scholarly journals Performance on the Nephrology In-Training Examination and ABIM Nephrology Certification Examination Outcomes

2018 ◽  
Vol 13 (5) ◽  
pp. 710-717 ◽  
Author(s):  
Daniel Jurich ◽  
Lauren M. Duhigg ◽  
Troy J. Plumb ◽  
Steven A. Haist ◽  
Janine L. Hawley ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Confidence Interval ◽  
Predictive Value ◽  
Medical Knowledge ◽  
Medical Specialty ◽  
Fellowship Training ◽  
Certification Examination ◽  
Fellowship Programs ◽  
American Society ◽  
First Time

Background and objectivesMedical specialty and subspecialty fellowship programs administer subject-specific in-training examinations to provide feedback about level of medical knowledge to fellows preparing for subsequent board certification. This study evaluated the association between the American Society of Nephrology In-Training Examination and the American Board of Internal Medicine Nephrology Certification Examination in terms of scores and passing status.Design, setting, participants, & measurementsThe study included 1684 nephrology fellows who completed the American Society of Nephrology In-Training Examination in their second year of fellowship training between 2009 and 2014. Regression analysis examined the association between In-Training Examination and first-time Nephrology Certification Examination scores as well as passing status relative to other standardized assessments.ResultsThis cohort included primarily men (62%) and international medical school graduates (62%), and fellows had an average age of 32 years old at the time of first completing the Nephrology Certification Examination. An overwhelming majority (89%) passed the Nephrology Certification on their first attempt. In-Training Examination scores showed the strongest association with first-time Nephrology Certification Examination scores, accounting for approximately 50% of the total explained variance in the model. Each SD increase in In-Training Examination scores was associated with a difference of 30 U (95% confidence interval, 27 to 33) in certification performance. In-Training Examination scores also were significantly associated with passing status on the Nephrology Certification Examination on the first attempt (odds ratio, 3.46 per SD difference in the In-Training Examination; 95% confidence interval, 2.68 to 4.54). An In-Training Examination threshold of 375, approximately 1 SD below the mean, yielded a positive predictive value of 0.92 and a negative predictive value of 0.50.ConclusionsAmerican Society of Nephrology In-Training Examination performance is significantly associated with American Board of Internal Medicine Nephrology Certification Examination score and passing status.

scholarly journals Novel Formative Approach of the ESAP-ITE Provides Strong Predictive Value for ABIM Certification Outcomes

2021 ◽  
Author(s):  
William B Horton ◽  
James T Patrie ◽  
Lauren M Duhigg ◽  
Maggie Graham ◽  
Mark W True ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Medical School ◽  
Fellowship Training ◽  
The Novel ◽  
Fellowship Program ◽  
Self Assessment ◽  
Predictive Tool ◽  
Certification Examination ◽  
Questions And Answers ◽  
Fellowship Programs

Abstract Background The Endocrine Self-Assessment Program In-Training Examination (ESAP-ITE) has the novel formative approach of allowing open access to all questions and answers after secure exam administration is complete, resulting in the creation of an entirely new in-training examination annually. Objective To determine whether scores on the novel ESAP-ITE predict pass/fail outcomes on the American Board of Internal Medicine-Endocrinology, Diabetes, and Metabolism Certification Examination (ABIM-ECE). Methods All endocrine fellows-in-training who took the ESAP-ITE between 2016 and 2019 and then subsequently attempted the ABIM-ECE within the same calendar year were included (n=982). Primary analyses utilized the ESAP-ITE score from the final year of fellowship training. Covariates included sex, age on date of ABIM-ECE, medical school country, fellowship program region, pass/fail outcomes on the ABIM Internal Medicine Certification Examination, and ESAP-ITE score. All variables were analyzed using multivariable logistic regression. Results ESAP-ITE score (p<0.001), ABIM Internal Medicine Certification Examination outcome (p<0.001), and age (p=0.005) were each significant predictors of passing the ABIM-ECE on the first attempt. ESAP-ITE score was the strongest predictor of passing the ABIM-ECE, and this relationship was such that a score of 75% correct yielded a 97% probability of passing the ABIM-ECE, whereas a score of 50% correct generated only a 70% probability of doing so. Sex, fellowship program region, and medical school country were not significant predictors of ABIM-ECE outcomes. Conclusions In addition to serving as an important learning instrument for endocrine fellowship programs, ESAP-ITE is a robust predictive tool for pass/fail outcomes on the ABIM-ECE.

