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Related Experiment Videos

Changes over time in the knowledge base of practicing internists.

P G Ramsey1, J D Carline, T S Inui

  • 1Department of Medicine, University of Washington School of Medicine, Seattle.

JAMA
|August 28, 1991
PubMed
Summary
This summary is machine-generated.

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Physician knowledge declines over time after initial board certification. Factors like time since certification and subspecialty impact general internal medicine knowledge, supporting time-limited recertification.

Area of Science:

  • Medical Education
  • Internal Medicine
  • Continuing Professional Development

Background:

  • Physician knowledge is crucial for patient care.
  • Maintaining medical knowledge is a challenge for practicing physicians.
  • The American Board of Internal Medicine (ABIM) certification is a benchmark for internist competence.

Purpose of the Study:

  • To identify factors influencing the knowledge base of practicing internists.
  • To assess the retention of general internal medicine knowledge over time.
  • To evaluate the impact of subspecialization on general medical knowledge.

Main Methods:

  • An 82-item multiple-choice examination based on the 1988 ABIM certifying examination was administered.
  • 289 practicing internists, certified 5-15 years prior, participated.

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  • Multivariate analyses were used to identify predictive factors of test performance.

    • Main Results:

    • A significant inverse correlation (r = -.30) was observed between examination scores and years since certification.
    • Medical knowledge declined notably within 15 years post-certification.
    • Procedure-oriented subspecialists (cardiologists, gastroenterologists) scored lower on general medical knowledge compared to other internists.

    Conclusions:

    • Study findings support the ABIM's move towards time-limited physician certification.
    • Results necessitate a review of content and standards for recertification examinations.
    • Ongoing assessment strategies are needed to ensure continued physician competence.