Al-Mohammed Ahmed, Al Mohanadi Dabia, Rahil Ali, Elhiday Abdul Haleem, Al Khal Abdulatif, Suliman Shireen
Qatar Med J. 2020 Apr 10;2020(1):6. doi: 10.5339/qmj.2020.6. eCollection 2020.
The American College of Physicians' (ACP) Internal Medicine In-Training Examination (IM-ITE) is designed to evaluate the cognitive knowledge of residents to aid them and program directors in evaluating the training experience. To determine the impact of the curriculum reform accompanied by the Accreditation Council for Graduate Medical Education (ACGME)-I alignment and accreditation on the internal medicine residency program (IMRP) using residents' performance in the ACP's ITE from 2008 to 2016, and where the IMRP stands in comparison to all ACGME and ACGME-I accredited programs. This is a descriptive study conducted at a hospital-based IMRP in Doha, Qatar from 2008 to 2016. The study population is 1052 residents at all levels of training in IMRP. The ACP-generated ITE results of all the United States and ACGME-I accredited programs were compared with IM-ITE results in Qatar. These results were expressed in the total program average and the ranking percentile. There is a progressive improvement in resident performance in Qatar as shown by the rise in total average program score from 52% in 2008 to 72% in 2016 and the sharp rise in percentile rank from 3rd percentile in 2008 to 93rd percentile in 2016 with a dramatic increase during the period 2013 to 2014 (from 32nd percentile to 73rd percentile), which represents the period of ACGME-I accreditation. None of the factors (ethnicity, USMLE or year of residency) were statistically significant with a value >0.05 and standard coefficient ( - 0.017-0.495). There was negligible correlation between the USMLE test scores with the residents' ITE scores with a value = 0.023 and a Pearson correlation r = 0.097. The initial ACGME-I alignment followed by the accreditation, together with whole curriculum redesign to a structured, competency-based program starting from 2008, has led to an improvement in the ITE scores in the IMRP. This was further evidenced by the lack of change in the residency entry selection criteria.
美国医师协会（ACP）的内科住院医师培训考试（IM-ITE）旨在评估住院医师的认知知识，以帮助他们及项目主任评估培训经历。为了利用2008年至2016年住院医师在ACP的ITE中的表现，确定伴随毕业后医学教育认证委员会（ACGME）-I的调整和认证而来的课程改革对内科住院医师培训项目（IMRP）的影响，以及IMRP与所有ACGME和ACGME-I认证项目相比的情况。这是一项于2008年至2016年在卡塔尔多哈一家基于医院的IMRP进行的描述性研究。研究人群为IMRP中各级培训的1052名住院医师。将美国所有ACGME-I认证项目由ACP生成的ITE结果与卡塔尔的IM-ITE结果进行比较。这些结果以项目总平均分和排名百分位数表示。卡塔尔住院医师的表现有逐步改善，如项目总平均分从2008年的52%上升到2016年的72%，百分位排名从2008年的第3百分位急剧上升到2016年的第93百分位，在2013年至2014年期间（从第32百分位到第73百分位）有显著增加，这一时期代表ACGME-I认证时期。没有一个因素（种族、美国医师执照考试或住院年限）具有统计学意义（P值>0.05，标准系数为-0.017至0.495）。美国医师执照考试成绩与住院医师ITE成绩之间的相关性可忽略不计（P值=0.023，皮尔逊相关系数r=0.097）。从2008年开始，最初的ACGME-I调整随后进行认证，以及将整个课程重新设计为基于能力的结构化项目，导致了IMRP中ITE成绩的提高。住院医师入学选拔标准没有变化进一步证明了这一点。
