Weekly assigned reading and examinations during residency, ABSITE performance, and improved pass rates on the American Board of Surgery Examinations

Christian de Virgilio, Tony Chan, Amy Kaji, Kel Miller
Journal of Surgical Education 2008, 65 (6): 499-503

OBJECTIVES: The objectives for this study are as follows: (1) to determine whether a weekly educational program for surgical residents resulted in an improvement in 5-year first-time pass rates on the ABS qualifying (QE), certifying (CE), and combined (QE/CE) examinations at our institution and (2) to determine a minimum ABSITE threshold for predicting ABS pass rates.

SETTING: In July 2001, we instituted a weekly educational program that consisted of assigned reading and examinations, prepared and administered by the program director (PD) to all our surgical residents. We previously demonstrated that this program resulted in a significant and sustained improvement in ABSITE scores.

DESIGN: Retrospective comparison of 2 periods before (1997-2001) and after (2002-2007) the institution of weekly assigned reading and examinations.

PARTICIPANTS: Forty-nine categorical surgical residents from 1997 through 2007 at a university-affiliated public teaching hospital and medical center.

RESULTS: In the academic period from 1997 to 2001, the first-time pass rates for the QE, CE, and QE/CE were 17 of 21 (81%), 17 of 21 (81%), and 14 of 21 (67%), respectively. From 2002 to 2007, the first-time pass rates were 26 of 28 (93%), 26 of 28 (93%), and 25 of 28 (89%), respectively. For each additional year of exposure to the educational program, the odds ratio for passing the combined QE/CE was 2.2 (p = 0.04). The median ABSITE percentile was the 60th in period 1 versus the 79th in period 2 (p < 0.0001). For each additional year of exposure to the educational program, the average ABSITE score increased by 2.6 percentile points (p = 0.04). An ABSITE score less than the 30th percentile at any time or scoring less than 35th percentile more than once during residency significantly increased the chance of the resident failing the QE, whereas a score less than the 25th percentile also predicted failure of the combination of the QE and CE.

CONCLUSION: An educational program of weekly assigned reading, followed by weekly examinations prepared and administered by the PD, resulted in an increase in the 5-year first-time pass rates on the QE, CE, and combined QE/CE. An ABSITE score less than the 30th percentile, or scoring less than the 35th percentile more than once during residency, identified a group at significantly increased risk of failing the QE. Programs that seek to increase the ABS examinations passage rates should consider instituting this type of program.

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