Relative United States Medical Licensing Examination (USMLE) Performance by Specialty Is Not a Predictor of Board Exam Pass Rate: The Case of Diagnostic Radiology.

Introduction In 2010 diagnostic radiology (DR) changed the board certification process for residents using the new Core exam. However, there is not a standardized way to evaluate DR residency graduates. With no specific target pass rate for the exam, the "appropriate" pass rate has remained a debated topic among the field. In this paper, the board certification exam passage rates of DR are compared to other medical specialties to assess the standardization method of the American Board of Radiology (ABR) and serve as basis for additional specialties considering changes to their board exam structure. Methods Performance on the United States Medical Licensing Examination (USMLE) was obtained from the National Resident Matching Program (NRMP) and San Francisco match. Boards passage rates were analyzed using data from the American Board of Medical Specialties. USMLE and board exam passage rates were averaged and ranked, and statistical analysis was conducted using Stata (College Station, TX). Results DR performance on USMLE Step 1 has increased at the lowest rate (0.563 points/year) since 2005 and anesthesiology performance has increased at the greatest rate (1.313 points/year). Residents matching from US allopathic medical schools during the 2010 and 2012 years had DR oral board exams with USMLE 1 averages of 232 and 235, respectively. First-time pass rate for the first Core exam was 87% and the overall pass rate since the first Core exam has been 88.54%. The Spearman rho coefficient for specialty ranks of board passage rate and USMLE 1 was 0.0679 (p = 0.8101). The Spearman rho coefficient for board passage rate and USMLE 2 CK was 0.1430 (p = 0.6257). The Spearman rho coefficient for USMLE 1 and USMLE 2 CK was 0.8317 (p = 0.0002). Conclusions Specialty board pass rates have not increased in concert with improved trainee performance on the USMLE. USMLE performance among those matching in diagnostic radiology has increased, ABR board exam passage rate has decreased. ABR determines passing thresholds to the relative performance of examinees rather than using a criterion referenced Angoff standard.

A Case of Lichen Planus Masquerading as Guttate Psoriasis.

Lichen planus (LP) is a chronic inflammatory disease that affects the skin, hair, nails, and mucous membranes, with variants such as drug-induced lichen planus, which is triggered by medications such as angiotensin-converting enzyme (ACE) inhibitors and antimalarials. Guttate psoriasis (GP), a clinical variant of psoriasis, is associated with streptococcal infections and presents with drop-like papules on the trunk and proximal extremities. In this report, we present a case of LP in an atypical location masquerading as GP and the importance of prompt dermatological referral to improve the patient's quality of life. Coexistence and similarities between several variants of LP and plaque psoriasis have been seen in the literature. However, to our knowledge, our report is the first to show LP specifically mimicking GP.

Factors Influencing In-State Retention Rates of Graduating Residents From Penn State College of Medicine Compared to National Average Retention Rates.

This study analyzes in-state retention rates at Penn State University (PSU) and nationally. Data were taken from the PSU handbook with location information of graduated residents and compared to data from the Association of American Medical Colleges (AAMC). The retention rate at PSU was lower than that nationally in all but three specialties. PSU retention rate was lower than that of Pennsylvania. Pennsylvania's retention rate was lower than the national average. Community size and physician per capita may play a role in graduating resident retention rate.

Residency Specialty and National Resident Matching Program Outcomes as Predictors of Academic vs Non-Academic Position as an Attending Physician.

PURPOSE: Previous studies have shown that research can be used as a predictive factor for an academic career for physicians in the fields of radiation oncology, orthopedic surgery, and diagnostic radiology. We seek to determine if this factor is predictive for all medical specialties based on an analysis of public data on physicians who have trained at Hershey Medical Center (HMC) and public National Resident Matching Program (NRMP) charting outcomes. METHODS: We determined the location and job title of all graduates of HMC residency training programs through a combination of publicly available information on HMC's website and other institutions' websites. We separated these into academic and non-academic positions and performed Chi-square analysis to determine if the number of research experiences was predictive of an academic career. RESULTS: Participating in the residency specialties of general surgery, pathology, internal medicine, and neurological surgery are statistically significant predictors of an academic career upon graduation. The average number of research experiences obtained by matched U.S. medical students is not a statistically significant predictor of an academic career upon graduation. CONCLUSION: In contrast to previously published studies, a higher number of research experiences in medical school is not a significant predictor of an academic career for attending physicians who graduated residency at HMC.

