Variation in Oral Board Examination Accommodations Among Specialties.

Area of Science:

• Medical Education
• Professional Standards

Background:

• Board certification is crucial for medical careers, yet disparities in oral examination pass rates suggest potential barriers.
• Existing research indicates sociodemographic factors may influence candidate success in high-stakes medical examinations.

Purpose of the Study:

• To analyze the policies and practices of oral certifying examinations across 16 Accreditation Council for Graduate Medical Education (ACGME)-accredited medical specialties.
• To identify variations in examination formats, administration, and available accommodations.

Main Methods:

• A cross-sectional study collected data on oral examination policies, including accommodations for lactation, military deployment, and emergencies, from March to April 2023.
• Data on resident demographics (female, underrepresented in medicine [URM]) and board of directors' gender composition were obtained.
• Statistical analyses, including Poisson and linear regression, assessed associations between accommodation scores and resident diversity, and board gender diversity.

Main Results:

• Significant variability in oral board examination accommodation scores (mean 8.28, median 9.25) was observed across the 16 specialties.
• No direct association was found between accommodation scores and the percentage of female or URM residents.
• A positive association emerged between the percentage of female board members and higher accommodation scores (P=.03).

Conclusions:

• Considerable variability exists in oral board examination accommodations, indicating a need for standardization and improvement.
• Policies addressing diverse candidate needs in medical specialty examinations require further development.
• Promoting gender diversity within leadership bodies may positively influence the availability of accommodations for examinees facing extenuating circumstances.