Division of Health Behavior Research, Washington University School of Medicine, 4444 Forest Park Ave, Ste 6700, St Louis, MO 63108, USA.
JAMA. 2011 Sep 7;306(9):961-70. doi: 10.1001/jama.2011.1099.
Certification by an American Board of Medical Specialties (ABMS) member board is emerging as a measure of physician quality.
To identify demographic and educational factors associated with ABMS member board certification of US medical school graduates.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective study of a national cohort of 1997-2000 US medical school graduates, grouped by specialty choice at graduation and followed up through March 2, 2009. In separate multivariable logistic regression models for each specialty category, factors associated with ABMS member board certification were identified.
ABMS member board certification.
Of 42,440 graduates in the study sample, 37,054 (87.3%) were board certified. Graduates in all specialty categories with first-attempt passing scores in the highest tertile (vs first-attempt failing scores) on US Medical Licensing Examination Step 2 Clinical Knowledge were more likely to be board certified; adjusted odds ratios (AORs) varied by specialty category, with the lowest odds for emergency medicine (87.4% vs 73.6%; AOR, 1.82; 95% CI, 1.03-3.20) and highest odds for radiology (98.1% vs 74.9%; AOR, 13.19; 95% CI, 5.55-31.32). In each specialty category except family medicine, graduates self-identified as underrepresented racial/ethnic minorities (vs white) were less likely to be board certified, ranging from 83.5% vs 95.6% in the pediatrics category (AOR, 0.44; 95% CI, 0.33-0.58) to 71.5% vs 83.7% in the other nongeneralist specialties category (AOR, 0.79; 95% CI, 0.64-0.96). With each $50,000 unit increase in debt (vs no debt), graduates choosing obstetrics/gynecology were less likely to be board certified (AOR, 0.89; 95% CI, 0.83-0.96), and graduates choosing family medicine were more likely to be board certified (AOR, 1.13; 95% CI, 1.01-1.26).
Demographic and educational factors were associated with board certification among US medical school graduates in every specialty category examined; findings varied among specialty categories.
美国医学专业委员会（ABMS）成员委员会的认证正在成为衡量医生质量的一个标准。
确定与美国医学院毕业生获得 ABMS 成员委员会认证相关的人口统计学和教育因素。
设计、地点和参与者：对 1997 年至 2000 年美国医学院毕业生的全国队列进行回顾性研究，按毕业时的专业选择分组，并随访至 2009 年 3 月 2 日。在每个专业类别的单独多变量逻辑回归模型中，确定了与 ABMS 成员委员会认证相关的因素。
ABMS 成员委员会认证。
在研究样本的 42440 名毕业生中，37054 名（87.3%）获得了委员会认证。在所有专业类别中，首次尝试通过美国医师执照考试第 2 步临床知识部分最高三分位（与首次尝试失败分数相比）的毕业生更有可能获得委员会认证；调整后的优势比（AOR）因专业类别而异，急诊医学的最低概率为 87.4%比 73.6%（AOR，1.82；95%CI，1.03-3.20），放射科的最高概率为 98.1%比 74.9%（AOR，13.19；95%CI，5.55-31.32）。在每个专业类别中，除了家庭医学专业，自我认定为代表性不足的少数族裔（与白人相比）的毕业生获得委员会认证的可能性较低，从儿科类别的 83.5%比 95.6%（AOR，0.44；95%CI，0.33-0.58）到其他非普通科专业类别的 71.5%比 83.7%（AOR，0.79；95%CI，0.64-0.96）。与没有债务相比，每增加 50000 美元的债务（与没有债务相比），选择妇产科的毕业生获得委员会认证的可能性降低（AOR，0.89；95%CI，0.83-0.96），而选择家庭医学的毕业生获得委员会认证的可能性增加（AOR，1.13；95%CI，1.01-1.26）。
在每个检查的专业类别中，人口统计学和教育因素与美国医学院毕业生的委员会认证相关；发现因专业类别而异。
