Delaying the American Board of Emergency Medicine qualifying examination is associated with poorer performance

When to take the primary certification examination: sooner or later?

Most Pathology residents take the Anatomic Pathology and/or Clinical Pathology primary pathology certification examination(s) near the end of their final year of training (i.e., Spring), whereas some postpone the examination(s) to the Fall administration of that year or even later. We compared the Spring and Fall administration pass rates of initial primary certification candidates for those who graduated in the same year they took the examination. We also compared the pass rates of same-year graduates with individuals who postponed the examination for a year or more. We also surveyed the candidates regarding the reasons they chose the Spring or Fall administration. Candidates who chose the earlier (i.e., Spring) administration were more likely to pass compared with those who took the later Fall administration (p = 0.0026 for Anatomic Pathology; p = 0.0004 for Clinical Pathology). Delaying the certifying exams beyond the calendar year of residency graduation was associated with a higher failure rate (p < 0.0001 for both Anatomic and Clinical Pathology). The survey results suggest that residents often take their certification examinations earlier to not interfere with fellowship training, because it coincides with the completion of residency training, or it is expected by their program. Pathology residents are more likely to pass the primary certification examinations when they are taken closer to the end of training, rather than postponing it to a later administration. Pathology residency program directors should encourage residents, who are deemed ready, to take their certification examinations at the earliest possible administration.

Comparison of performance data between emergency medicine 1-3 and 1-4 program formats

Objective

This study compares performance data from physicians completing 3-year versus 4-year emergency medicine residency training programs. Currently, there are 2 training formats and little is known about objective performance differences.

Methods

This was a retrospective cross-sectional analysis of emergency residents and physicians. Multiple analyses were conducted comparing physicians' performances, including Accreditation Council of Graduate Medical Education Milestones and American Board of Emergency Medicine In-training Examination (ITE), Qualifying Examination (QE), Oral Certification Examination (OCE), and program extensions from 3-year and 4-year residency programs. Some confounding variables were not or could not be considered, such as rationale for medical students to choose one format over another, as well as application and final match rates.

Results

Milestone scores are higher for emergency medicine 3 residents in 1-3 programs (3.51) versus emergency medicine 3 residents in 1-4 programs (3.07; P < 0.001, d = 1.47) and highest for emergency medicine 4 residents (3.67). There was no significant difference in program extension rates (emergency medicine 1-3, 8.1%; emergency medicine 1-4, 9.6%; P = 0.05, ω = 0.02). ITE scores were higher for emergency medicine 1, 2, and 3 residents from 1-3 programs and emergency medicine 4 residents from 1-4 programs scored highest. Mean QE score was slightly higher for emergency 1-3 physicians (83.55 vs 83.00; P < 0.01, d = 0.10). QE pass rate was higher for emergency 1-3 physicians (93.1% vs 90.8%; P < 0.001, ω = 0.08). Mean OCE score was slightly higher for emergency 1-4 physicians (5.67 vs 5.65; P = 0.03, d = -0.07) but did not reach a priori statistical significance (α < 0.01). OCE pass rate was also slightly higher for emergency 1-4 physicians (96.9% vs 95.5%; P = 0.06, ω = -0.07) but also non-significant.

Conclusions

These results suggest that although performance measures demonstrate small differences between physicians from emergency medicine 1-3 and 1-4 programs, these differences are limited in their ability to make causal claims about performance on the basis of program format alone.

Taking Leave During Residency: Types of Absences and Subsequent Delays and Variations in Physical Medicine and Rehabilitation Medical Board Pass Rates

ABSTRACT

There is limited literature examining the reasons physical medicine and rehabilitation residents take an extended leave of absence during residency and the impact of leave on board examination performance. Such information could better inform leave policies, help guide residency program directors, and potentially destigmatize taking leave. Study objectives were to describe the characteristics of physical medicine and rehabilitation residents who take leave during residency, compare differences in part I (written) and part II (oral) certification examination performance, and determine the prevalence of delays in taking board examinations. Study methodology was a retrospective analysis of deidentified information from the American Board of Physical Medicine and Rehabilitation database between 2008 and 2020. Results indicated four reasons for extended leave of absence: medical, parental, academic/remediation, and unspecified personal reasons. Residents who took an extended leave of absence for medical or parental reasons had similar or better odds of passing their part I and part II examinations compared with those without leave. Residents who took leave for academic/remediation concerns or unspecified personal reasons had lower odds of passing their board examinations. Examination delays for those taking parental or personal health leaves did not affect board pass rates. Further investigation is needed to identify how to support residents on academic/remediation and unspecified leaves during training.

Predictors of performance on the pediatric board certification examination

BACKGROUND

Examining the predictors of summative assessment performance is important for improving educational programs and structuring appropriate learning environments for trainees. However, predictors of certification examination performance in pediatric postgraduate education have not been comprehensively investigated in Japan.

METHODS

The Pediatric Board Examination database in Japan, which includes 1578 postgraduate trainees from 2015 to 2016, was analyzed. The examinations included multiple-choice questions (MCQs), case summary reports, and an interview, and the predictors for each of these components were investigated by multiple regression analysis.

RESULTS

The number of examination attempts and the training duration were significant negative predictors of the scores for the MCQ, case summary, and interview. Employment at a community hospital or private university hospital were negative predictors of the MCQ and case summary score, respectively. Female sex and the number of academic presentations positively predicted the case summary and interview scores. The number of research publications was a positive predictor of the MCQ score, and employment at a community hospital was a positive predictor of the case summary score.

