Mid-Year Medical Knowledge Milestones and ABSITE Scores in First-Year Surgery Residents

Area of Science:

• Medical Education
• Surgical Training
• Competency Assessment

Background:

• Accreditation Council for Graduate Medical Education (ACGME) milestone ratings, specifically "Knowledge of Diseases and Conditions" (MK1), are correlated with American Board of Surgery In Training Examination (ABSITE) scores.
• The predictive value of MK1 ratings for future ABSITE performance requires further investigation, particularly to mitigate bias from prior ABSITE scores.

Purpose of the Study:

• To evaluate the predictive accuracy of mid-year MK1 milestone ratings for the subsequent ABSITE scores of first-year (PGY-1) surgical residents.
• To assess this relationship while excluding the influence of previous ABSITE scores.

Main Methods:

• Collected de-identified data from 247 PGY-1 residents across ten surgical residency programs over five academic years (2014-2019).
• Included United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, mid-year MK1 ratings, and subsequent ABSITE standard scores.
• Analyzed correlations between mid-year MK1 ratings and first ABSITE scores, differentiating between preliminary and categorical residents.

Main Results:

• Mid-year MK1 ratings significantly predicted subsequent ABSITE scores for the overall cohort and categorical residents.
• Each half-point increase in MK1 rating correlated with a 25-point increase in ABSITE score, independent of other predictors.
• Preliminary residents showed significantly lower ABSITE scores with no significant correlation to their MK1 ratings.

Conclusions:

• Mid-year MK1 milestone ratings are predictive of first ABSITE scores in PGY-1 categorical surgical residents.
• The findings suggest that MK1 ratings accurately reflect the knowledge base of categorical residents who subsequently perform better on the ABSITE.
• The lack of correlation in preliminary residents warrants further investigation into assessment methods for this group.