scholarly journals Milestone Level Changes From Residency to Fellowship: A Multicenter Cohort Study

2021 ◽  
Vol 13 (3) ◽  
pp. 377-384
Author(s):  
Taylor Sawyer ◽  
Megan Gray ◽  
Shilpi Chabra ◽  
Lindsay C. Johnston ◽  
Melissa M. Carbajal ◽  
...  
Keyword(s):  
Professional Development ◽  
Medical Knowledge ◽  
Fellowship Training ◽  
Multicenter Cohort Study ◽  
Perinatal Medicine ◽  
Linear Trajectory ◽  
Next Accreditation System ◽  
Fellowship Programs ◽  
The Individual ◽  
Vital Element

ABSTRACT Background A vital element of the Next Accreditation System is measuring and reporting educational Milestones. Little is known about changes in Milestones levels during the transition from residency to fellowship training. Objective Evaluate the Accreditation Council for Graduate Medical Education (ACGME) Milestones' ability to provide a linear trajectory of professional development from general pediatrics residency to neonatal-perinatal medicine (NPM) fellowship training. Methods We identified 11 subcompetencies that were the same for general pediatrics residency and NPM fellowship. We then extracted the last residency Milestone level and the first fellowship Milestone level for each subcompetency from the ACGME's Accreditation Data System on 89 subjects who started fellowship training between 2014 and 2018 at 6 NPM fellowship programs. Mixed-effects models were used to examine the intra-individual changes in Milestone scores between residency and fellowship after adjusting for the effects of the individual programs. Results A total of 1905 subcompetency Milestone levels were analyzed. The average first fellowship Milestone levels were significantly lower than the last residency Milestone levels (residency, mean 3.99 [SD = 0.48] vs fellowship 2.51 [SD = 0.56]; P < .001). Milestone levels decreased by an average of -1.49 (SD = 0.65) from the last residency to the first fellowship evaluation. Significant differences in Milestone levels were seen in both context-dependent subcompetencies (patient care and medical knowledge) and context-independent subcompetencies (professionalism). Conclusions Contrary to providing a linear trajectory of professional development, we found that Milestone levels were reset when trainees transitioned from general pediatrics residency to NPM fellowship.

scholarly journals MON-122 Introduction of an Ambulatory Curriculum in Endocrinology Diabetes and Metabolism for Internal Medicine Trainees

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Caitlin A White ◽  
Serena Cardillo
Keyword(s):  
Internal Medicine ◽  
Medical Education ◽  
Faculty Member ◽  
Medical Knowledge ◽  
Training Model ◽  
Fellowship Training ◽  
Outpatient Setting ◽  
High Yield ◽  
Content Areas ◽  
Academic Promotion

Abstract Internal Medicine (IM) training programs are disproportionately weighted to inpatient learning opportunities. IM residents‘ exposure to outpatient internal medicine subspecialties, such as Endocrinology, Diabetes and Metabolism (EDM), is limited. This may contribute to gaps in medical knowledge in these content areas in spite of the frequent occurrence of EDM disorders. Further, reduced exposure during training may adversely impact interest in pursuing fellowship training in these fields, in spite of increased societal need. In July 2015 the IM residency program at the University of Pennsylvania switched to a “6 + 2” training model. In this training module, trainees are grouped into four cohorts, each of which have 6 weeks of inpatient rotations, followed by 2 weeks of an ambulatory experience. This model allowed the introduction of an organized ambulatory curriculum during the 2-week outpatient blocks, which was named the Interactive Learning Module (ILM). This creates the opportunity to deliver a standardized curriculum to all residents. Through this module we coordinate an immersive experience in five distinct outpatient themes: General Internal Medicine, Infectious Disease, EDM, Nephrology, and Rheumatology. The EDM ILM is co-led by a core faculty member and senior endocrinology fellow with interest in pursuing a career in medical education. During the EDM ILM, IM interns receive 12 hours of interactive didactics in high yield content areas including: Diabetes Workshop, Adrenal and Pituitary Diseases, Osteoporosis, Thyroid Diseases, Women’s Health, Calcium Disorders, Obesity and Endocrine Emergencies. Interns are given 3-4 opportunities to work with an EDM faculty member in the outpatient setting. Interns are also asked to read and review three publications within the field, which are discussed as a group. The EDM ILM has been consistently praised by IM interns, and feedback for the curriculum has been overwhelmingly positive. 97% of interns agreed the breadth of content was comprehensive and 94% agreed that the content was applicable to their delivery of ambulatory primary care. The quality of the teaching was rated high among 96% of interns. 89% reported improved understanding of EDM. Four years after the institution of the curriculum, we have not yet noted an increase in graduating IM residents choosing fellowship in EDM. However, all three of our IM residents who have matched into EDM fellowship over the past four years have chosen to stay at our institution. Faculty have thrived with these teaching opportunities: their consistently high evaluations have been an important criterion for academic promotion. Co-leading this course has been an important opportunity for senior EDM fellows to build expertise in medical education; three out of four participating fellows accepted academic positions with GME support.

