Western Michigan University Homer Stryker M.D. School of Medicine, 1000 Oakland Drive, Kalamazoo, MI, 49008, USA.
Indiana University School of Medicine, 1520 North Senate, Indianapolis, IN, 46202, USA.
BMC Med Educ. 2021 Feb 2;21(1):84. doi: 10.1186/s12909-021-02518-w.
Family Medicine residencies are navigating recruitment in a changing environment. The consolidation of accreditation for allopathic and osteopathic programs, the high volume of applicants, and the forthcoming transition of the United States Medical Licensing Exam (USMLE) Step 1 to pass/fail reporting all contribute. This retrospective cohort study evaluated which components of a student's academic history best predict readiness for residency.
In 2020, we analyzed applicant data and initial residency data for program graduates at a single residency program between 2013 and 2020. This included undergraduate education characteristics, medical school academic performance, medical school academic problems (including professionalism), STEP exams, location of medical school, and assessments during the first 6 months of residency. Of 110 matriculating residents, assessment data was available for 97 (88%).
Pre-matriculation USMLE data had a positive correlation with initial American Board of Family Medicine (ABFM) in-training exams. Pre-matriculation exam data did not have a positive correlation with resident assessment across any of the six Accreditation Council for Graduate Medical Education (ACGME) competency domains. A defined cohort of residents with a history of academic struggles during medical school or failure on a USMLE exam performed statistically similarly to residents with no such history on assessments across the six ACGME competency domains.
Applicants with a history of academic problems perform similarly in the clinical environment to those without. While a positive correlation between pre-matriculation exams and the ABFM in-training exam was found, this did not extend to clinical assessments across the ACGME competency domains.
家庭医学住院医师培训项目正在不断变化的环境中探索招聘策略。所有opathic 和 osteopathic 项目的认证整合、大量申请人以及即将到来的美国医师执照考试（USMLE）第 1 步成绩由及格/不及格改为报告制，所有这些都造成了影响。这项回顾性队列研究评估了学生学术背景的哪些部分最能预测他们是否能胜任住院医师培训。
2020 年，我们分析了 2013 年至 2020 年期间，一个单一住院医师培训项目的申请人数据和项目毕业生的初始住院医师培训数据。这包括本科教育特征、医学院学业成绩、医学院学业问题（包括职业操守）、STEP 考试、医学院所在地以及住院医师培训前 6 个月的评估。在 110 名入学的住院医师中，有 97 名（88%）的评估数据可用。
入学前 USMLE 数据与初始美国家庭医学委员会（ABFM）住院医师培训中的考试成绩呈正相关。入学前考试数据与任何六个毕业后医学教育认证委员会（ACGME）能力领域的住院医师评估都没有正相关。一个明确的有过医学院学业困难或 USMLE 考试失败史的住院医师群体，在六个 ACGME 能力领域的评估中，表现与没有此类病史的住院医师相似。
有学术问题史的申请人在临床环境中的表现与没有此类问题的申请人相似。虽然入学前考试与 ABFM 住院医师培训中的考试之间存在正相关，但这种相关性并没有扩展到 ACGME 能力领域的临床评估。
