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Certification in internal medicine: 1989-1992

J J Norcini1, H R Kimball, L J Grosso

  • 1American Board of Internal Medicine, Philadelphia, PA 19104.

Journal of General Internal Medicine
|July 1, 1994
PubMed
Summary
This summary is machine-generated.

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Changes in the internal medicine candidate pool from 1986-1989 correlated with lower certification exam pass rates for all groups. These declines in performance were observed across all test areas and were not influenced by program quality.

Area of Science:

  • Medical Education
  • Internal Medicine Training
  • Physician Certification

Background:

  • The demographic and educational profile of physicians entering internal medicine has evolved.
  • Understanding the impact of these changes on physician competency is crucial for medical education and patient care.

Purpose of the Study:

  • To investigate the association between shifts in the internal medicine candidate pool (1986-1989) and their certification examination performance.
  • To identify potential challenges facing internal medicine training and certification.

Main Methods:

  • Analysis of demographic data, medical school background, residency training, and examination performance for candidates taking the American Board of Internal Medicine certifying examinations (1989-1992).
  • Inclusion of data on internal medicine training program characteristics (quality, size, subspecialties).

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Main Results:

  • Increased numbers of female, foreign-citizen non-U.S. medical school graduates, and osteopathic medical school graduates entered the field.
  • Pass rates for first-time examination takers declined across all demographic groups.
  • Program quality, size, and subspecialty offerings showed modest positive correlations with examination performance.

Conclusions:

  • Changes in the internal medicine candidate pool's characteristics between 1986 and 1989 were linked to decreased certification examination performance.
  • Performance declines were consistent across all test content areas and independent of training program quality.
  • These findings highlight significant challenges for the future of internal medicine training and practice.