement among examiners was between the pre-treatment aesthetic index and the pre-treatment buccal segment relationship. Conclusion: Inter-examiner reliability was lower than expected, indicating that the orthodontic board test scoring is too subjective. The addition of a 3-dimensional cast is recommended for better objective evaluation.

ChatGPT Earns American Board Certification in Hand Surgery

PurposeArtificial Intelligence (AI), and specifically ChatGPT, has shown potential in healthcare, yet its performance in specialized medical examinations such as the Orthopaedic Surgery In-Training Examination and European Board Hand Surgery diploma has been inconsistent. This study aims to evaluate the capability of ChatGPT-4 to pass the American Hand Surgery Certifying Examination. MethodsChatGPT-4 was tested on the 2019 American Society for Surgery of the Hand (ASSH) Self-Assessment Exam. All 200 questions available online (https://onlinecme.assh.org) were retrieved. All media-containing questions were flagged and carefully reviewed. Eight media-containing questions were excluded as they either relied purely on videos or could not be rationalized from the presented information. Descriptive statistics were used to summarize the performance (% correct) of ChatGPT-4. The ASSH report was used to compare ChatGPT-4’s performance to that of the 322 physicians who completed the 2019 ASSH self-assessment. ResultsChatGPT-4 answered 192 questions with an overall score of 61.98%. Performance on media-containing questions was 55.56%, while on non-media questions it was 65.83%, with no statistical difference in performance based on media inclusion. Despite scoring below the average physician’s performance, ChatGPT-4 outperformed in the ‘vascular’ section with 81.82%. Its performance was lower in the ‘bone and joint’ (48.54%) and ‘neuromuscular’ (56.25%) sections. ConclusionsChatGPT-4 achieved a good overall score of 61.98%. This AI language model demonstrates significant capability in processing and answering specialized medical examination questions, albeit with room for improvement in areas requiring complex clinical judgment and nuanced interpretation. ChatGPT-4’s proficiency is influenced by the structure and language of the examination, with no replacement for the depth of trained medical specialists. This study underscores the supportive role of AI in medical education and clinical decision-making while highlighting the current limitations in nuanced fields such as hand surgery.

The Birth and Development of the Lactation Consultant Profession (1980-2007): An Interview With Chele Marmet (Part II).

The remarkable world-changing growth of International Board Certified Lactation Consultants (globally over 35,000 IBCLCs in 2023), as the internationally recognized lactation professional since Chele Marmet conceptualized the field in 1977, demonstrates its importance for society and breastfeeding dyads. The early 1980s was a seminal time in the development of lactation care as a allied health field with specialized knowledge, study, and certification. Chele Marmet played a significant role as an innovator and activist during all these major changes. In this interview, she details these historic events, which she is elaborating further in her upcoming memoir.Although the terms LC and lactation professional have commonly been used to refer to those working clinically with breastfeeding families, in this article both terms refer only to the International Board Certified Lactation Consultant (IBCLC). JHL has a policy not to use the term LC (Dodgson, 2016, 2020); our rationale is that this term is currently too vague and is often misused by those with less education and experience than IBCLCs. However, we have used LC in this article at times when referring to lactation professionals prior to the development of the international board examination. This article is the second part of the interview; Part I was published in the previous JHL issue (February 2014). This interview has been transcribed with minor editing for ease of reading. (CM = Chele Marmet, JD = Joan Dodgson).

The American Board of Pathology cytopathology board examination: Personal recollections of the first cytopathology board exam and a brief historical perspective.

The American Board of Pathology cytopathology board examination: Personal recollections of the first cytopathology board exam and a brief historical perspective.

Use of In-Training Examination Scores as a Fellowship Candidate Evaluation Metric: Time for a Change.

In the field of obstetrics and gynecology (OB/GYN), the Council on Resident Education in Obstetrics and Gynecology (CREOG) administers an annual in-training examination to all OB/GYN residents as a formative educational tool for assessing medical knowledge and promoting self-improvement. Although the CREOG examination is not designed or intended for knowledge certification, many OB/GYN subspecialty fellowship programs request and use CREOG examination scores as a metric to evaluate fellowship candidates. Among the 57 gynecology-based urogynecology fellowship programs, 30 programs (53%) request CREOG examination scores to be submitted by candidates, as of March 2023. Although the use of CREOG examination scores as an evaluation metric may constitute a minor component within the fellowship match process, this practice fundamentally contradicts the intended purpose of the examination as an educational self-assessment. In addition, it introduces the potential for bias in fellowship recruitment, lacks psychometric validity in predicting specialty board examination failure, and shifts the CREOG examination from its original intention as low-stakes self-assessment into a high-stakes examination akin to a certification examination. For these reasons, we call upon the urogynecology community to prioritize the educational mission of the CREOG examination and reconsider the practice of requesting or using CREOG examination scores in the fellowship match progress.