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Do medical certification exams present more challenges to international medical school graduates?


Zhang Y, Cubbellotti SJ. — American Board of Internal Medicine

Presented: American Educational Research Association Annual Meeting, April 2015

Abstract: International medical graduates (IMGs) have gradually increased in number in the U.S. medical training and the medical workforce over the last two decades. Since IMGs play a key role in filling the workforce need, it is important to evaluate the qualifications and consequent quality of care of this group of physicians as they were exposed to different training curricula and English is not likely their primary language. The objective of this study was to evaluate whether IMGs face any barriers that would affect their medical knowledge via their performance on the American Board of Internal Medicine (ABIM) Certification and Maintenance of Certification (MOC) examinations in the subspecialty of medical oncology. Candidate performance, demographics and examination time used were analyzed through various methods including descriptive statistics, graphic displays, Mantel-Haenszel statistics, differential item functioning (DIF) and multiple regression analysis. The results indicated that IMGs performed better on average and had equal or higher pass rates on both the examinations. DIF analysis yielded a small percentage of large DIF items in Certification and MOC examinations, with half of them favoring IMGs and the other half favoring U.S. medical graduates (USMGs). In terms of examination time used, MOC candidates used more time than Certification candidates and IMGs used more time than USMGs in both exams. Regression analysis results revealed that examination performance, age and medical school attended were significant contributors to Certification examination time used. Age and medical school attended were significant contributors to MOC examination time used. However, in both exams, the variance of examination time used was not explained substantially by these predictors. In summary, this study corroborated some findings from previous research showing that IMGs demonstrated equal performance in medical knowledge compared to their U.S. counterparts. Thus, the examinations investigated are appropriate assessments for IMGs on their medical knowledge in the subspecialty of medical oncology.

For more information about this presentation, please contact Research@abim.org.