Abstract 16053: Impact of COVID-19 Pandemic on Cardiology Fellowship Echocardiography Training

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Merilyn S Varghese ◽  
Joseph P Kannam ◽  
Marilyn Riley ◽  
Warren J Manning
Keyword(s):  
Cardiovascular Disease ◽  
Fellowship Training ◽  
Electronic Database ◽  
Clinical Rotations ◽  
Fellowship Programs ◽  
American Society ◽  
Level 2 ◽  
Reading Session ◽  
At Home

Introduction: Training in the acquisition and interpretation of echocardiograms is integral to cardiovascular disease fellowship training. The American Society of Echocardiography recommends 150 transthoracic echo (TTE) scans and 300 interpretations for level 2 training. Hypothesis: The COVID-19 pandemic led to the temporary restructuring of many fellowship programs. At our institution, fellows not involved in essential clinical rotations served in a backup capacity or were re-assigned with the onset of the Massachusetts stay-at-home advisory on March 15, 2020. A one-hour mid-day Zoom TTE reading session was offered when fellows were available. We hypothesized that these restrictions would impact fellow education in TTE scanning and interpretation volumes. Methods: We examined the number of TTE performed or interpreted by F1 and F2 fellows between July 2017 and June 2020 as recorded in our echo lab electronic database. Results: In the 21 months prior to the onset of the COVID-19 pandemic, 45 + 1 TTE scans/wk were performed by fellows which was reduced to 9 + 3 scans/wk (-80%, p<0.01) during the pandemic. The average number of F1 and F2 TTE interpretations also fell from 64 + 2/wk to 27 + 5 (-58%, p<0.01). When evaluating scans by year of training (see Table), the 2019-2020 F1s and F2s will have the lowest TTE scan and interpretation volumes compared to prior two academic years (F1: -14% scanning, -28% interpretations, F2: - 33% scanning, -10% interpretations). Conclusions: By recognizing that there has already been an impact on echo education, fellowship programs will need to optimize fellow exposure and instruction in echocardiography so as to maintain adequate training volumes.

scholarly journals Identifying and Supporting the Needs of Internal Medicine and Pediatrics Residents Interested in Pediatric Hospital Medicine Fellowship

2021 ◽  
Author(s):  
Elizabeth Boggs ◽  
Harrison Luttrell ◽  
William Basco ◽  
Mark Brittan ◽  
Karen Jerardi ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Clinical Training ◽  
Hospital Medicine ◽  
Fellowship Training ◽  
Pediatric Hospital ◽  
Training Environment ◽  
Cross Sectional ◽  
Electronic Survey ◽  
Fellowship Programs ◽  
Almost All

BACKGROUND: Pediatric hospital medicine (PHM) became a subspecialty of the American Board of Pediatrics (ABP) in 2016. Starting in 2019, residency graduates are required to complete fellowship training to qualify for PHM board eligibility. These requirements pose unique challenges to internal medicine–pediatrics (med-peds) residents interested in practicing combined adult hospital medicine (HM) and PHM. OBJECTIVE: To describe the needs of med-peds residents interested in PHM fellowship training and how the current PHM training environment can meet these needs. METHODS: We conducted two cross-sectional electronic survey studies: one of med-peds residents and one of PHM fellowship program directors (FDs). Surveys were distributed to resident and FD listservs. Questions were designed using an iterative consensus process among authors. Responses were analyzed with descriptive statistics. RESULTS: Four hundred sixty-six residents responded to the resident survey. Ninety-six percent (n = 446) had considered a career in HM. Almost all (n = 456, 97.9%) respondents indicated a preference for a fellowship with both adult HM and PHM clinical training. Subspecialty designation decreased desire to pursue a career including PHM for 90.1% of respondents. Twenty-eight (58.3%) FDs responded to the FD survey. Fifteen (53.6%) programs reported being able to accommodate adult HM and PHM clinical time. CONCLUSION: The majority of resident respondents reported a desire for a PHM fellowship with clinical time in both PHM and adult HM. Approximately 30% of current US PHM fellowship programs can accommodate adult HM practice for med-peds fellows, and many other programs would be willing to explore such opportunities.

