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Association between Subspecialty In-Training Examination Scores and First Attempt Results in Neonatal-Perinatal
Imran N Mir1, Riti Chokshi1, Jennifer Wambach2
1Department of Pediatrics, University of Texas Southwestern Medical Center, Dallas, Texas, United States.
American Journal of Perinatology
|September 8, 2025
Summary
Neonatal-Perinatal Medicine (NPM) subspecialty in-training examination (SITE) scores predict success on the NPM certification exam (CE). Early identification of fellows struggling with SITE can improve pediatric subspecialty training outcomes.
Area of Science:
- Medical Education
- Pediatric Subspecialties
- Neonatal-Perinatal Medicine
Background:
- No prior multicenter studies have linked subspecialty in-training examination (SITE) scores to certification exam (CE) outcomes in pediatric subspecialties.
- The Neonatal-Perinatal Medicine (NPM) SITE is a key assessment during fellowship training.
Purpose of the Study:
- To investigate the predictive value of NPM SITE performance on first-attempt NPM-CE outcomes.
- To identify potential gaps in fellowship training based on examination performance.
Main Methods:
- A multicenter, retrospective cohort study analyzed data from 326 NPM fellows across 15 US programs (2014-2024).
- SITE scores and CE results were collected, and year-specific Z-scores were calculated.
- Mixed-model generalized linear equations and logistic regression assessed the odds of CE failure.
Main Results:
- Fellows scoring below 55% on the SITE in the first two years had four times higher odds of failing the NPM-CE (OR: 4.28).
- Those with an average SITE Z-score ≤ -1.0 had 12 times higher odds of CE failure (OR: 12.12).
- Program characteristics did not significantly impact CE outcomes.
Conclusions:
- NPM SITE performance in the initial fellowship years is a significant predictor of first-attempt NPM-CE success.
- Early identification of at-risk fellows via SITE scores can facilitate targeted educational interventions.
- The SITE serves as a valuable predictive tool for assessing readiness for pediatric subspecialty certification.
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