Furman S McDonald1, Daniel Jurich2, Lauren M Duhigg3, Miguel Paniagua4, Davoren Chick5, Margaret Wells6, Amber Williams7, Patrick Alguire8. 1. F.S. McDonald is senior vice president for academic and medical affairs, American Board of Internal Medicine, Philadelphia, Pennsylvania, adjunct professor of medicine, Mayo Clinic College of Medicine and Science, Rochester, Minnesota, adjunct professor of medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, and clinical associate, J. Edwin Wood Clinic, Pennsylvania Hospital, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0001-7952-3776. 2. D. Jurich is senior psychometrician, National Board of Medical Examiners, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0002-1870-2436. 3. L.M. Duhigg is senior research associate, American Board of Internal Medicine, Philadelphia, Pennsylvania. 4. M. Paniagua is medical advisor, National Board of Medical Examiners, and adjunct professor of medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ORCID: https://orcid.org/0000-0003-2307-4873. 5. D. Chick is senior vice president of medical education, American College of Physicians, and adjunct professor of medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; ORCID: http://orcid.org/0000-0003-4477-1272. 6. M. Wells is director of assessment and education programs, American College of Physicians, Philadelphia, Pennsylvania. 7. A. Williams is manager, Relationship Development, National Board of Medical Examiners, Philadelphia, Pennsylvania. 8. P. Alguire is senior vice president emeritus medical education, American College of Physicians, Philadelphia, Pennsylvania.
Abstract
PURPOSE: To assess the correlations between United States Medical Licensing Examination (USMLE) performance, American College of Physicians Internal Medicine In-Training Examination (IM-ITE) performance, American Board of Internal Medicine Internal Medicine Certification Exam (IM-CE) performance, and other medical knowledge and demographic variables. METHOD: The study included 9,676 postgraduate year (PGY)-1, 11,424 PGY-2, and 10,239 PGY-3 internal medicine (IM) residents from any Accreditation Council for Graduate Medical Education-accredited IM residency program who took the IM-ITE (2014 or 2015) and the IM-CE (2015-2018). USMLE scores, IM-ITE percent correct scores, and IM-CE scores were analyzed using multiple linear regression, and IM-CE pass/fail status was analyzed using multiple logistic regression, controlling for USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 scores; averaged medical knowledge milestones; age at IM-ITE; gender; and medical school location (United States or Canada vs international). RESULTS: All variables were significant predictors of passing the IM-CE with IM-ITE scores having the strongest association and USMLE Step scores being the next strongest predictors. Prediction curves for the probability of passing the IM-CE based solely on IM-ITE score for each PGY show that residents must score higher on the IM-ITE with each subsequent administration to maintain the same estimated probability of passing the IM-CE. CONCLUSIONS: The findings from this study should support residents and program directors in their efforts to more precisely identify and evaluate knowledge gaps for both personal learning and program improvement. While no individual USMLE Step score was as strongly predictive of IM-CE score as IM-ITE score, the combined relative contribution of all 3 USMLE Step scores was of a magnitude similar to that of IM-ITE score.
PURPOSE: To assess the correlations between United States Medical Licensing Examination (USMLE) performance, American College of Physicians Internal Medicine In-Training Examination (IM-ITE) performance, American Board of Internal Medicine Internal Medicine Certification Exam (IM-CE) performance, and other medical knowledge and demographic variables. METHOD: The study included 9,676 postgraduate year (PGY)-1, 11,424 PGY-2, and 10,239 PGY-3 internal medicine (IM) residents from any Accreditation Council for Graduate Medical Education-accredited IM residency program who took the IM-ITE (2014 or 2015) and the IM-CE (2015-2018). USMLE scores, IM-ITE percent correct scores, and IM-CE scores were analyzed using multiple linear regression, and IM-CE pass/fail status was analyzed using multiple logistic regression, controlling for USMLE Step 1, Step 2 Clinical Knowledge, and Step 3 scores; averaged medical knowledge milestones; age at IM-ITE; gender; and medical school location (United States or Canada vs international). RESULTS: All variables were significant predictors of passing the IM-CE with IM-ITE scores having the strongest association and USMLE Step scores being the next strongest predictors. Prediction curves for the probability of passing the IM-CE based solely on IM-ITE score for each PGY show that residents must score higher on the IM-ITE with each subsequent administration to maintain the same estimated probability of passing the IM-CE. CONCLUSIONS: The findings from this study should support residents and program directors in their efforts to more precisely identify and evaluate knowledge gaps for both personal learning and program improvement. While no individual USMLE Step score was as strongly predictive of IM-CE score as IM-ITE score, the combined relative contribution of all 3 USMLE Step scores was of a magnitude similar to that of IM-ITE score.
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