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15 July 1996 | Volume 125 Issue 2 | Page 158
The In-Training Examination in Internal Medicine [1] is taken by almost all postgraduate year (PGY) II residents (6150 in 1995) and most PGY-I (4727) and PGY-III (4242) residents. The results are used by trainees to evaluate their performance relative to that of their peers and have proven to predict later performance by residents on the certifying board examination [2, 3]. Registration data allow comparison of scores of graduates of allopathic medical schools in the United States and of schools in other countries except Canada.
The mean scores in 1995 for international medical school graduates at all three training levels [4] were, for the first time, significantly higher than those of U.S. medical school graduates (Table 1). This finding strengthens a trend that was first observed only for PGY-Is in the 1994 examination [5]. Highly significant differences (P < 0.001) were noted when mean scores were compared by level of training (PGY-I, PGY-II, and PGY-III) or by location of medical school attended, based on analysis of variance. LETTER
Performance of U.S. and International Medical Graduates on the 1995 Internal Medicine In-Training Examination
TO THE EDITOR:
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The above data document, but certainly do not explain, a significant trend toward relative improvement in performance by international medical school graduates compared with U.S. medical school graduates. Possible explanatory factors might include differences in the number of years of previous residency training, changes in medical school curriculum, and diminished interest in internal medicine careers by the best test-takers from U.S. schools. It is also possible that the scores of international medical school graduates who are accepted through the National Residency Matching Program significantly differ from scores of graduates recruited outside the program.
Changes in the physician workforce are currently being actively debated on a national level. The above data provide an objective benchmark for showing the existence of the relatively high quality of training at some schools outside the United States. There is clearly a need for further analysis, but such data should serve as one point of reference when comparisons are being made among groups of residents with different backgrounds.
Author and Article Information
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References
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1. Garibaldi RA, Trontell MC, Waxman HS, 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 RE, 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.
3. Waxman H, Braunstein G, Dantzker D, Goldberg S, Lefrak S, Lichstein E, et al. Performance on the internal medicine second year residency In-Training Examination predicts the outcome of the ABIM certifying examination. J Gen Intern Med. 1994; 9:692-4.
4. Final Report on the 1995 Internal Medicine In-Training Examination. National Board of Medical Examiners; 1995.
5. Final Report on the 1994 Internal Medicine In-Training Examination. National Board of Medical Examiners; 1994.
About Letters
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•Type with double-spacing
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This article has been cited by other articles:
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  S. S. Mick and M. E. Comfort The Quality of Care of International Medical Graduates: How does it Compare to that of U.S. Medical Graduates? Med Care Res Rev, December 1, 1997; 54(4): 379 - 413. [Abstract] [PDF]
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