Lawrence E M Grierson1, Mathew Mercuri1, Carlos Brailovsky1, Gary Cole1, Caroline Abrahams1, Douglas Archibald1, Glen Bandiera1, Susan P Phillips1, Glenna Stirrett1, J Mark Walton1, Eric Wong1, Inge Schabort1. 1. Affiliations: Department of Family Medicine (Grierson, Mercuri, Schabort); Program for Educational Research and Development (Grierson); Division of Emergency Medicine (Mercuri); Division of Pediatric Surgery (Walton), McMaster University, Hamilton, Ont.; College of Family Physicians of Canada (Brailovsky), Mississauga, Ont.; Royal College of Physicians and Surgeons of Canada (Cole), Ottawa, Ont.; Post-MD Program (Abrahams, Bandiera), University of Toronto, Toronto, Ont.; Department of Family Medicine (Archibald), University of Ottawa, Ottawa, Ont.; Department of Family Medicine (Phillips), Queen's University, Kingston, Ont.; Department of Family Medicine (Stirrett), Northern Ontario School of Medicine, Sudbury, Ont.; Schulich School of Medicine & Dentistry (Wong), Western University, London, Ont.
Abstract
BACKGROUND: The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates. METHODS: We conducted retrospective analyses of admissions and certification data to determine the factors associated with success of international medical graduate residents on the certification examinations. International medical graduates who entered an Ontario residency program between 2005 and 2012 and had written a certification examination by the time of the analysis (2015) were included in the study. Data available at the time of admission for each resident, including demographic characteristics, previous experiences and previous professional experiences, were collected from each of the 6 Ontario medical schools and matched with certification examination results provided by The CFPC and the RCPSC. We developed logistic regression models to determine the association of each factor with success on the examinations. RESULTS: Data for 900 residents were analyzed. The models revealed resident age to be strongly associated with performance across all examinations. Fluency in English, female sex and the Human Development Index value associated with the country of medical school training had differential associations across the examinations. INTERPRETATION: The findings should contribute to an improved understanding of certification success by international medical graduates, help residency programs identify at-risk residents and underpin the development of specific educational and remedial interventions. In considering the results, it should be kept in mind that some variables are not amenable to changes in selection criteria. Copyright 2017, Joule Inc. or its licensors.
BACKGROUND: The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates. METHODS: We conducted retrospective analyses of admissions and certification data to determine the factors associated with success of international medical graduate residents on the certification examinations. International medical graduates who entered an Ontario residency program between 2005 and 2012 and had written a certification examination by the time of the analysis (2015) were included in the study. Data available at the time of admission for each resident, including demographic characteristics, previous experiences and previous professional experiences, were collected from each of the 6 Ontario medical schools and matched with certification examination results provided by The CFPC and the RCPSC. We developed logistic regression models to determine the association of each factor with success on the examinations. RESULTS: Data for 900 residents were analyzed. The models revealed resident age to be strongly associated with performance across all examinations. Fluency in English, female sex and the Human Development Index value associated with the country of medical school training had differential associations across the examinations. INTERPRETATION: The findings should contribute to an improved understanding of certification success by international medical graduates, help residency programs identify at-risk residents and underpin the development of specific educational and remedial interventions. In considering the results, it should be kept in mind that some variables are not amenable to changes in selection criteria. Copyright 2017, Joule Inc. or its licensors.
Authors: Anne-Marie MacLellan; Carlos Brailovsky; Paul Rainsberry; Ian Bowmer; Micheline Desrochers Journal: Can Fam Physician Date: 2010-09 Impact factor: 3.275