Council On Resident Education In Obstetrics And Gynecology Research Articles

Improving OBGYN resident CREOG scores

Background: OBGYN residents take an annual in-service training exam from the Council on Resident Education in Obstetrics and Gynecology (CREOG). The CREOG exam is used within the residency program to identify areas of improvement in education and to help residents prepare for passing the written boards. Introduction: This study’s aim was to improve knowledge and preparation for the CREOG exam through an improved didactic schedule and more focused test preparation strategy. This included incorporating a question bank and CREOG preparation throughout the year. Methods: The average standardized scores per resident class year for Corewell Health East- Dearborn were reviewed from 2019 to 2024. Study Design: The didactic schedule emphasized areas of weakness identified in the prior year, a question bank gamified, and CREOG preparation was initiated at the beginning of the academic year. Residents were also given a personal analysis with areas of improvement from prior years and a faculty liaison. Results: From 2019 to 2024, scores of each class year increased. In the PGY1 class year, the score increased from 54% in 2019 to 60% in 2024. In the PGY2 class year, the score increased from 57% in 2019 to 69% in 2024. In the PGY3 class year, the score increased from 55% in 2019 to 70% in 2024. In the PGY4 class year, the score increased from 58% in 2019 to 71% in 2024. The overall score has increased from 56% in 2019 to 67% in 2024. Discussion: Over six years, our residency didactic schedule and learning environment was revamped by our residents and faculty which resulted in improved scores in the CREOG exam. Conclusion: The improvement in CREOG scores will continue to guide future changes in our didactic schedule.

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.

Obstetrics and Gynecology residency training in transgender care: a national survey of residents and program directors

Aim: Obstetricians and gynecologists (OB-GYN) routinely care for transgender patients though most OB-GYN practitioners do not have any transgender care-specific training. The pervasive lack of training and education leads to dire health consequences for transgender patients. Residents and program directors within U.S. OB-GYN residency programs have been surveyed separately. To our knowledge, this is the first study that compares responses from residents and program directors related to their training. Our study aims to assess OB-GYN residents’ and program directors’ levels of comfort, preparedness, and knowledge in caring for transgender patients. Methods: Electronic surveys were sent to 183 OB-GYN residency programs. Resident and program director surveys consisted of questions regarding experiences with transgender care, perceptions about current transgender care training, and levels of comfort, preparedness, and knowledge in caring for transgender patients. Data were collected via Qualtrics and analyzed using IBM SPSS Statistics. Results: Responses were collected from 37 program directors and 94 residents across five regions defined by the Council on Resident Education in Obstetrics and Gynecology (CREOG). Over 67% of program directors reported not having an established transgender care training curriculum in their program. Among those without an established curriculum, 89% of program directors reported plans to implement one within the next year. Average levels of comfort, preparedness, and knowledge in caring for transgender patients was low for both groups, with residents scoring lower on these variables. Most program directors (89%) were amenable to using standardized training materials as part of their transgender care curriculum, if available. Conclusion: While a majority of U.S. OBGYN residency programs do not have an established transgender care training curriculum, most would use standardized training materials to implement one. This is important given that the current knowledge of transgender care amongst both program directors and residents is low. This study contributes to the limited pool of data that aims to support the development of curricula within OB-GYN residency programs to improve care and reduce health inequities for transgender patients.

