Resident factors associated with American board of internal medicine certification exam failure

ABSTRACT

Introduction

Performance on the certifying examinations such as the American Board of Internal Medicine Certification Exam (ABIM-CE) is of great interest to residents and their residency programs. Identification of factors associated with certification exam result may allow residency programs to recognize and intervene for residents at risk of failing. Despite this, residency programs have few evidence-based predictors of certification exam outcome. The change to pass-or-fail score reporting of the USA Medical Licensing Exam (USMLE) Step 1 removes one such predictor.

Materials and Methods

We performed a retrospective study of residents from a medium-sized internal medicine residency program who graduated from 1998 through 2017. We used univariate tests of associations between ABIM-CE result and various demographic and scholastic factors.

Results

Of 166 graduates, 14 (8.4%) failed the ABIM-CE on the first attempt. Failing the first attempt of the ABIM-CE was associated with older median age on entering residency (29 vs 27 years; P = 0.01); lower percentile rank on the Internal Medicine In-Training Examination (IM-ITE) in each of the first, second, and third years of training (P < 0.001 for all); and lower scores on the USMLE Steps 1, 2 Clinical Knowledge, and 3 (P < 0.05 for all). No association was seen between a variety of other scholastic or demographic factors and first-attempt ABIM-CE result.

Discussion

Although USMLE step 1 has changed to a pass-or-fail reporting structure, there are still other characteristics that allow residency programs to identify residents at risk of ABIM-CE first time failure and who may benefit from intervention.

KEYWORDS:

• Internal medicine
• graduate medical education
• internship and residency
• american board of internal medicine
• learner assessment
• physician certification
• computer-based assessment
• physician certifying examination
• board examination
• standardized test

Acknowledgments

We thank internal medicine residency program coordinator Lois Bell for her help with data abstraction, daily coordination of resident education, and building an effective educational environment. We also thank volunteer Elsa A. Vernon for her help with data abstraction. Alyssa B. Quiggle, PhD, Mayo Clinic, substantively edited the manuscript. The Scientific Publications staff at Mayo Clinic provided proofreading and administrative and clerical support

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so supporting data are not available.

Correction Statement

This article has been corrected with minor changes. These changes do not impact the academic content of the article.

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.