急危重症医学（EM/CCM）住院医师在标准化急危重症医学考试中的表现：十年回顾。

Emergency Medicine/Critical Care Medicine (EM/CCM) Trainees' Performance on Standardized Critical Care Medicine Examinations: A Ten-Year Review.

机构信息

Department of Anesthesiology, Washington University in St. Louis, School of Medicine, St. Louis, Missouri; Department of Emergency Medicine, Washington University in St. Louis, School of Medicine, St. Louis, Missouri; Critical Care Medicine Fellowship, Washington University in St. Louis, School of Medicine, St. Louis, Missouri.

Department of Emergency Medicine, Division of Pulmonary, Allergy, & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama; Department of Internal Medicine, Division of Pulmonary, Allergy, & Critical Care Medicine, University of Alabama at Birmingham, Birmingham, Alabama.

出版信息

J Emerg Med. 2020 Mar;58(3):473-480. doi: 10.1016/j.jemermed.2020.02.017. Epub 2020 Apr 1.

DOI:10.1016/j.jemermed.2020.02.017

PMID:32247657

Abstract

BACKGROUND

Emergency Medicine/Critical Care Medicine (EM/CCM) trainees may obtain board certification through Internal Medicine (American Board of Internal Medicine [ABIM]), Surgery (American Board of Surgery [ABS]), and Anesthesiology (American Board of Anesthesiology [ABA]). However, EM/CCM trainees experience challenges, including: 1) additional training requirements and 2) an unwillingness to accept EM graduates by many programs.

OBJECTIVES

We sought to: 1) compare EM/CCM knowledge acquisition to medicine (Internal Medicine [IM]/CCM), surgery (surgical critical care [SCC]), and anesthesiology (anesthesiology critical care medicine [ACCM]) Fellows at the local and national level using the Multidisciplinary Critical Care Knowledge Assessment Program (MCCKAP) in-service examination as an objective measure; and 2) compare American Board of Medical Specialties (ABMS) pass rates for EM/CCM.

METHODS

Single-center retrospective analysis comparing scores obtained by EM/CCM on the MCCKAP examination with SCC and ACCM over a 10-year period. Scores are presented as means with standard deviations. We performed similar analysis on ABMS examination pass rates.

RESULTS

There were 117 MCCKAP scores (37 EM/CCM; 80 SCC and ACCM) evaluated. EM/CCM mean score 562.4 (SD 67.4); SCC and ACCM mean score 505.3, (SD 87.5) at the institutional level (p < 0.001). Similarly, EM/CCM scored higher than the national mean (562.4, SD 67.4 vs. 500 SD 100, p < 0.001). Nationally, ABIM-CCM board certification rate was 91.2% for 137 EM/CCM, compared with 93.2% for IM/CCM (p = 0.22); 28 EM/CCM have obtained ABA-CCM board certification with rates similar to ACCM (90.4 vs. 89.3%; p = 0.85).

CONCLUSIONS

EM/CCM Fellows demonstrate successful knowledge acquisition both locally and at a national level. EM/CCM achieve ABMS pass rates similar to other CCM trainees. The current arbitrary additional training requirements placed on EM/CCM should be removed.

摘要

背景

急诊医学/危重病医学（EM/CCM）的住院医师可以通过内科（美国内科医师学会 [ABIM]）、外科（美国外科医师学会 [ABS]）和麻醉学（美国麻醉学会 [ABA]）获得委员会认证。然而，EM/CCM 的住院医师面临着挑战，包括：1）额外的培训要求和 2）许多项目不愿意接受 EM 专业的毕业生。

目的

我们旨在：1）使用多学科危重病知识评估计划（MCCKAP）的在职考试作为客观测量方法，比较 EM/CCM 与内科（内科/CCM）、外科（外科重症监护 [SCC]）和麻醉学（麻醉重症监护医学 [ACCM]）住院医师在当地和全国范围内的知识获取情况；2）比较 EM/CCM 的美国医学专业委员会（ABMS）通过率。

方法

单中心回顾性分析，比较了 10 年来 EM/CCM 学员在 MCCKAP 考试中的成绩与 SCC 和 ACCM 的成绩。分数以平均值和标准差表示。我们对 ABMS 考试通过率进行了类似的分析。

结果

共评估了 117 项 MCCKAP 评分（37 项 EM/CCM；80 项 SCC 和 ACCM）。EM/CCM 的平均分数为 562.4（SD 67.4）；SCC 和 ACCM 的平均分数为 505.3（SD 87.5），在机构层面上（p<0.001）。同样，EM/CCM 的得分高于全国平均水平（562.4，SD 67.4 与 500 SD 100，p<0.001）。在全国范围内，137 名 EM/CCM 住院医师获得了 ABIM-CCM 委员会认证，比率为 91.2%，而 IM/CCM 的比率为 93.2%（p=0.22）；28 名 EM/CCM 获得了 ABA-CCM 委员会认证，其比率与 ACCM 相似（90.4%与 89.3%；p=0.85）。