(065) Let’s Talk about Sex: Resident Run Didactic Curriculum

Abstract Introduction The Council on Resident Education in Obstetrics and Gynecology (CREOG) includes sexual health learning objectives as part of the core education for Ob/Gyn training. Residents are expected to gain understanding of normal sexual function as well as common areas of sexual dysfunction. Unfortunately, several studies have demonstrated a lack of knowledge in this area by Ob/Gyn residents and that educational didactic programs are not standardized on this topic. In 2010, over 90% of post graduate year (PGY)3 and PGY4 residents reported attending fewer than 5 didactic activities on sexual function/dysfunction, with only 50% feeling able to perform a targeted physical exam. Over the past decade, there has not been substantial improvement in this subject matter. In a 2021 survey evaluating the sexual health CREOG objectives showed that more than half of Ob/Gyn residents were not able to describe the disorders of sexual function or list common medications that effect sexual function. This is not isolated to the US, with studies in other countries including Singapore and Brazil, showing residents lack formal training and residents want increased didactic time focused on sexual health. Objective Our hypothesis was that at our institution the baseline knowledge of sexual dysfunction among Ob/Gyn residents would be low. The primary objective was formulating a needs assessment through implementation of a pre/post survey with a curriculum component. The secondary objective was to determine what areas of sexual medicine are most commonly areas of confusion or where residents lack comfort in regard to patient care. Methods The resident-designed curriculum was built with collaboration from a pelvic floor physical therapist. The journal club format was based on American College of Obstetricians and Gynecologists (ACOG) Practice Bulletins, the International Society for the Study of Women’s Sexual Health (ISSWSH) clinical pearls, and the North American Menopausal Society (NAMS) position statements. The pelvic floor physical therapy component focused on pelvic pain, perinatal considerations, and incontinence. The WCG IRB deemed this study exempt. After the pre-curriculum assessment was used to identify knowledge gaps, a month of one-hour weekly sexual health sessions were implemented followed by a post-curriculum survey. Results Due to small sample size, (N=14) there was no way to establish significance in our results. In general, areas that residents were weak and the curriculum focused on were: 1) Pelvic floor/vulvar/vestibular disorders. 2) Genitourinary syndrome of menopause and vasomotor symptoms of menopause. 3) Sexual medicine disorders (hypoactive sexual desire disorder, female sexual arousal disorder, persistent genital arousal disorder, female orgasm disorders, genitopelvic pain penetration dysfunction). Conclusions The baseline knowledge of sexual dysfunction and menopausal concerns among Ob/Gyn residents was low. However, implementation of a structured curriculum after a formal needs assessment improved comfort with these topics. Now that the baseline curriculum is designed it is imperative to expand to further residency programs (in Ob/Gyn as well as other specialties) to disseminate the knowledge to providers in training who require competency in sexual health concerns. Disclosure No

Editorial introductions.

Editorial introductions.

Nutrition education and nutrition knowledge amongst obstetrics and gynecology residents

Nutrition in pregnancy is a component of the Council on Resident Education in Obstetrics and Gynecology (CREOG) core curriculum. Our objective was to assess Ob/Gyn residents’ education and knowledge surrounding nutrition in pregnancy, including 1) amount of dedicated didactic time on nutrition and attitudes on its utility, 2) subjective comfort in counseling patients on nutrition in pregnancy and perceived barriers to providing nutrition counseling, and 3) objective knowledge of pregnancy-related nutrition recommendations.

Impact of an Online Question Bank on Resident In-Training Exam Performance.

In-training exams (ITEs) are administered annually to Obstetrics and Gynecology (OBGYN) residents and have been demonstrated to correlate with success on licensing examinations. Our study objective was to determine the impact of a question bank and mock exam on the performance of Council on Resident Education in Obstetrics and Gynecology (CREOG) ITEs. Secondarily, we investigated the correlation between the extent of question bank usage and performance on the exam. Pre-post intervention study of resident performance on CREOG ITE before and after implementation of the question bank and mock ITE at Indiana University in 2018. Performance was measured as year-to-year improvement in percent correct on ITE exams. Scores were excluded if a resident did not have a prequestion bank score report or if they did not sit for all eligible ITE exams. There were 51 OBGYN residents at Indiana University during the study period, with 38 available for analysis (75%). Before implementation, average year-to-year improvement for PGY1-2, PGY2-3 and PGY3-4 classes were 0.60%, 1.0% and -1.6%, respectively. After implementation, all resident classes had significant improvements in ITE scores of 6.6% (P < .01), 9.0% (P < .01), and 7.2% (P < .01), respectively. There was a moderate program-wide correlation between the number of questions completed and the percent improvement on the ITE of R = 0.36 (P = .046). Our study demonstrated that access to a question bank and mock ITE significantly improved CREOG ITE performance of OBGYN residents at Indiana University.

THE OBGYN RESIDENT EXPERIENCE IN REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY IN 2022: A SURVEY OF RESIDENCY PROGRAM DIRECTORS

Prior publications have highlighted low scores on reproductive endocrinology and infertility (REI) topics on the annual Council on Resident Education in Obstetrics and Gynecology (CREOG) exam as motivation for improving the quality of resident exposure to REI (1). Over the last 30 years, several studies have proposed changes to the resident curriculum related specifically to REI (1-2). The goal of this study is to provide an updated appraisal of resident REI education in OBGYN residency training.

