Academic Achievement and Competency in Rural and Urban Family Medicine Residents.
Lars Peterson1,2, Zachary J Morgan1, C Holly A Andrilla3
1American Board of Family Medicine, Lexington, KY.
Family Medicine
|March 8, 2023
Summary
Rural family medicine residents show slightly lower initial certification exam pass rates than urban counterparts. However, knowledge growth appears similar, suggesting nuanced quality differences warranting further investigation.
Area of Science:
- Medical Education
- Family Medicine Training
- Rural Health Professions
Background:
- Concerns exist regarding the quality of training in rural family medicine residencies.
- This study addresses the need to assess academic performance differences between rural and urban family medicine programs.
Purpose of the Study:
- To compare the academic performance of residents trained in rural versus urban family medicine programs.
- To evaluate differences in knowledge acquisition, milestone achievement, and certification examination outcomes.
Main Methods:
- Utilized American Board of Family Medicine (ABFM) data from 2016-2018 residency graduates.
- Assessed medical knowledge via the ABFM in-training examination (ITE) and Family Medicine Certification Examination (FMCE).
- Analyzed milestone achievement across six core competencies using multilevel regression models.
Main Results:
- Rural residents had lower initial Family Medicine Certification Examination (FMCE) pass rates (96.2% vs 98.9%), though the gap narrowed on subsequent attempts.
- Rural programs were not associated with lower FMCE scores but showed higher failure odds.
- While initial milestone achievement was similar, rural residents showed a divergence over time, with fewer meeting all expectations compared to urban residents.
Conclusions:
- Small but persistent academic performance differences exist between rural and urban family medicine residents.
- The implications for rural program quality require further study, particularly concerning rural patient outcomes and community health.
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