Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores

Jeffrey H. Silber, Patrick S Romano, Kamal M F Itani, Amy K. Rosen, Dylan Small, Rebecca S. Lipner, Charles L. Bosk, Yanli Wang, Michael J. Halenar, Sophia Korovaichuk, Orit Even-Shoshan, Kevin G. Volpp

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Abstract

Purpose: To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. Method: The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. Results: The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were-5.43 (-7.63,-3.23),-3.44 (-5.65,-1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. Conclusions: The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations.

Original languageEnglish (US)
Pages (from-to)644-651
Number of pages8
JournalAcademic Medicine
Volume89
Issue number4
DOIs
StatePublished - 2014

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Internal Medicine
medicine
resident
reform
examination
Licensure
cohort analysis
Graduate Medical Education
Coroners and Medical Examiners
medical examiner
Accreditation
accreditation
Cohort Studies
graduate
Demography
regression

ASJC Scopus subject areas

  • Medicine(all)
  • Education

Cite this

Silber, J. H., Romano, P. S., Itani, K. M. F., Rosen, A. K., Small, D., Lipner, R. S., ... Volpp, K. G. (2014). Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores. Academic Medicine, 89(4), 644-651. https://doi.org/10.1097/ACM.0000000000000193

Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores. / Silber, Jeffrey H.; Romano, Patrick S; Itani, Kamal M F; Rosen, Amy K.; Small, Dylan; Lipner, Rebecca S.; Bosk, Charles L.; Wang, Yanli; Halenar, Michael J.; Korovaichuk, Sophia; Even-Shoshan, Orit; Volpp, Kevin G.

In: Academic Medicine, Vol. 89, No. 4, 2014, p. 644-651.

Research output: Contribution to journalArticle

Silber, JH, Romano, PS, Itani, KMF, Rosen, AK, Small, D, Lipner, RS, Bosk, CL, Wang, Y, Halenar, MJ, Korovaichuk, S, Even-Shoshan, O & Volpp, KG 2014, 'Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores', Academic Medicine, vol. 89, no. 4, pp. 644-651. https://doi.org/10.1097/ACM.0000000000000193
Silber, Jeffrey H. ; Romano, Patrick S ; Itani, Kamal M F ; Rosen, Amy K. ; Small, Dylan ; Lipner, Rebecca S. ; Bosk, Charles L. ; Wang, Yanli ; Halenar, Michael J. ; Korovaichuk, Sophia ; Even-Shoshan, Orit ; Volpp, Kevin G. / Assessing the effects of the 2003 resident duty hours reform on internal medicine board scores. In: Academic Medicine. 2014 ; Vol. 89, No. 4. pp. 644-651.
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abstract = "Purpose: To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. Method: The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. Results: The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95{\%} CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were-5.43 (-7.63,-3.23),-3.44 (-5.65,-1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. Conclusions: The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations.",
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AU - Silber, Jeffrey H.

AU - Romano, Patrick S

AU - Itani, Kamal M F

AU - Rosen, Amy K.

AU - Small, Dylan

AU - Lipner, Rebecca S.

AU - Bosk, Charles L.

AU - Wang, Yanli

AU - Halenar, Michael J.

AU - Korovaichuk, Sophia

AU - Even-Shoshan, Orit

AU - Volpp, Kevin G.

PY - 2014

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N2 - Purpose: To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. Method: The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. Results: The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were-5.43 (-7.63,-3.23),-3.44 (-5.65,-1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. Conclusions: The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations.

AB - Purpose: To determine whether the 2003 Accreditation Council for Graduate Medical Education (ACGME) duty hours reform affected medical knowledge as reflected by written board scores for internal medicine (IM) residents. Method: The authors conducted a retrospective cohort analysis of postgraduate year 1 (PGY-1) Internal Medicine residents who started training before and after the 2003 duty hour reform using a merged data set of American Board of Internal Medicine (ABIM) Board examination and the National Board of Medical Examiners (NMBE) United States Medical Licensing Examination (USMLE) Step 2 Clinical Knowledge test scores. Specifically, using four regression models, the authors compared IM residents beginning PGY-1 training in 2000 and completing training unexposed to the 2003 duty hours reform (PGY-1 2000 cohort, n = 5,475) to PGY-1 cohorts starting in 2001 through 2005 (n = 28,008), all with some exposure to the reform. Results: The mean ABIM board score for the unexposed PGY-1 2000 cohort (n = 5,475) was 491, SD = 85. Adjusting for demographics, program, and USMLE Step 2 exam score, the mean differences (95% CI) in ABIM board scores between the PGY-1 2001, 2002, 2003, 2004 and 2005 cohorts minus the PGY-1 2000 cohort were-5.43 (-7.63,-3.23),-3.44 (-5.65,-1.24), 2.58 (0.36, 4.79), 11.10 (8.88, 13.33) and 11.28 (8.98, 13.58) points respectively. None of these differences exceeded one-fifth of an SD in ABIM board scores. Conclusions: The duty hours reforms of 2003 did not meaningfully affect medical knowledge as measured by scores on the ABIM board examinations.

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