Editorial introductions.

Editorial introductions.

Impact of Question Bank Use for In-Training Examination Preparation by OBGYN Residents – A Multicenter Study

To examine the impact of access to and utilization of a commercially available question bank (TrueLearn) for in-training examination (ITE) preparation in Obstetrics and Gynecology (OBGYN). This was a retrospective cohort study examining the impact of TrueLearn usage on ITE examination performance outcomes. Produced by the educational arm of the American College of Obstetricians and Gynecologists, the Council on Resident Education in Obstetrics and Gynecology (CREOG) exam is a multiple-choice test given to all residents annually. Residency programs participating in this study provided residency program mean CREOG scores from the year prior (2015), and the first (2016) and second (2017) years of TrueLearn usage. Programs also contributed resident-specific CREOG scores for each resident for 2016 and 2017. This data was combined with each resident's TrueLearn usage data that was provided by TrueLearn with residency program consent. The CREOG scores consisted of the CREOG score standardized to all program years, the CREOG score standardized to the same program year (PGY) and the total percent (%) correct. TrueLearn usage data included number of practice questions completed, number of practice tests taken, average number of days between successive tests, and percent correct of answered practice questions. OBGYN Residency Training Programs. OBGYN residency programs that purchased and utilized TrueLearn for the 2016 CREOG examination were eligible for participation (n = 14). Ten residency programs participated, which consisted of 212 residents in 2016 and 218 residents in 2017. TrueLearn was used by 78.8% (167/212) of the residents in 2016 and 84.9% (185/218) of the residents in 2017. No significant difference was seen in the average CREOG scores available on a per- program level before versus after the first year of implementation either using the CREOG score standardized to all PGYs (mean difference 1.0; p = 0.58) or standardized to the same PGY (mean difference 3.1; p = 0.25). Using resident-level data, there was no significant difference in mean CREOG score standardized to all PGYs between users and non-users of TrueLearn in 2016 (mean, 199.4 vs 196.7; p = 0.41) or 2017 (mean, 198.2 vs 203.4; p = 0.19). The percent of practice questions answered correctly on TrueLearn was positively correlated with the CREOG score standardized to all PGYs (r = 0.47 for 2016 and r = 0.60 for 2017), as well as with the CREOG total percent correct (r = 0.47 for 2016 and r = 0.61 for 2017). Based on a simple linear regression, for every 500 practice questions completed, the CREOG score significantly increased for PGY-2 residents by an average (±SE) of 7.3 ± 2.8 points (p = 0.013); the average increase was 0.7 ± 2.5 (p = 0.79) for PGY-3 residents and 5.8 ± 3.3 points (p = 0.09) for PGY-4 residents. Adoption of an online question bank did not result in higher mean CREOG scores at participating institutions. However, performance on the TrueLearn questions correlated with ITE performance, supporting predictive validity and the use of this question bank as a formative assessment for resident education and exam preparation.

Novel Spaced Repetition Flashcard System for the In-training Examination for Obstetrics and Gynecology

Electronic flashcards allow repeated information exposure over time along with active recall. It is increasingly used for self-study by medical students but remains poorly implemented for graduate medical education. The primary goal of this study was to determine whether a flashcard system enhances preparation for the in-training examination in obstetrics and gynecology (ob-gyn) conducted by the Council on Resident Education in Obstetrics and Gynecology (CREOG). Ob-gyn residents at Duke University were included in this study. A total of 883 electronic flashcards were created and distributed. CREOG scores and flashcard usage statistics, generated internally by interacting with the electronic flashcard system, were collected after the 2019 exam. The primary outcome was study aid usage and satisfaction. The secondary outcome was the impact of flashcard usage on CREOG exam scores. Of the 32 residents, 31 (97%) participated in this study. Eighteen (58%) residents used the study's flashcards with a median of 276 flashcards studied over a median of 3.7h. All of the flashcard users found the study aid helpful, and all would recommend them to another ob-gyn resident. Using the flashcards to study for the 2019 CREOG exam appeared to correlate with improvement in scores from 2018 to 2019, but did not achieve statistical significance after adjusting for post-graduate year (beta coefficient = 10.5; 95% confidence interval = - 0.60,21.7; p = 0.06). This flashcard resource was well received by ob-gyn residents for in-training examination preparation, though it was not significantly correlated with improvement in CREOG scores after adjusting for post-graduate year.

