Endocrine In-Training exam strong predictor of pass/fail board exam outcomes
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The Endocrine Self-Assessment Program In-Training Examination is a strong predictor of pass/fail outcomes on the American Board of Internal Medicine-Endocrinology, Diabetes, and Metabolism Certification Examination, data show.
The Endocrine Society’s in-training exam, part of the society’s Fellows Training Series, was created to provide support to fellows and program directors. The Endocrine Self-Assessment Program In-Training Examination (ESAP-ITE) has a unique design that allows open access to all questions and answers after secure exam administration is complete, resulting in the creation of an entirely new in-training examination annually. However, researchers have acknowledged the unique model risks losing the ability to predict outcomes on the American Board of Internal Medicine-Endocrinology, Diabetes, and Metabolism Certification Exam (ABIM-ECE).
“While I was in fellowship, I took the in-training exam each year and found it to be very beneficial for my development as a fellow and my assessment of medical knowledge,” William B. Horton, MD, MSc, FACP, assistant professor in the division of endocrinology and metabolism at the University of Virginia School of Medicine, told Healio. “But there were no data available on how [the in-training exam] related to or predicted board certification outcomes. Board certification is increasingly important; many hospitals and insurance companies require it for employment and payment. Many other subspecialities have data showing how their in-training exams predict board outcomes and/or if they predict it at all.”
In a retrospective study, Horton and colleagues analyzed data from 982 endocrine fellows-in-training who took the ESAP-ITE between 2016 and 2019 and subsequently attempted the ABIM-ECE within the same calendar year. Primary analyses assessed the ESAP-ITE score from the final year of fellowship training. Covariates included sex, age on date of ABIM-ECE, medical school country, fellowship program region, pass/fail outcomes on the ABIM Internal Medicine Certification Examination, and ESAP-ITE score. All variables were analyzed using multivariable logistic regression.
“We ran a model to see which of those factors were significant predictors of pass/fail outcomes on the endocrine board certification exam and then which predictor was, theoretically, the most significant,” Horton said.
Researchers found that ESAP-ITE score (P < .001), ABIM Internal Medicine Certification Examination outcome (P < .001) and age (P = .005) were each predictors of passing the ABIM-ECE on the first attempt.
ESAP-ITE score was the strongest predictor of passing the ABIM-ECE; a score of 75% correct yielded a 97% probability of passing the ABIM-ECE, whereas a score of 50% correct generated only a 70% probability of doing so.
Sex, fellowship program region and medical school country were not significant predictors of ABIM-ECE outcomes.
“Interestingly, the Endocrine Society in-training exam was far and away the most significant predictor [of pass/fail outcomes],” Horton said. “It showed robust predictive value; as your score goes up, your odds of passing the endocrine board certification exam continued to go up, until you get to around 70% correct, where it begins to level off. This shows that in-training exam scores do matter. It also shows you do not have to score really high in order to have a good chance of passing the endocrine board certification exam.”
Horton said the data also show the endocrine in-training exam is covering similar content tested on the endocrine board exams.
“We view this as something fellows and program directors can be excited about,” Horton said.
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