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Related Experiment Videos

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

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.

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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.