Sexual Health Education in Obstetrics and Gynecology (Ob-Gyn) Residencies—A Resident Physician Survey

Many women will experience a sexual health concern and present to their Obstetrics and Gynecology (Ob-Gyn) care provider, yet a large portion of graduating Ob-Gyn resident physicians in the United States may not feel comfortable helping patients with some sexual health issues. To perform a cross-sectional study of U.S. Ob-Gyn resident physicians that assesses sexual health education didactic sessions and comfort level with sexual health clinical vignettes. A 32-item anonymous survey was sent to all 4,065 Ob-Gyn residents on June 7, 2016. Respondents voluntarily completed the survey electronically. The primary outcome measures are the comfort level of Ob-Gyn resident physicians in taking a sexual history and providing counseling to patients represented in clinical vignettes, which were based on sexual health learning objectives from the Council on Resident Education in Obstetrics and Gynecology (CREOG). Of the 4,065 eligible U.S. examinees, 968 (23.8%) agreed to participate in the study, and 802 (19.7%) completed the survey and were included in the final analysis. Nearly two-thirds of the residents indicated that sexual health training was a priority in residency. However, more than half were not able to describe the disorders of sexual function or list common medications that effect sexual function. When posed with clinical vignettes, residents felt very comfortable obtaining a sexual history (98.5%) and providing counseling (97.0%) for a 16-year-old seeking contraception, yet fewer felt very comfortable obtaining a history and providing counseling for a 26-year-old who is a refugee from Somalia (77.2% and 73.8%). Smaller cohorts felt prepared to take a sexual history and provide counseling for a 17-year-old who discloses that she is a victim of sex trafficking (61.2% and 57.7%), and for a 58-year-old transgender patient planning hormone therapy and surgery (49.9% and 37.9%). In logistic regression analysis, the factors that were influential in an Ob-Gyn resident physician's program to prepare them to describe the disorders of sexual function were post-graduate year (OR 1.387, 95% CI 1.189, 1.618; P = .0001), those that rated the importance of a sexual health curriculum highly (OR 0.701, 95% CI 0.569, 0.864; P = .0012), and a greater number of didactic sessions on sexual health in the residency curriculum (OR 0.685, 95% CI 0.626, 0.750; P < .0001). These findings highlight strengths in the comfort of Ob-Gyn resident physicians about sexual health and illustrate areas of opportunity to engage resident learners by improving the sexual health curriculum.

Can ACGME Milestones predict surgical specialty board passage: an example in Obstetrics and Gynecology.

Background:Multiple tools including Accreditation Council for Graduate Medical Education (ACGME) standardized milestones can be utilized to assess trainee and residency program performance. However, little is known regarding the objective validation of these tools in predicting written board passage.Methods:In this retrospective study, data was gathered on n = 45 Wayne State University Obstetrics and Gynecology program graduates over the five-year period ending July 2018. United States Medical Licensing Examination (USMLE) scores, Council on Resident Education in Obstetrics and Gynecology (CREOG) in-training scores and ACGME milestones were used to predict American Board of Obstetrics and Gynecology (ABOG) board passage success on first attempt. Significance was set at p < 0.05.Results:Written board passage was associated with average CREOGs (p = 0.01) and milestones (p = 0.008) while USMLE1 was not significantly associated (p = 0.055). USMLE1 <217 (Positive predictive value (PPV) = 96%). CREOGs <197 (PPV = 100%) and milestones <3.25 (PPV = 100%), particularly practice-based learning and systems-based practice milestones were most strongly correlated with board failure. Using a combination of these two milestones, it is possible to correctly predict board passage using our model (PPV = 86%).Discussion:This study is the first validating the utility of milestones in a surgical specialty by demonstrating their ability to predict board passage. Residents with CREOGs or milestones below thresholds are at risk for board failure and may warrant early intervention.

