LETTER
In-Training Examination in Internal Medicine
James R. O'Dell, MD
1 January 1995 | Volume 122 Issue 1 | Pages 73-74
TO THE EDITOR:
As an internal medicine program director, I read with interest the recent article by Garibaldi and colleagues on the ITE-IM [1]. Since the ITE-IM was first offered in 1988, we have required that all of our first-, second-, and third-year residents take the examination each year, allowing us to follow the early progress (as measured by the examination) of all our residents.
During this period we have evaluated the correlation between the performance of our residents on the ITE-IM in relation to their results on the ABIM certifying examination. We have found an even stronger correlation between residents' performance on the third-year ITE-IM and their ABIM examination scores than has previously been reported [2] (r = 0.85; P < 0.001). The mean percentile score on the ABIM examination for our residents is 9 percentile points lower than the score on the corresponding third-year ITE-IM. An ITE-IM score of 50 percentile points or higher predicts success on the ABIM examination with 91% accuracy in our residents, whereas a score of lower than 50 percentile points predicts failure on the ABIM examination with 67% accuracy. From this data, we have been able to provide timely feedback to residents and have counseled them about developing the databases they will need to achieve their common goal of passing the ABIM examination.
The data that we have received from the ITE-IM have also been useful in helping us to evaluate our subspecialty rotations. When scores for one or more of our subspecialties have been low (compared with scores in other subspecialties) we have been able to stimulate these subspecialties to make changes in the educational opportunities available to residents during their rotation.
I congratulate the American College of Physicians, the Association of Program Directors in Internal Medicine, and the Association of Professors of Medicine for developing the ITE-IM, which has become a useful measuring instrument for both internal medicine residents and program directors of internal medicine training programs.
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Author and Article Information
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University of Nebraska Medical Center; Omaha, NE 68198-3025
1. Garibaldi RA, Trontell MC, Waxman H, Holbrook JH, Kanya DT, Khoshbin S, et al. The In-Training Examination in Internal Medicine. Ann Intern Med. 1994; 121:117-23.
2. Grossman RS, Fincher RM, Layne RD, Seelig CB, Berkowitz LR, Levine MA. Validity of the in-training examination for predicting American Board of Internal Medicine Certifying Examination scores. J Gen Intern Med. 1992; 7:63-7.
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