CONCLUSION

This study found that delayed and repeated examination taking were negative predictors, while the scholarly activity of trainees was a positive predictor, of pediatric board certification examination performance.

The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination

BACKGROUND

In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted requirements that limited the number of hours residents could spend on duty, and in 2011, it revised these requirements.

OBJECTIVE

This study explored whether the implementation of the 2003 and 2011 duty hour limits was associated with a change in emergency medicine residents' performance on the American Board of Emergency Medicine (ABEM) Qualifying Examination (QE).

METHODS

Beginning with the 1999 QE and ending with the 2014 QE, candidates for whom all training occurred without duty hour requirements (Group A), candidates under the first set of duty hour requirements (Group C), and candidates under the second set of duty hour requirements (Group E) were compared. Comparisons included mean scores and pass rates.

RESULTS

In Group A, 5690 candidates completed the examination, with a mean score of 82.8 and a 90.2% pass rate. In Group C, 8333 candidates had a mean score of 82.4 and a 90.5% pass rate. In Group E, there were 1269 candidates, with a mean score of 82.5 and an 89.4% pass rate. There was a small but statistically significant decrease in the mean scores (0.04, P < .001) after implementation of the first duty hour requirements, but this difference did not occur after implementation of the 2011 standards. There was no difference among pass rates for any of the study groups (χ² = 1.68, P = .43).

CONCLUSIONS

We did not identify an association between the 2003 and 2011 ACGME duty hour requirements and performance of test takers on the ABEM QE.

Voluntarily Postponing Testing Is Associated with Lower Performance on the Pediatric Board Certifying Examinations

OBJECTIVE

To investigate whether postponing certification testing, either voluntarily or involuntarily, affects a candidate's performance on pediatric certifying examinations.

STUDY DESIGN

Both general pediatrics (GP) and pediatric subspecialty (PS) examination candidates were included in the study. Candidates were classified into 3 groups based on time since the completion of training: no delay (<12 months), short delay (12-24 months), and long delay (≥24 months). Examination scores and pass rates in the first GP and PS certifying examinations were compared to assess between-group differences.

RESULTS

Significant differences in scores and pass rates were found for GP candidates who voluntarily waited 1 year or longer to take the certifying examination. Similarly, PS candidates who opted not to take the first examination available had significantly lower scores and pass rates. However, no significant difference was found for PS candidates who had to wait to take their examination owing to the Board's offered examination schedule.

CONCLUSION

Candidates who postpone taking the certifying examination are less likely to pass the examination. The longer a candidate elects to wait to take the examination, the less likely he or she is to pass. The availability of the PS examinations once every 2 years does not affect pass rates and scores, as long as PS candidates take the first available examinations after completing fellowship.

Does Delay in Taking the American Board of Physical Medicine and Rehabilitation Certification Examinations Affect Passing Rates?

OBJECTIVES

The objective of this study was to examine whether a delay in initially taking the Part I or Part II American Board of Physical Medicine and Rehabilitation certification examinations influences the score or passing rates of candidates and whether enrollment in a subspecialty fellowship influences performance on the Part II certification examination.

DESIGN

This was a retrospective review of first-time candidates taking the American Board of Physical Medicine and Rehabilitation initial certification examinations from 2010 to 2014.

RESULTS

Passing rates declined as candidates delayed the examination past the time of initial eligibility. Passing rates for Part I were as follows (mean [95% confidence interval]): no delay, 91% (89%-94%); 1-yr delay, 68% (56%-82%); and more that 2 yrs' delay, 59% (55%-68%). For Part II, passing rates were as follows: no delay, 90% (85%-94%); 1-yr delay, 83% (72%-94%); and more than 2 yrs' delay, 68% (50%-83%). Those completing an accredited fellowship performed better (92% pass rate) on the Part II examination than did those who did not (81% pass rate), but they also had higher final year evaluations from their residency program directors.

CONCLUSIONS

It seems preferable to take both Part I and Part II examinations as soon as one is eligible. Enrollment in an accredited fellowship may be associated with a higher chance of passing the examination.

Impact of Time Lapse on ASCP Board of Certification Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) Examination Scores

BACKGROUND

Research in several professional fields has demonstrated that delays (time lapse) in taking certification examinations may result in poorer performance by examinees. Thirteen states and/or territories require licensure for laboratory personnel. A core component of licensure is passing a certification exam. Also, many facilities in states that do not require licensure require certification for employment or preferentially hire certified individuals.

OBJECTIVE

To analyze examinee performance on the American Society for Clinical Pathology (ASCP) Board of Certification (BOC) Medical Laboratory Scientist (MLS) and Medical Laboratory Technician (MLT) certification examinations to determine whether delays in taking the examination from the time of program completion are associated with poorer performance.

METHODS

We obtained examination data from April 2013 through December 2014 to look for changes in mean (SD) exam scaled scores and overall pass/fail rates. First-time examinees (MLS: n = 6037; MLT, n = 3920) were divided into 3-month categories based on the interval of time between date of program completion and taking the certification exam.

RESULTS

We observed significant decreases in mean (SD) scaled scores and pass rates after the first quarter in MLS and MLT examinations for applicants who delayed taking their examination until the second, third, and fourth quarter after completing their training programs.

CONCLUSIONS

Those who take the ASCP BOC MLS and MLT examinations are encouraged to do so shortly after completion of their educational training programs. Delays in taking an exam are generally not beneficial to the examinee and result in poorer performance on the exam.