American Board of Family Medicine Initial Certification Examination performance of 3- versus 4-year medical school graduates
Sally A Santen, Catherine Coe, Sarah Owens, Keeley Hobart, Lars E PetersonAbstract
Purpose
Three-year accelerated (A3YP) medical students graduate in three years and enter residency frequently in a directed pathway to a specific program. Some schools have found lower United States Medical Licensing Examination Step 2 scores for the A3YP graduates. There are no studies exploring if this difference extends into residency with board certification scores and pass rates. The objective of this study was to explore whether A3YP graduates have equivalent performance to traditional four-year graduates (T4YP) from similar contexts on American Board of Family Medicine (ABFM) examinations and in training examination (ITE).
Method
A3YP graduates’ performance from ABFM data (ITE, pass rate, initial certification examination score, score growth) were compared between A3YP graduates and all T4YP United States Medical Degree graduates of residencies who accepted any A3YP graduate from 2016 to 2021. The team conducted bivariate analysis with t-tests, Fisher exact, Chi-Square tests and Bonferroni correction was applied for multiple comparisons; statistical significance P<.006.
Results
The study population was 117 A3YP and 2718 T4YP. There were not statistically significant differences between groups. A3YP graduates’ intern ITE scores were slightly higher (421 vs 416, mean difference 5.57 [99.5% Confidence Limit (CL) (-14.49, 25.62)], P=.36) compared to T4YP. A3YP had a lower exam score slope (growth in scores) (30.77 vs 38.23, mean difference -7.45 [99.5% CL -16.90, 1.99], P = 0.03) resulting in a non-significant 10-point lower average performance on their Initial Certification Examination. The pass rates were similar (A3YP 100.0%,99.4% T4YP, P=.42).
Conclusions
This study tested whether the length of medical school is associated with performance on ITE and board certification examination and found that there were no significant differences in performance between three-year and four-year medical school graduates in Family Medicine. This finding adds to a growing body of evidence that A3YP graduates in Family Medicine have similar outcomes to T4YP graduates.