Should Pediatricians Fret Their Falling Board Scores? - Medscape

Few pediatricians person warm, fuzzy memories astir taking their archetypal committee exam.

But galore reacted powerfully erstwhile they work a recent post connected Twitter by Bryan Carmody, MD, who noted that the passing complaint for first-time trial takers had dipped to its lowest level successful 5 years ― hitting 81% successful 2021, down from 91% 3 years earlier.

"It's virtually an awfully written exam," replied 1 idiosyncratic who posted. Another asked: "At what constituent is the exam conscionable not reflective of objective practice?" And, inevitably, the question of the effect of COVID-19 surfaced: "Is immoderate of this attributable to pulling aboriginal vocation physicians into the pandemic?"

But Carmody, an subordinate prof of pediatrics astatine the University of Eastern Virginia Medical School, successful Norfolk, isn't buying that explanation. He researched committee scores for interior medicine, wide surgery, and household medicine for 2021. All were unchangeable during the aforesaid period, helium said, starring him to disregard the thought that the pandemic drove the decline. "It's not truly wide to maine wherefore different specialties wouldn't person seen akin drops," Carmody said.

The gaffe has caught the attraction of the American Board of Pediatrics, according to Judy Schaechter, MD, MBA, who was seat of the Department of Pediatrics astatine the University Miami earlier taking a station arsenic president and CEO of the American Board of Pediatrics (ABP) successful 2021.

"So, our archetypal question was, was this wrong the scope of what 1 mightiness expect?" Schaechter said. "Were determination different factors that mightiness person travel into play?"

The committee performs an extended investigation each twelvemonth earlier releasing scores, and it didn't uncover immoderate changes successful the trouble oregon contented of the trial successful 2021, nor did the people that was needed to walk increase. Schaechter pointed retired that the passing complaint that twelvemonth was not unprecedented ― successful 2016, it besides dipped to 81%.

Schaechter said COVID-19 mightiness person affected trial takers. "Remember, pediatrics was antithetic from immoderate different specialty during the pandemic," she said. The census successful pediatric wards astir the state dropped dramatically successful the archetypal 2 winters of the pandemic, leaving residents with little hands-on acquisition with patients and mentorship from attendings ― some of which tin assistance test-takers walk the exam.

Eyal Ben-Isaac, MD, an subordinate prof of the Department of Pediatrics astatine the Keck School of Medicine astatine the University of Southern California, successful Los Angeles, said residents apt suffered during the pandemic, erstwhile noon lectures and expansive rounds became virtual events.

"I'm definite that intelligibly affected a person's quality to beryllium and perceive and truly larn the material, arsenic opposed to either doing it hands connected oregon learning the worldly from a module subordinate look to face," Ben-Isaac said.

But however overmuch bash the didactic experiences of residency programs lend to residents' readiness to instrumentality the boards? Thomas Welch, MD, prof and seat emeritus of the Department of Pediatrics astatine SUNY Upstate Medical University, successful Syracuse, credits his ain occurrence successful advancing done college, aesculapian school, pediatric residency, and nephrology fellowship to his accomplishment arsenic a trial taker.

He confirmed his suspicions by conducting a study that evaluated correlations betwixt residents' show connected the US Medical Licensing Exam (USMLE) taken during aesculapian schoolhouse and their committee scores aft completing residency.

Welch said helium wasn't amazed to find that "the champion predictor of one's passing the pediatric boards was not the grooming programme successful which 1 worked. It was their show connected Step 2 [taken during the 4th twelvemonth of aesculapian school] of the USMLE."

Although Ben-Isaac felt that changes successful residency grooming opportunities mightiness person partially explained the driblet successful passing rates, helium agreed that different factors lend to occurrence connected boards. As manager of the pediatric residency programme astatine Children's Hospital of Los Angeles from 1994 to 2019, 1 of his archetypal goals was to summation the walk complaint of graduates. He developed a committee reappraisal people for residents, revising it implicit clip connected the ground of residents' feedback and adding idiosyncratic coaching for residents who wanted much help.

"Without a question, it raised our committee walk complaint to being 1 of the highest successful the country," helium said.

Welch said that portion "being up each nighttime with a sick kid teaches you a batch astir medicine and surely makes you a amended doctor, it doesn't bash thing to amended your committee scores."

None of the pediatricians was excessively disquieted astir a 1-year driblet successful scores, and the statement was that supporting residents with reappraisal courses and coaching connected however to instrumentality aggregate prime tests would rise passing rates.

"There are decidedly radical who are astonishing clinicians who did not walk the boards connected their archetypal attempt," Ben-Isaac said.

But Schaechter defended the value of the examination. "Our archetypal work is truly to the public," she said. The ABP's relation is to guarantee that pediatricians "provide the attraction that parents privation their kids to have."

As Welch enactment it, "Would I spot idiosyncratic who didn't walk the committee exam to instrumentality attraction of my ain kid? Probably not."

Ann Thomas, MD, MPH, is simply a pediatrician and epidemiologist surviving successful Portland, Oregon.

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