Abstract
Objective:To document the timings, frequencies, and outcomes of attempts at certification in internal medicine and the internal medicine subspecialties in the years following residency training for two coborts of residents.
Design:Residents who had completed residency training and had been admitted to an American Board of Internal Medicine (ABIM) certifying examination in 1982 or 1983 were tracked through the ABIM database for five years.
Participants:A total of 10,568 residents were studied. Of the cohort, 79% were men, 21% were women, 79% were graduates of U.S./Canadian medical schools (USMGs), and 21% were graduates of foreign medical schools (FMGs).
Main results:Ultimately, 85% of the residents achieved certification in internal medicine. Cumulative pass rates were 87% for men, 81% for women, 92% for USMGs, and 60% for FMGs; rates increased minimally after the second attempt. Most (87%) residents first attempted the internal medicine examination in the year in which training had been completed. Delaying the first examination was associated with lower pass rates. Half of the candidates who had passed the internal medicine examination attempted subspecialty certification. Over all nine subspecialty examinations, the two-cycle cumulative pass rate was 87%. Higher percentages of FMGs than of any other subgroup attempted subspecialty certification.
Conclusions:The detailed description extends the body of knowledge about certification in internal medicine and the nine internal medicine subspecialties. Questions are raised, such as why some candidates delay the first internal medicine examination and why some residents never seek certification. Future research could explore these issues as well as explanations for the observed differences in pass rates.
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References
Tarlov AR, Weil PA, Schleiter MK, and The Association of Professors of Medicine Task Force on Manpower. National Study of Internal Medicine Manpower: I. Residency training 1976–1977. Ann Intern Med. 1978;88:413–20.
Schleiter MK, Tarlov AR, Weil PA. National Study of Internal Medicine Manpower: VII. Residency and fellowship training 1976–1977 through 1980–1981. Ann Intern Med. 1981;95:762–8.
Schleiter MK, Tarlov AR. National Study of Internal Medicine Manpower: VIII. Internal medicine residency and fellowship training: 1983 update. Ann Intern Med. 1983;99:380–7.
Kohrman CH, Lyttle CS, Andersen RM, Levey GS. National Study of Internal medicine Manpower XIV: Patterns of residency and fellowship over time, 1987 update. Arch Intern Med. 1989;149:2179–85.
Norcini JJ, Fletcher SW, Quimby BB, Shea JA. Performance of women candidates on the American Board of Internal Medicine certifying examination, 1973–1982. Ann Intern Med. 1985;102:115–8.
Shea JA, Norcini JJ, Day SC, Webser GD, Benson JA Jr. Performance of US citizen Caribbean medical school graduates on the American Board of Internal Medicine certifying examinations, 1984 to 1987. Teach Learn Med. 1989;1:10–5.
Norcini JJ, Shea JA, Webster GD, Benson JA Jr. Predictors of the performance of medical school graduates on the 1982 certifying examination in internal medicine. JAMA. 1986;256:3367–70.
Day SC, Shea JA, Norcini JJ, Benson JA Jr. Gender differences in subspecialty career choices and examination performance on the 1983–1988 American Board of Internal Medicine subspecialty certifying examinations. Proceedings of the 28th annual conference, Research in Medical Education (RIME). 1989;28:107–12.
Shea JA, Norcini JJ, Benson JA Jr. Performance of foreign medical graduates on the 1983–1988 American Board of Internal Medicine subspecialty certifying examinations. Proceedings of the 28th annual conference, Research in Medical Education (RIME). 1989;28:20–5.
Norcini JJ, Maihoff NA, Day SC, Benson JA Jr. Trends in medical knowledge as assessed by the certifying examination in internal medicine. JAMA. 1989;262:2402–4.
Schleiter MK, Tarlov AR. National Study of Internal Medicine Manpower: IX. Internal medicine residency and fellowship training: 1984 update. Ann Intern Med. 1985;102:681–5.
Cox MW, Andersen RM, Aday LA, Levey GS, Lyttle CS. National Study of Internal Medicine Manpower: XI. Internal medicine residency and fellowship training in the 1980s. Ann Intern Med. 1987;106:734–40.
Shea JA, Frenkel EP, Webster GD. Training and practice activities of hematology and medical oncology diplomates. Arch Intern Med. 1990;150:145–8.
Cox MW, Aday LA, Levey GS, Andersen RM. National Study of Internal Medicine Manpower: X. Internal medicine residency and fellowship training: 1985 update. Ann Intern Med. 1986;104:241–5.
Day SC, Norcini JJ, Shea JA, Benson JA, Jr. Gender differences in the clinical competence of residents in internal medicine. J Gen Intern Med. 1989;4:309–12.
Norcini JJ, Shea JA, Benson JA, Jr. Changes in the medical knowledge of candidates for certification. Ann Intern Med. 1991;114:33–5.
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Received from the American Board of Internal Medicine, Philadelphia, Pennsylvania.
Supported by the American Board of Internal Medicine.
This work does not necessarily reflect the views or opinions of the American Board of Internal Medicine.
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Shea, J.A., Norcini, J.J., Day, S.C. et al. A longitudinal description of patterns of certification in internal medicine and the subspecialties. J Gen Intern Med 6, 553–557 (1991). https://doi.org/10.1007/BF02598227
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DOI: https://doi.org/10.1007/BF02598227