The Association of Pediatric Critical Care Medicine Training Programs with Research Publication Productivity and Employment Outcomes of Their Graduates

2020 ◽  
Author(s):  
Sonali Basu ◽  
Robin Horak ◽  
Murray M. Pollack
Keyword(s):  
Critical Care ◽  
Intensive Care ◽  
Medical School ◽  
Training Programs ◽  
Fellowship Training ◽  
Publication Productivity ◽  
Research Publication ◽  
Pediatric Critical Care ◽  
Publication Success ◽  
Fellowship Programs

AbstractOur objective was to associate characteristics of pediatric critical care medicine (PCCM) fellowship training programs with career outcomes of PCCM physicians, including research publication productivity and employment characteristics. This is a descriptive study using publicly available data from 2557 PCCM physicians from the National Provider Index registry. We analyzed data on a systematic sample of 690 PCCM physicians representing 62 fellowship programs. There was substantial diversity in the characteristics of fellowship training programs in terms of fellowship size, intensive care unit (ICU) bed numbers, age of program, location, research rank of affiliated medical school, and academic metrics based on publication productivity of their graduates standardized over time. The clinical and academic attributes of fellowship training programs were associated with publication success and characteristics of their graduates' employment hospital. Programs with greater publication rate per graduate had more ICU beds and were associated with higher ranked medical schools. At the physician level, training program attributes including larger size, older program, and higher academic metrics were associated with graduates with greater publication productivity. There were varied characteristics of current employment hospitals, with graduates from larger, more academic fellowship training programs more likely to work in larger pediatric intensive care units (24 [interquartile range, IQR: 16–35] vs. 19 [IQR: 12–24] beds; p < 0.001), freestanding children's hospitals (52.6 vs. 26.3%; p < 0.001), hospitals with fellowship programs (57.3 vs. 40.3%; p = 0.01), and higher affiliated medical school research ranks (35.5 [IQR: 14–72] vs. 62 [IQR: 32, unranked]; p < 0.001). Large programs with higher academic metrics train physicians with greater publication success (H index 3 [IQR: 1–7] vs. 2 [IQR: 0–6]; p < 0.001) and greater likelihood of working in large academic centers. These associations may guide prospective trainees as they choose training programs that may foster their career values.

scholarly journals How do we assess resilience and grit among internal medicine residents at the Mayo Clinic? A longitudinal validity study including correlations with medical knowledge, professionalism and clinical performance

BMJ Open ◽  
2020 ◽  
Vol 10 (12) ◽  
pp. e040699
Author(s):  
Fares Alahdab ◽  
Andrew J Halvorsen ◽  
Jayawant N Mandrekar ◽  
Brianna E Vaa ◽  
Victor M Montori ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Internal Consistency ◽  
Test Performance ◽  
Mayo Clinic ◽  
Clinical Performance ◽  
Medical Knowledge ◽  
Internal Consistency Reliability ◽  
Validity Study ◽  
Training Environment ◽  
Conference Attendance

