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Open Access Research article

Impact of subspecialty elective exposures on outcomes on the American board of internal medicine certification examination

Victoria K Shanmugam2*, Katina Tsagaris1, Amber Schilling2, Sean McNish2, Sameer Desale3, Mihriye Mete3 and Michael Adams1

Author affiliations

1 Department of Medicine, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW Washington, DC, 20007, USA

2 Division of Rheumatology, Immunology and Allergy, MedStar Georgetown University Hospital, 3800 Reservoir Road, NW Washington, DC, 20007, USA

3 Division of Biostatistics and Epidemiology, MedStar Health Research Institute, 6525 Belcrest Road, Suite 700, Hyattsville, MD, 20782, USA

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Citation and License

BMC Medical Education 2012, 12:94  doi:10.1186/1472-6920-12-94

Published: 12 October 2012

Abstract

Background

The American Board of Internal Medicine Certification Examination (ABIM-CE) is one of several methods used to assess medical knowledge, an Accreditation Council for Graduate Medical Education (ACGME) core competency for graduating internal medicine residents. With recent changes in graduate medical education program directors and internal medicine residents are seeking evidence to guide decisions regarding residency elective choices. Prior studies have shown that formalized elective curricula improve subspecialty ABIM-CE scores. The primary aim of this study was to evaluate whether the number of subspecialty elective exposures or the specific subspecialties which residents complete electives in impact ABIM-CE scores.

Methods

ABIM-CE scores, elective exposures and demographic characteristics were collected for MedStar Georgetown University Hospital internal medicine residents who were first-time takers of the ABIM-CE in 2006–2010 (n=152). Elective exposures were defined as a two-week period assigned to the respective subspecialty. ABIM-CE score was analyzed using the difference between the ABIM-CE score and the standardized passing score (delta-SPS). Subspecialty scores were analyzed using percentage of correct responses. Data was analyzed using GraphPad Prism version 5.00 for Windows.

Results

Paired elective exposure and ABIM-CE scores were available in 131 residents. There was no linear correlation between ABIM-CE mean delta-SPS and the total number of electives or the number of unique elective exposures. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures (143.4 compared to 129.7, p=0.051). Repeated electives in individual subspecialties were not associated with significant difference in mean ABIM-CE delta-SPS.

Conclusions

This study did not demonstrate significant positive associations between individual subspecialty elective exposures and ABIM-CE mean delta-SPS score. Residents with ≤14 elective exposures had higher ABIM-CE mean delta-SPS than those with ≥15 elective exposures suggesting there may be an “ideal” number of elective exposures that supports improved ABIM-CE performance. Repeated elective exposures in an individual specialty did not correlate with overall or subspecialty ABIM-CE performance.

Keywords:
Resident education; Gender; Elective; Subspecialty; Graduate medical education