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Thomas W. Biester MS, Jonathan D. Rubright MS, Andrew T. Jones PhD, Mark A. Malangoni MD, FACS

Does success on the American Board of Surgery Qualifying Examination guarantee Certifying Examination success?. Thomas W. Biester MS, Jonathan D. Rubright MS, Andrew T. Jones PhD, Mark A. Malangoni MD, FACS The American Board of Surgery, Philadelphia, PA. Board Certification Matters.

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Thomas W. Biester MS, Jonathan D. Rubright MS, Andrew T. Jones PhD, Mark A. Malangoni MD, FACS

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  1. Does success on the American Board of Surgery Qualifying Examination guarantee Certifying Examination success? Thomas W. Biester MS, Jonathan D. Rubright MS, Andrew T. Jones PhD, Mark A. Malangoni MD, FACS The American Board of Surgery, Philadelphia, PA

  2. Board Certification Matters • Important benchmark to achieve following completion of residency (Nahrwold DL, Surg, 1999) • Associated with better outcomes in patient care (Wenthofer E, Med Educ2009; Reid RO, Arch Intern Med, 2010) • Often required to obtain or maintain hospital privileges

  3. Mission of the American Board of Surgery • Serves as an agent for protection of the public and for quality surgical care • Certifies surgeons who have met education and training standards • Sets standards for maintenance of certification

  4. Process of Obtaining Board Certification • Appropriate undergraduate medical education • Successfully complete an ACGME-approved surgery residency program • Obtain favorable summary evaluation from the program director • Pass the ABS Qualifying Examination (QE) • Pass the ABS Certifying Examination (CE)

  5. Oral Exams “Bridge the gap” between the cognitive domain and behavioral evaluation of performance in practice 15/24 ABMS boards have an oral exam

  6. Purposes • Determine whether there is a correlation between passing the QE and passing the CE • Ascertain whether there is a discrete QE score that would predict passing the CE

  7. Design • Examinees who passed the ABS QE from 2006-10 • QE equated scores matched to 1st CE pass/fail decisions • Contingency table analysis • Phi coefficient and point bi-serial for correlation • ROC curve constructed • p < 0.01

  8. Results • 4,385 examinees who passed the QE • Mean QE score = 82.1 + 5.8 (range, 58-99) • 92.3% passed the QE on the 1st attempt • 82.8% passed the CE on the 1st attempt

  9. Relationship between 1st QE outcome and 1st CE CE fail CE pass Total QE pass 639 (16%) 3407 (84%) 4046 (92%) QE fail 115 (34%) 224 (66%) 339 (8%) Total 754 (17%) 3631 (83%) 4385 Φ = 0.13, p < 0.001

  10. 1st QE scaled scores and CE pass/fail decisions CE QE rpb = 0.229, p < 0.001

  11. 1st QE scaled scores and successful certification (2001-05) rpb = 0.339, p < 0.001

  12. Summary • The correlation between the 1st QE score and CE pass/fail rate is low • Failure on the 1st QE doubles the risk of CE failure • Excellent correlation between 1st QE score and eventual board certification

  13. Conclusions • These exams measure different aptitudes (knowledge vs. application) • QE scores and CE results correlate well only at the extremes • There is no discrete QE score that predicts passing the CE on the 1st attempt

  14. Thank you

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