Opioid Education in Obstetrics and Gynecology Training Programs

Our primary objective was to assess the current state of pain and opioid education in obstetrics and gynecology (OBGYN) by performing a detailed review of the national educational curricula guiding OBGYN residency and fellowship training programs in the United States. From 2019 to 2020 we reviewed seven documents created to guide learning and structure educational training for OBGYN residency and fellowship programs in the United States: the Council on Resident Education in Obstetrics and Gynecology (CREOG) Educational Objectives Core Curriculum in Obstetrics and Gynecology, the 2016 Educational Objectives-Fellowship in Minimally Invasive Gynecologic Surgery, and the 2018 Guides to Learning in Complex Family Planning, Female Pelvic Medicine & Reconstructive Surgery, Gynecologic Oncology, Maternal Fetal Medicine, and Reproductive Endocrinology and Infertility. Each document was reviewed by two authors to assess for items referring to pain or opioids. The CREOG educational objectives, used to inform educational curricula for residency programs, were the most comprehensive, mentioning pain and/or opioid educational objectives the highest number of times and including the most categories. The CREOG document was followed by the Guides to Learning for Gynecologic Oncology and for Minimally Invasive Gynecologic Surgery. The Reproductive Endocrinology and Infertility Guide to Learning did not mention pain and/or opioids in the educational objectives. Our study identifies an opportunity for consistent and appropriate opioid and pain management education in OBGYN training.

CREOGs Over Coffee: Feasibility of an Ob-Gyn Medical Education Podcast by Residents.

Podcasts and other digital resources are increasingly popular among medical learners and allow the dissemination of research to larger audiences. Little is known about the feasibility of graduate medical education trainees developing podcasts for their own and others' learning. We described the development and implementation of a medical education podcast series by residents for obstetrics and gynecology (Ob-Gyn) resident learning, and demonstrated feasibility, sustainability, and acceptance of this series. We used the Council on Resident Education in Obstetrics and Gynecology (CREOG) educational guidelines to create a weekly study podcast for Ob-Gyn residents over 10 months. Costs and donations (for feasibility), downloads over time (for sustainability), and number of reviews on Apple iTunes and followers on Twitter (for acceptability) were measured. Sixty episodes were released from September 30, 2018, to July 28, 2019 (43 weeks). Initial costs included $3,150 startup and $29 monthly. Online donations through Patreon amounted to $200 a month, which covered 58% of startup costs at 10 months and are projected to cover full costs by 1.5 years. The podcast had 173 995 downloads as recorded through Podbean (39 a month in September, increased to 31 206 a month in July). It gained 644 followers on Twitter and 147 ratings on iTunes, with an average of 4.86 out of 5 stars. Medical podcasts created by Ob-Gyn residents during their training appear feasible and highly acceptable over a sustained period.

Training and Knowledge of Transgender Health Among Obstetrics and Gynecology Residents

BACKGROUND: Transgender individuals experience significant health disparities, including stigma and lack of provider knowledge. The Council on Resident Education in Obstetrics and Gynecology (CREOG) has specific educational objectives regarding care for transgender individuals; however, the extent to which OB/GYN residents meet these objectives is not known. METHODS: We invited all current US OB/GYN residents to complete an electronic, anonymous 42-item survey including questions regarding transgender health training, experiences caring for transgender patients, and comfort meeting the CREOG educational objectives. RESULTS: Of programs that had at least one respondent, 313 of 2,276 eligible trainees completed the survey for a corrected response rate of 13.8%. The majority (76%) of respondents had received at least some form of training on transgender health topics. Forty-two percent of respondents had cared for a transgender individual as a resident. Although most residents (80%) felt comfortable with basic trans-sensitivity protocols, only 22% of respondents felt competent to provide trans-relevant services. More than 90% of respondents felt this was an important topic for OB/GYN residents to learn and desired to receive more training. DISCUSSION: While many respondents felt comfortable with basic topics regarding terminology and sensitivity protocols, a minority of respondents reported feeling prepared to provide care for transgender individuals independently. Given the high desire among respondents for more training, creation of high-quality educational materials for OB/GYN residents should be a priority for residency programs and national organizations, such as CREOG.

Committee Opinion No. 715: Social Etiquette for Program Directors and Faculty.

Educators in obstetrics and gynecology work within a changing clinical learning environment. Ethnic, cultural, and social diversity among colleagues and learners have increased, and methods of communication have expanded in ever more novel ways. Clerkship, residency, and fellowship directors, in partnership with chairs and senior faculty, are urged to take the lead in setting the tone for workplace etiquette, communication, and social behavior of faculty and trainees to promote a high standard of civility and citizenship. The Council on Resident Education in Obstetrics and Gynecology (CREOG) Education Committee has promulgated recommendations that can be used to help address professional relationships, professional appearance, and social media usage. These recommendations also address communications pertinent to educational processes such as interviewing, teaching, evaluation, and mentoring.

