The in-training examination in internal medicine

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.