In our study, we analyze whether USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, and residency third year ITE scores correlated with the results of ABIM-CE.Īll residents enrolled in our IM residency training program from 2004 through 2017 were included. A modest correlation between failing USMLE Step 1 and scoring at the bottom quartile in ITE scores with risk of failing ABIM-CE was reported by Kay et al. . A few studies reported an association between USMLE scores and IM-ITE performance. Previously, several studies have reported variable degrees of correlation between USMLE and ITE scores.
Also, the ITE exam score is used by the training programs to evaluate the residents readiness for ABIM-CE and the residents ability pass ABIM-CE. By assessing the knowledge gap (the deficit in the knowledge that can be improved to achieve better scores), ITE exams allow the residents to understand the areas in need for improvement. A national standardized ITE was developed for various specialties, including IM, to provide feedback to the residents and the training program. During the residency training, the annual in-service training exam (ITE) serves as a tool to assess the medical knowledge of the residents. United States Medical Licensing Examination (USMLE) scores are commonly used by residency programs to screen residency applicants. Various tools are used by IM residency programs to select candidates likely to perform well in ABIM-CE to maintain ABIM-CE success rate. In order for the residency programs to maintain their ACGME accreditation, ACGME requires a 80% pass rate in ABIM-CE from the first-time takers of the exam in the latest three-year period. ABIM-CE results are important for both the residents and their residency programs. ABIM-CE is administered once every year for residents who complete their training. The factors include fulfillment of the graduate medical education training requirements, demonstration of clinical competence in patient care, and passing the American Board of Internal Medicine Certifying Exam (ABIM-CE) . American Board of Internal Medicine (ABIM) uses various factors to test the skills of the physicians and their ability to deliver high-quality care. Residency programs perform a twice yearly evaluation of the six core competencies identified by Accreditation Council for Graduate Medical Education (ACGME) to improve the overall performance of the residents. The assessment of a resident's competency during training is a complex process. Measures such as enrolling them in question banks or board review courses can be helpful in improving their chances of passing ABIM-CE. Thus, residency programs can identify internal medicine residents at risk of failing ABIM-CE and formulate interventions at an early stage during residency training. USMLE Step 1, USMLE Step 2 CK, and third-year ITE scores can predict the chances of passing ABIM-CE. The third-year ITE score has a higher preditive value compared to USMLE Step 1 and USMLE Step 2 scores. USMLE Step 1 scores more predictive of ABIM-CE results compared to USMLE Step 2CK scores. The probability curve predicted that the chance of passing ABIM- CE was around 80% with USMLE scores greater than 200 and increased to almost 100% with USMLE scores of 250 or more. Similarly, 9% of residents with USMLE Step 3 score < 220 failed ABIM-CE all residents who failed had scored < 220.
Among 31 residents with Step 2 CK score < 220, 20% ( n = 6) failed ABIM. All residents who failed ABIM-CE had Step 1 scores < 220. A 5 % increase in ITE percentage raised the likelihood of passing ABIM-CE (OR 2.92, 95% CI 1.15–7.38). The OR of ABIM-CE passing chance was 2.96 (95% CI = 0.95–9.20), with a ten-point increase in the average score of the above three exams.
ResultsĪmong 114 Internal Medicine MD residents included in the study, 92% ( n = 105) passed the ABIM-CE. We used Multivariate logistic regression to predict pass or fail results in ABIM-CE based on USMLE and third-year ITE test scores controlling for other covariates. Statistical analysis was perfrormed using Pearson correlation coefficient, and logistic regression to assess the relationship between USMLE Step 1, USMLE Step 2CK, USMLE Step 3, 3rd year ITE scores and ABIM-CE results. We performed a retrospective review of USMLE Step 1, USMLE Step 2 CK, USMLE Step 3, third-year residency ITE scores and ABIM-CE results of IM residents at our residency program from 2004 through 2017. To evaluate if United States Medical Licensing Examination (USMLE) Step 1, USMLE Step 2 CK, USMLE Step 3, and residency third-year in-service training exam (ITE) scores predict the results of American Board of Internal Medicine Certifying Exam (ABIM-CE).
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