Committee Opinion No. 715 Summary: Social Etiquette for Program Directors and Faculty.

Educators in obstetrics and gynecology work within a changing clinical learning environment. Ethnic, cultural, and social diversity among colleagues and learners have increased, and μethods of communication have expanded in ever more novel ways. Clerkship, residency, and fellowship directors, in partnership with chairs and senior faculty, are urged to take the lead in setting the tone for workplace etiquette, communication, and social behavior of faculty and trainees to promote a high standard of civility and citizenship. The Council on Resident Education in Obstetrics and Gynecology (CREOG) Education Committee has promulgated recommendations that can be used to help address professional relationships, professional appearance, and social media usage. These recommendations also address communications pertinent to educational processes such as interviewing, teaching, evaluation, and mentoring.

Identifying Gaps and Inconsistencies in Urogynecologic Surgical Training of Obstetrics and Gynecology Residents.

This study aims to determine the expectations of Obstetrics and Gynecology (ObGyn) residency and Female Pelvic Medicine & Reconstructive Surgery (FPMRS) fellowship program directors (FPDs) for the independent performance of urogynecologic procedures during residency and to compare these expectations with the Council on Resident Education in Obstetrics and Gynecology (CREOG) educational objectives. Two parallel, anonymous surveys were distributed simultaneously to all directors of accredited ObGyn residency and FPMRS fellowship programs in the United States. Respondents provided their own professional and program demographic information and indicated whether they expected their residents to independently perform 27 selected urogynecologic procedures. Among residency program directors (RPDs) and FPDs, the online survey response rate was 24.8% (n = 59) and 51.9% (n = 27), respectively. More RPDs expected residents to perform prolapse procedures with mesh, including laparoscopic sacrocolpopexy, all apical suspensions, mesh excisions, and cystotomy repairs, than FPDs. In addition, RPDs expected mastery of most urogynecologic procedures by the Post Graduate Year 3 level, whereas most FPDs did not expect independent performance of these procedures during residency at all. There were notable differences between RPDs' expectations and CREOG objectives regarding several surgical procedures. Whereas CREOG recommends independent performance of anterior and posterior repair, vaginal suspension, vaginal hysterectomy, and transobturator slings, a significant number of RPDs did not report expecting mastery of these procedures during residency. Approximately 30% of RPDs expected residents to perform open sacrocolpopexy and vesicovaginal fistula repair, whereas CREOG recommends only the understanding of these, without procedural mastery. Although community needs vary by region and setting, CREOG objectives serve as the standard for resident surgical education. This study highlights the discordance between these objectives and ObGyn RDPs' reported expectations for resident performance as well as those held by FPMRS FPDs, the outcome of which reflects a misalignment in graduate medical education between RPDs and FPDs, thus hindering a clear standard for resident surgical competencies.

CREOG In-Training Examination Results: Contemporary Use to Predict ABOG Written Examination Outcomes.

The in-training examination (ITE) offers formative assessments of residents' developing medical knowledge. Identification of an ITE performance level associated with success on the specialty board examination allows identification of "at risk" residents. This study sought to identify a threshold score for obstetrics and gynecology residents' performance on the Council on Resident Education in Obstetrics and Gynecology (CREOG) ITE that predicts successful performance on the American Board of Obstetrics and Gynecology (ABOG) written examination. We analyzed ITE and ABOG results of 80 residents who completed 4 years of CREOG ITEs at 2 institutions between 2002 and 2012. We assessed the level of performance associated with successful performance on the ABOG written examination. Data analyzed included scores for 71 of 80 residents (89%), with an overall pass rate of 82%. A postgraduate year (PGY) 4 score of 200 on the CREOG ITE or twice in any of the PGY training years was associated with a 100% ABOG pass rate. Scoring ≥ 205 in any PGY also was associated with a 100% pass rate. Residents who did not attain a score of 200 had a 35% to 45% chance of failing the ABOG written examination, depending on the PGY of the ITE performance. Our findings suggest that a CREOG ITE score of at least 200 twice, or as a PGY-4, offers assurance of successful performance on the ABOG examination. Scores lower than this threshold may be used to identify "at risk" residents for added learning and provide program elements in need of improvement.