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Analysis of Performance Trends from 2010-2019 on the American Board of Internal Medicine Nephrology Certifying Exam

Jeffrey S Berns1,2, Weifeng Weng3, Bernard G Jaar4,5,6,7

  • 1Department of Medicine, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania.

Journal of the American Society of Nephrology : JASN
|October 28, 2021
PubMed

Insights

Nephrology board exam pass rates are declining due to lower internal medicine exam scores and trainee demographics. Internal medicine exam performance is the key factor influencing nephrology certification success.

Area of Science:

  • Nephrology
  • Medical Education
  • Physician Certification

Background:

  • The American Board of Internal Medicine (ABIM) nephrology certifying exam pass rates have declined, ranking among the lowest in internal medicine subspecialties.
  • Fewer applicants are entering nephrology fellowship programs in recent years.

Purpose of the Study:

  • To assess factors associated with nephrology certifying exam performance among US graduates from 2010-2019.
  • To analyze changes in fellowship program characteristics and their impact on exam outcomes.

Main Methods:

  • Retrospective observational study of 4094 US ACGME-accredited nephrology fellowship graduates.
  • Examined first-time takers of the ABIM nephrology certifying exam.
  • Analyzed trainee characteristics and fellowship program data from 2010 to 2019.

Main Results:

  • Lower internal medicine (IM) certifying exam scores, older age, female sex, international medical graduate (IMG) status, and smaller fellowship programs correlated with lower nephrology exam performance.
  • Mean IM certifying exam percentile scores decreased from 56.7 to 46.1 between 2010 and 2019.
  • IMGs performed worse than US medical graduates (USMGs) on the nephrology exam, even with comparable IM exam performance.

Conclusions:

  • Declining IM certifying exam performance, trainee demographics, and smaller program size contribute to lower nephrology certifying exam pass rates.
  • Internal medicine certifying exam performance is the primary determinant of success on the nephrology certifying exam.
Abstract

Keywords:
ABIMUS medical graduatecertifying examinternational medical graduatenephrology fellowship

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