The ACGME Duty Hour Standards and Board Certification Examination Performance Trends in Surgical Specialties

Abstract

Background Duty hour limitations initiated by the Accreditation Council for Graduate Medical Education (ACGME) in 2003 could improve resident education in surgical specialties. Objective The purpose of this study was to evaluate national surgical board examination performance and its relationship to the ACGME duty hour standards. Methods In this retrospective cohort study, electronically published website content was evaluated for examination statistics for the 10 surgical boards in the American Board of Medical Specialties. To evaluate examination trends over time, we performed simple linear regression. We also performed interrupted time series analyses, using segmented logistic regression. The secondary analyses consisted of a χ2 test of passing and failing examinees before and after 2003. All statistics used α = .05. Results There were 8 of 10 (80%) surgical boards with examinations that met inclusion criteria and a total of 72 482 unique examination results. Of the 16 examinations evaluated (50% written, 50% oral), 13 (81%) had either significant pass rate trends on regression analyses and/or a significant pre-post pass rate surrounding the initiation of the ACGME duty hour standards in 2003 in the secondary analysis (P < .05). Conclusions There are both increasing examination pass rates and some downward trends in examination performance on surgical board examinations since the initiation of the ACGME duty hour standards in 2003. The etiology of these trends is unclear, but trends are important to know for individual examinees, residency training programs, and surgical boards.

Relationship of residency program characteristics with pass rate of the American Board of Internal Medicine certifying exam

“…Previous studies on what variables relate to pass rate have looked primarily at the relationship between pass rate and exam scores (i.e., for in-training examinations or USMLE) ( 5 – 11 ) or the effect of duty hour reform ( 12 – 14 ). Unfortunately, neither factor is directly related to the characteristics of a residency program, because the former is an important predictor of individual performance whereas the latter is a regulatory factor.…”

The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination

“…9 This is in contrast to the improving trends on the American Board of Orthopaedic Surgery, Part I (written) Certification Examination. 11 Candidates taking the American Board of Urology QE demonstrated similar improvement, 11 while performance on the American Board of Obstetrics and Gynecology written examination had a downward trend in the pass rate.…”

“…8 There have been several studies examining the effect of the ACGME duty hour requirements on board certification examination performances. 4,[9][10][11] The findings have been inconsistent, with improved performance in some specialties, decline in others, and a third group that showed no impact. The relationship between the ACGME duty hour requirements and performance on the American Board of Emergency Medicine (ABEM) Qualifying Examination (QE) has not been examined.…”

Training and Performance Differences in US Internal Medicine Residents Trained in Community- and University-Based Programs – a Systematic Review

“…Our review differs from previously published reviews by capturing outcomes that aligned with ACGME recommendations. Other studies (Fletcher, Davis., Underwood, Mangrulkar, McMahon et al, 2004;Fletcher, Underwood, Davis, Mangrulkar, McMahon et al, 2005;Brateanu, Yu, Kattan, Olender, & Nielsen C., 2012;Falcone, & Feinn, 2013;Rajaram, Chung, Jones, Cohen, Dahlke et al 2014;Silber, Romano, Itani, Rosen, Small et al, 2014), only explored the effect of duty hours or explored the association of specific factors such as USMLE pass rate and score (Brown RS., 2010;Kay, Jackson, & Frank M., 2015;Yost, Gardner, Bell, Fann, Lisk, et al, 2015) in UBP and CBP residents. Previous studies were unable to associate findings with compliance overall ACGME recommendations for scholarship of learning and teaching opportunities for residents.…”