Assessing the Linking Between the Orthopaedic In-Training Examination and the American Board of Orthopaedic Surgery...

Since 2020, the American Academy of Orthopaedic Surgeons (AAOS) and American Board of Orthopaedic Surgery (ABOS) have collaborated to link the AAOS Orthopaedic In-Training Examination (OITE) and the ABOS part I Certification Examination, allowing the identification of a minimum score on each annual OITE that corresponds to a minimum passing part I score. The purpose of this study is to assess the performance of this examination linking over these past 3 years.

From 2020 to 2022, the AAOS provided each graduating resident's OITE score; from 2021 to 2023, the ABOS provided each examinee's ABOS part I pass-fail result. Examination scores were matched at the individual level and deidentified for data analysis.

A total of 2,247 subjects took both the OITE and the ABOS during the same cycle, during the 3-year study period. The ABOS part I pass rates in 2021, 2022, and 2023 were 92.9%, 98.1%, and 98.4%, respectively, for those taking the OITE the prior year. The positive predictive value of achieving the minimum passing score on the OITE for passing part I increased from 95.1% in 2021 to 99.8% and 99.7% in 2022 and 2023, respectively. The negative predictive value of not achieving the minimum passing score on the OITE for failing part I decreased from 24.7% in 2021 to 5.3% in 2022 and 10.1% in 2023.

This study is the first of its kind and demonstrates the initial results of the examination linking between the OITE and the ABOS part I Examination. This information can be helpful for residents and residency program directors. Moreover, the examination linking provides a step toward obtaining a standardized assessment of knowledge throughout all 5 years of residency.