RESUMO
BACKGROUND: The pass rate on the American Board of Internal Medicine (ABIM) nephrology certifying exam has declined and is among the lowest of all internal medicine (IM) subspecialties. In recent years, there have also been fewer applicants for the nephrology fellowship match. METHODS: This retrospective observational study assessed how changes between 2010 and 2019 in characteristics of 4094 graduates of US ACGME-accredited nephrology fellowship programs taking the ABIM nephrology certifying exam for the first time, and how characteristics of their fellowship programs were associated with exam performance. The primary outcome measure was performance on the nephrology certifying exam. Fellowship program pass rates over the decade were also studied. RESULTS: Lower IM certifying exam score, older age, female sex, international medical graduate (IMG) status, and having trained at a smaller nephrology fellowship program were associated with poorer nephrology certifying exam performance. The mean IM certifying exam percentile score among those who subsequently took the nephrology certifying exam decreased from 56.7 (SD, 27.9) to 46.1 (SD, 28.7) from 2010 to 2019. When examining individuals with comparable IM certifying exam performance, IMGs performed less well than United States medical graduates (USMGs) on the nephrology certifying exam. In 2019, only 57% of nephrology fellowship programs had aggregate 3-year certifying exam pass rates ≥80% among their graduates. CONCLUSIONS: Changes in IM certifying exam performance, certain trainee demographics, and poorer performance among those from smaller fellowship programs explain much of the decline in nephrology certifying exam performance. IM certifying exam performance was the dominant determinant.
Assuntos
Certificação/tendências , Avaliação Educacional/estatística & dados numéricos , Bolsas de Estudo/tendências , Medicina Interna/educação , Nefrologia/educação , Adulto , Fatores Etários , Certificação/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/tendências , Bolsas de Estudo/estatística & dados numéricos , Feminino , Médicos Graduados Estrangeiros/estatística & dados numéricos , Humanos , Medicina Interna/estatística & dados numéricos , Medicina Interna/tendências , Masculino , Nefrologia/estatística & dados numéricos , Nefrologia/tendências , Médicos Osteopáticos/estatística & dados numéricos , Fatores Sexuais , Estados UnidosRESUMO
BACKGROUND: The transition from American Osteopathic Association (AOA) and Accreditation Council for Graduate Medical Education (ACGME) residency matches to a single graduate medical education accreditation system culminated in a single match in 2020. Without AOA-accredited residency programs, which were open only to osteopathic medical (DO) graduates, it is not clear how desirable DO candidates will be in the unified match. To avoid increased costs and inefficiencies from overapplying to programs, DO applicants could benefit from knowing which specialties and ACGME-accredited programs have historically trained DO graduates. OBJECTIVE: This study explores the characteristics of residency programs that report accepting DO students. METHODS: Data from the American Medical Association's Fellowship and Residency Electronic Interactive Database Access were analyzed for percentage of DO residents in each program. Descriptive statistics and a logit link generalized linear model for a gamma distribution were performed. RESULTS: Characteristics associated with graduate medical education programs that reported a lower percentage of DO graduates as residents were surgical subspecialties, longer training, and higher US Medical Licensing Examination Step 1 scores of their residents compared with specialty average. Characteristics associated with a higher percentage of DO graduates included interviewing more candidates for first-year positions and reporting a higher percentage of female residents. CONCLUSIONS: Wide variation exists in the percentage of DO graduates accepted as residents among specialties and programs. This study provides valuable information about the single Match for DO graduates and their advisers and outlines education opportunities for the osteopathic profession among the specialties with low percentages of DO students as residents.
Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Medicina Osteopática/educação , Feminino , Humanos , Masculino , Médicos Osteopáticos/estatística & dados numéricos , Especialização/estatística & dados numéricos , Estados UnidosRESUMO
PURPOSE: To determine the number of DO (doctor of osteopathic medicine) and MD (doctor of medicine) residents in training programs accredited by the Accreditation Council for Graduate Medical Education (ACGME) and the American Osteopathic Association (AOA) and to examine the behavior of DO residents who moved between the two types of programs. METHOD: In 2013, the authors linked data on residents reported in ACGME-accredited and AOA-accredited programs in 2009, 2010, and 2011 to produce a count of all residents, including an unduplicated count of residents reported in joint programs. DO residents were identified who moved between AOA-accredited and ACGME-accredited programs. RESULTS: There were 106,923 MD residents and 14,789 DO residents on duty on December 31, 2011. Fifty-one percent of DO residents were in ACGME-accredited programs, 40% in AOA-accredited programs, and 9% in joint programs. DOs were 12% of all residents and 14% of first-year residents. Of 3,742 DOs and 16,863 MDs graduating in 2009-2010, 663 MDs and 222 DOs were not reported in graduate medical education (GME) in either 2010 or 2011. A larger percentage of DO graduates were training in the primary care specialties, especially in family medicine. CONCLUSIONS: These data provide the first comprehensive accounting of the numbers of individuals in U.S. GME, in both ACGME- and AOA-accredited residencies. The number of graduates from U.S. medical schools is increasing rapidly; residency positions are growing more slowly. The planned unified accreditation of U.S. GME may cause significant changes in the patterns of GME for future trainees.
Assuntos
Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Internato e Residência/estatística & dados numéricos , Medicina Osteopática/educação , Médicos Osteopáticos/estatística & dados numéricos , Especialização/estatística & dados numéricos , Acreditação , Humanos , Sociedades Médicas , Estados UnidosRESUMO
Osteopathic graduate medical education (OGME) continues to evolve. With the restructuring of the traditional osteopathic internship, which became effective July 1, 2008, for most specialties, the number of trainees in osteopathic residency programs has substantially grown. The authors detail the effects of the restructuring on OGME and provide an update on the current availability of OGME training opportunities. The present article does not, however, report data from the American Osteopathic Association Intern/Resident Registration Program (ie, the AOA "Match").