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The in-training examination in internal medicine

R A Garibaldi1, M C Trontell, H Waxman

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The In-Training Examination in Internal Medicine (ITE-IM) shows declining resident scores over six years, with participation increasing. This trend may reflect exam difficulty or knowledge gaps in internal medicine trainees.

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Area of Science:

  • Medical Education
  • Internal Medicine Training
  • Assessment and Evaluation

Background:

  • The In-Training Examination in Internal Medicine (ITE-IM) has been an annual self-assessment tool for internal medicine trainees since 1988.
  • The examination serves to evaluate knowledge base and compare performance against national peer groups.

Purpose of the Study:

  • To outline the preparation process of the ITE-IM.
  • To review examination results and analyze trends over a six-year period (1988-1993).
  • To assess the examination's reliability, consistency, and discriminating power.

Main Methods:

  • Analysis of demographic characteristics of test-takers, including previous training and program affiliations.
  • Review of annual examination results from 1988 to 1993.
  • Statistical analysis of examination reliability and consistency.

Main Results:

  • Increased resident participation in the ITE-IM, with over 12,000 participants in 1993.
  • Rising percentage of international medical school graduates taking the exam (27% in 1988 to 47% in 1993).
  • Consistent trend of declining scores from 1988 to 1993, most notably among US and osteopathic medical school graduates, potentially due to increased exam difficulty or decreased knowledge.

Conclusions:

  • The ITE-IM is a valuable tool for assessing resident knowledge and program effectiveness.
  • The examination provides objective data for monitoring trends in resident performance over time.
  • Score trends correlate with changing trainee demographics and curriculum innovations in internal medicine.