Public Intent to Comply with COVID-19 Public Health Recommendations.

Stay-at-home orders have been an essential component of coronavirus 2019 (COVID-19) management in the United States. As states start lifting these mandates to reopen the economy, voluntary public compliance with public health recommendations may significantly influence the extent of resurgence in COVID-19 infection rates. Population-level risk from reopening may therefore be predicted from public intent to comply with public health recommendations. We are conducting a global, convergent design mixed-methods survey on public knowledge, perceptions, preferred health information sources, and understanding of and intent to comply with public health recommendations. With over 9,000 completed surveys from every US state and over 70 countries worldwide, to our knowledge this is the largest pandemic messaging study to date. Although the study is still ongoing, we have conducted an analysis of 5,005 US surveys completed from April 9-15, 2020 on public intent to comply with public health recommendations and offer insights on the COVID-19 pandemic-related risk of reopening. We found marked regional differences in intent to follow key public health recommendations. Regional efforts are urgently needed to influence public behavior changes to decrease the risk of reopening, particularly in higher-risk areas with low public intent to comply with preventive health recommendations. [HLRP: Health Literacy Research and Practice. 2020;4(3):e160-e165.].

Synergistic Growth in Number of Diagnostic and Interventional Radiology Matches at Pennsylvania State College of Medicine After 2016.

In 2016, when interventional radiology (IR) separated from diagnostic radiology (DR), the future implications were unknown. The goal of this study is to investigate trends in DR and IR matches at Penn State College of Medicine (PSCOM) from 2011-2020, particularly before and after 2016. This retrospective study generated descriptive statistics and paired t-tests, finding a statistically significant difference in mean number of DR and IR matches before and after 2016. More specifically, the number of DR matches increased from 3.8 to 6.4 (p = 0.0004) and IR matches increased from 0 to 2 (p = 0.03). These trends suggest a synergistic growth in both specialties.

Spinal Coccidioidomycosis: A Complication From Medication Noncompliance.

Spinal coccidioidomycosis is a rare disseminated form of coccidioidomycosis infection. According to the literature, majority of patients are African American males. We present a rare case of spinal coccidioidomycosis in a young, Caucasian female with coccidioidomycosis meningitis at age 16 years who presented with bilateral lower extremity weakness after antifungal medication lapse for one year. Imaging revealed cystic arachnoid formations along her thoracic spine. Pathology report confirmed spinal arachnoiditis with coccidioidomycosis. This case report details a rare incidence of spinal coccidioidomycosis and reviews previous literature.

Scientometric Analysis: University Hospital Versus University College of Medicine.

Many medical specialties use scientometrics to assess the impact of publications, journals, and authors. The aim of this study was to analyze and compare trends of publications from a hospital medical center to publications from a college of medicine connected to that hospital and compare collaboration rates between them to other domestic and international institutions. We used Elsevier's SCOPUS database to compare Penn State College of Medicine (PSCOM) publications to Hershey Medical Center (HMC) publications, analyzing 31,856 total publications. We hypothesized that HMC and PSCOM have room to improve on both internal and international collaborations. Our results show that despite PSCOM's international collaboration being nearly three times higher than HMC, overall international collaboration is less than 2%, far below the US national average.

Trends in Gender Representation and Post-residency In-State Retention at Both an Academic Medical Center and in the United States.

This study examines gender representation and in-state retention rates of practicing residency graduates from Pennsylvania State University (PSU), as well as at the national level. PSU and national data were collected from a PSU handbook and the Association of American Medical Colleges (AAMC), respectively. There were significant differences between male and female representation both at PSU and at the national level. Furthermore, there was a significant difference between male and female retention rates nationally. This study demonstrates a true gender discrepancy for graduates from PSU and at the national level. Moving forward, investigating potential causes of this discrepancy may help minimize gender differences.