Association Between Resident In-Service Exam Scores by Post-Graduate Year and Subsequent Board Qualifying Exam.

INTRODUCTION: Prior work notes the AUA in-service exam (ISE) percentile ranking of chief residents correlates with qualifying exam (QE) performance. We present a 5-year analysis of resident performance on the ISE and subsequent QE to determine if earlier time points in training may identify those needing additional educational support. METHODS: Participant ISE scores over a 5-year period from 2014 to 2018 and subsequent QE scores in 2019 were recorded. Pearson's correlation coefficient measured the association between percentage questions correct for each ISE year and QE. Youden Index calculated the optimal cut-point for yearly ISE percentage correct that would predict scoring greater than the lowest quartile and decile on the QE. RESULTS: Median percent questions correct on ISE increased over PGY1 (47%), PGY2 (56.5%), and PGY3 (70%) years but remained stable thereafter (PGY4-5) at approximately 70%. Median QE percent correct in 2019 was 66% (Std Dev 7.6%). Correlation of percent questions correct between ISE and QE improved from 0.31 to 0.53 over training duration. The lowest decile and quartile percent correct scores on the QE were 56% and 60%, respectively. Percent correct ISE score predicting performance above the lowest decile 2019 QE score increased from 38% PGY1, 57% PGY2, and leveled off after PGY3 year (∼70%). Similar observations were noted with lowest quartile QE score. CONCLUSIONS: Scoring approximately 70% of questions correct on the ISE during PGY3 and later years was associated with low risk of failing the QE. Such information provides benchmarks for residency programs to offer targeted educational content for at-risk candidates.

Impact of Fellowship-Trained Andrology and Sexual Medicine Specialists on Performance on the Annual American Urological Association In-Service Examination.

OBJECTIVE: To demonstrate the distribution and impact of fellowship-trained andrology and/or sexual medicine urological specialists (FTAUS) on resident in-service examination (ISE) performance. METHODS: Residency program websites were accessed to create a database of FTAUS in the United States between 2007 and 2017. This database was reviewed by three separate FTAUS and cross referenced with membership lists to the Sexual Medicine of North America Society and the Society for the Study of Male Reproduction. De-identified ISE scores were obtained from the American Urological Association from 2007-2017 and scores from trainees at programs with a FTAUS were identified for comparison. Resident performance was analyzed using a linear model of the effect of a resident being at a program with an FTAUS, adjusting for post-graduate year. RESULTS: ISE data from 13,757 residents were obtained for the years 2007-2017. The number of FTAUS in the United States increased from 40-102 during this study period. Mean raw scores on the "Sexual Dysfunction, Endocrinopathy, Fertility Problems" (SDEFP) section of the ISE ranged from 52.1% ± 17.7% to 65.7% ± 16% (mean ± SD). Throughout the study period, there was no difference in performance within the SDEFP section (P < .01). Residents at a program with a FTAUS answered 0.95% more questions correctly in the SDEFP than those without a FTAUS (P < .001). For these residents, there was an improvement of approximately 0.66% on the percentage of questions answered correctly on the ISE overall (P < .001). Performance improved significantly as residents progressed from PGY-2-PGY-5. CONCLUSION: There is a small but statistically significant improvement in overall ISE and SDEFP sub-section performance.