Factors Associated With American Board of Medical Specialties Member Board Certification Among US Medical School Graduates

Abstract

Context Certification by an American Board of Medical Specialties (ABMS) member board is emerging as a measure of physician quality. Objective To identify demographic and educational factors associated with ABMS-member-board certification of US medical graduates. Design, Setting, Participants Retrospective study of a national cohort of 1997–2000 US medical graduates, grouped by specialty choice at graduation and followed up through March 2, 2009. In separate multivariable logistic regression models for each specialty category, factors associated with ABMS-member-board certification were identified. Main Outcome Measure ABMS-member-board certification Results Of 42 440 graduates in the study sample, 37 054 (87.3%) were board certified. Graduates in all specialty categories with first-attempt passing scores in the highest tertile (vs first-attempt failing scores) on US Medical Licensing Examination Step 2 Clinical Knowledge were more likely to be board certified; adjusted odds ratios (aOR) varied by specialty category with the lowest odds for emergency medicine (87.4% vs 73.6%; aOR, 1.82; 95% confidence interval [CI], 1.03–3.20) and highest odds for radiology (98.1% vs 74.9%; aOR, 13.19; 95% CI, 5.55–31.32). In each specialty category except family medicine, graduates self-identified as underrepresented racial/ethnic minorities (vs white) were less likely to be board certified, ranging from 83.5% vs 95.6% in the pediatrics category (aOR, 0.44; 95% CI, 0.33–0.58) to 71.5% vs 83.7% in the other non-generalist specialties category (aOR, 0.79; 95% CI, 0.64–0.96). With each $50 000 unit increase in debt (vs no debt), graduates choosing obstetrics/gynecology were less likely to be board certified (aOR, 0.89; 95% CI, 0.83–0.96), and graduates choosing family medicine were more likely to be board certified (aOR 1.13; 95% CI, 1.01–1.26). Conclusion Demographic and educational factors were associated with board certification among US medical graduates in every specialty category examined; findings varied among specialty categories.

Delaying the American Board of Emergency Medicine Qualifying Examination Is Associated With Poorer Performance

“…[14][15][16] A sizeable analysis involving 42,440 residency graduates in several specialties was conducted by Jeffe and Andriole. 17 Despite some interspecialty variation, the investigators found that underrepresented racial and ethnic minorities, older medical school graduates, and physicians who withdrew or were dismissed from residency programs had greater difficulty becoming board-certified.…”

A National Long-term Outcomes Evaluation of U.S. Premedical Postbaccalaureate Programs Designed to Promote Health care Access and Workforce Diversity

“…However, when compared with the certification rate of 87.3% from a comparable national sample of 42,440 physicians from about the same graduation cohort (1997-2000), the American Board of Medical Specialties certification rate of PBP graduates is nearly equal to the national mean. 31 This is a salient result, especially when taking into consideration that these PBP physician graduates participated in these programs specifically designed to academically prepare disadvantaged and underrepresented students who might not otherwise have become physicians.…”

Maintenance of Certification and the Challenge of Professionalism

“…Nearly all graduating residents attempt to become board certified, and confounding variables, such as age or graduating institution, separate those attaining and maintaining board certification from those who do not. 54,55 Pediatrics faces some special challenges in MOC research. These include the scarcity of validated pediatric quality measures, small sample sizes in pediatrics, and the absence of a national pediatric database akin to the Medicare database for adults.…”