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Quantifying For-Profit Outcomes in GME: A Multispecialty Analysis of Board Certifying Examination Pass Rates in
Jared W Lassner1, James Ahn2, Shannon Martin3
1is a Third Year Medical Student, University of Chicago Pritzker School of Medicine.
The number of for-profit residency programs significantly increased across internal medicine, general surgery, and pediatrics. For-profit programs were linked to lower board exam pass rates, particularly in pediatrics.
Area of Science:
- Medical Education Research
- Healthcare Management
- Surgical Education
Background:
- The presence of for-profit hospitals in the U.S. has grown, yet their impact on graduate medical education (GME) remains insufficiently understood.
- This study investigates the evolving role and outcomes of for-profit institutions within GME.
Purpose of the Study:
- To quantify the rise of for-profit involvement in Internal Medicine (IM), General Surgery (GS), and Pediatrics GME.
- To compare board certification examination pass rates between for-profit and nonprofit-affiliated residency programs.
Main Methods:
- Utilized Accreditation Council for Graduate Medical Education and Medicare data (2001-2021) to track for-profit GME prevalence.
- Analyzed public board pass rate data from 2017-2020 for Surgery, Internal Medicine, and Pediatrics.
- Employed linear regression models to assess the relationship between for-profit status and examination pass rates.
Main Results:
- For-profit affiliated residency programs saw substantial increases: 400.0% in IM, 334.4% in GS, and 23.2% in Pediatrics (2001-2021).
- Initial analysis showed significantly lower pass rates in for-profit programs across IM, Pediatrics, and combined specialties.
- After adjusting for covariates, this association persisted significantly only for Pediatrics.
Conclusions:
- For-profit programs have significantly expanded within IM, GS, and Pediatrics GME from 2001 to 2021.
- While for-profit affiliation correlated with lower pass rates overall, this effect was significant only in Pediatrics after controlling for other factors.
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