BackgroundThere has been limited research on the positive aspects of physician wellness and to our knowledge there have been no validity studies on measures of resilience and grit among internal medicine (IM) residents.ObjectivesTo investigate the validity of resilience (10 items Connor-Davidson Resilience Scale (CD-RISC 10)) and grit (Short Grit Scale (GRIT-S)) scores among IM residents at a large academic centre, and assess potential associations with previously validated measures of medical knowledge, clinical performance and professionalism.MethodsWe evaluated CD-RISC 10 and GRIT-S instrument scores among IM residents at the Mayo Clinic Rochester, Minnesota between July 2017 and June 2019. We analysed dimensionality, internal consistency reliability and criterion validity in terms of relationships between resilience and grit, with standardised measures of residents’ medical knowledge (in-training examination (ITE)), clinical performance (faculty and peer evaluations and Mini-Clinical Evaluation Examination (mini-CEX)) and professionalism/dutifulness (conference attendance and evaluation completion).ResultsA total of 213 out of 253 (84.2%) survey-eligible IM residents provided both CD-RISC 10 and GRIT-S survey responses. Internal consistency reliability (Cronbach alpha) was excellent for CD-RISC 10 (0.93) and GRIT-S (0.82) overall, and for the GRIT subscales of consistency of interest (0.84) and perseverance of effort (0.71). CD-RISC 10 scores were negatively associated with ITE percentile (β=−3.4, 95% CI −6.2 to −0.5, p=0.02) and mini-CEX (β=−0.2, 95% CI −0.5 to −0.02, p=0.03). GRIT-S scores were positively associated with evaluation completion percentage (β=2.51, 95% CI 0.35 to 4.67, p=0.02) and conference attendance (β=2.70, 95% CI 0.11 to 5.29, p=0.04).ConclusionsThis study revealed favourable validity evidence for CD-RISC 10 and GRIT-S among IM residents. Residents demonstrated resilience within a competitive training environment despite less favourable test performance and grittiness that was manifested by completing tasks. This initial validity study provides a foundation for further research on resilience and grit among physicians in training.

Practice Guidelines: How Good are Medicine's New Recipes?

1995 ◽  
Vol 23 (1) ◽  
pp. 47-48 ◽  
Author(s):  
Alexander Morgan Capron
Keyword(s):  
Health Care ◽  
Nonprofit Organizations ◽  
Medical Knowledge ◽  
Medical Specialty ◽  
Therapeutic Interventions ◽  
Medical Interventions ◽  
Practice Parameters ◽  
Wide Range ◽  
Standard Of Practice

Over the last decade, standards for when and how to undertake a wide range of medical interventions have poured forth from medical specialty groups, commercial and nonprofit organizations, and state and federal panels. Known by a variety of names—from practice parameters to clinical guidelines—and intended for a range of purposes—from diminishing the incidence of maloccurences in hospitals to cutting the costs of health care—these guidelines share one important feature: the intention of decreasing the range of variation in medical practice. Such standardization immediately appeals to anyone interested in improving the quality of health care and, in particular, reducing inappropriate medical interventions, in light of the difficulties for a conscientious physician today in adhering to the best standard of practice when faced with ever increasing medical knowledge and the growing number and complexity of diagnostic, preventive, and therapeutic interventions.

Statement on Pediatric Fellowship Training

PEDIATRICS ◽  
1991 ◽  
Vol 87 (2) ◽  
pp. 265-265
Author(s):  
Keyword(s):  
Research Training ◽  
Clinical Care ◽  
Fellowship Training ◽  
The Body ◽  
Pediatric Residents ◽  
Pediatric Society ◽  
Research Fellowship ◽  
Research Activities ◽  
Fellowship Programs ◽  
Interest In Research

The following statement was adopted by the Federation of Pediatric Organizations in February, 1990. The Federation consists of the following pediatric organizations: Ambulatory Pediatric Association, American Academy of Pediatrics, American Board of Pediatrics, American Pediatric Society, Association of Medical School Pediatric Department Chairmen, Association of Pediatric Program Directors, Society for Pediatric Research. The Federation supports the concept that "the principal goal of fellowship training should be the development of future academic pediatricians." Graduates of pediatric fellowship programs usually work in academic centers with significant time set aside for research. Some fellowship-trained pediatricians, particularly neonatologists, allergists, and neurologists, may not work in hospitals or ambulatory settings that are associated closely with academic programs. Fellowship-trained pediatricians in all settings should be encouraged to continue their interest in research to add to the body of pediatric knowledge. To achieve the goal of training pediatric scientists, the following guidelines for fellowship education are recommended: 1. Upon completion of a pediatric fellowship, the trainee should be proficient in clinical care, teaching, and research. Fellowship training should prepare a pediatrician to care for children with complex illnesses within his/her area of special expertise and to serve as a consultant for the general pediatrician. In addition, the fellowship-trained pediatrician should be responsible for the education of pediatric residents and the continuing education of practicing pediatricians. For this reason, fellowship training should include interpersonal skills and pedagogical techniques. 2. Research training should begin as soon as possible; premedical students, medical students, and pediatric residents should be encouraged strongly to participate in meaningful research, and research activities should be carried out throughout fellowship training.

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