Performance on the American Board of Physical Medicine and Rehabilitation certifying examinations: Rural and urban physicians

Abstract

Background: Over 60 million people in the United States live in a rural community making up approximately 20% of the population. Data are minimal about the physiatrists who serve this rural population, their performance on certification examinations and how the American Board of Physical Medicine and Rehabilitation (ABPM&R) serves their ongoing educational, assessment, and practice needs. Objective: To compare the performance of rural and urban physicians on the Part I, Part II, and maintenance of certification (MOC) examinations along with subspecialty preference and continuance of primary certification. Design: Retrospective cross-sectional study. Setting: Board-eligible PM&R physicians and certified diplomates of the ABPM&R. Participants: Physicians who participated in an initial certification or maintenance of certification examination with the ABPM&R between 2010 and 2019. Methods: Comparisons of physician pass rates, mean scaled scores (aggregates), and program pass rates on ABPM&R certifying examinations were completed. Cross-reference to national database and ABPM&R practice site zip codes provided sociogeographic linkage. Interventions: Not applicable Main Outcome Measures: Physician mean scaled scores, pass rates, subspecialty preferences, and primary certification status. Results: There were no meaningful differences in performance on the ABPM&R Part I, II, and MOC examinations between rural and urban physiatrists. Most common subspecialty is the pain medicine certification whose diplomates most frequently drop their primary certification. Pediatric rehabilitation medicine certification is rare in rural localities and a health care disparity. Conclusion:The study found no meaningful differences in the performance of rural and urban physicians on the ABPM&R certifying examinations.

Key Findings From Peer-Reviewed Published Research by the American Board of Physical Medicine and Rehabilitation in Review

“…There were no meaningful differences in performance on the ABPMR certification examinations among physiatrists in rural versus urban locations. Community size of the location of practice was not associated with the pass rate for either the Part I ( P = 0.599) or Part II Examination ( P = 0.072) 10 …”

“…15 • In a study examining the association of demographic site of practice with both scaled scores and pass rates on the ABPMR MOC examination, there were no significant differences in MOC examination mean scaled scores ( P = 0.70) or MOC examination pass rates between physicians in rural and urban communities ( P = 0.92). 10…”

American Board of Physical Medicine and Rehabilitation Diplomate Customization Choices on the Longitudinal Assessment for Physical Medicine and Rehabilitation

“…Rural-Urban Continuum Codes were then identified through the zip code database and stratified based on population size: (1) small rural (<50,000), large rural (50,000-99,999), urban (100,000-250,000), and metropolitan (>250,000). 8 Data analysis included analysis of variance to compare sample means from multiple groups. To determine group differences within the independent variables, Tukey honestly significant difference post hoc test was used.…”

“…Practice site zip codes were matched with zip codes in a database supplied by zip-codes.com (Hopewell Junction, NY). Rural-Urban Continuum Codes were then identified through the zip code database and stratified based on population size: (1) small rural (<50,000), large rural (50,000–99,999), urban (100,000–250,000), and metropolitan (>250,000) 8 …”