Factors That Influence Medical Students' Likelihood Of Becoming Board Certified

According to a report in the September 7 issue of JAMA, a medical
education theme issue, the likelihood of a medical school graduate becoming
board certified is linked with certain factors, such as race/ethnicity, age at
graduation and level of debt.

The authors wrote, as background
information:

"Specialty-board certification by an American Board of Medical
Specialties (ABMS) member board is an increasingly important credential for
physicians engaged in clinical practice. Although lack of ABMS board
certification does not necessarily mean that a physician is not well qualified,
its presence is associated with the quality of medical care that physicians
deliver to their patients.

Better patient outcomes have been observed for
patients under the care of board-certified physicians compared with those under
the care of non-board-certified physicians."

Donna B. Jeffe,
Ph.D., and Dorothy A. Andriole, M.D., of the Washington University School of
Medicine, St. Louis, led an investigation in order to identify demographic,
medical school, and graduate medical education (GME) variables linked with ABMA
member board certification among a national cohort of U.S. medical school
graduates between the years 1997 to 2000.

The graduates were grouped by
specialty choice at graduation and followed up through March 2009. Eight
specialty categories were each examined to find out which factors might have an
impact on ABMS member board certification. These categories were: internal
medicine, family medicine, pediatrics, emergency medicine, radiology,
surgery/surgical specialties, obstetrics/gynecology and other non-generalist
specialties.

Overall, 87.3% (37,054) of graduates out of 42,440 in the
investigation sample were board certified. They discovered that graduation year,
race/ethnicity, age at graduation, U.S. Medical Licensing Examination Step 1 and
Step 2 Clinical Knowledge results, leave of absence during GME, and
withdrawal/dismissal during graduate medical education were linked in all eight
specialty categories with board certification.

In all eight categories,
older medical graduates and those who had withdrawn or who were dismissed from a
graduate medical education were not as likely to become board certified.

The researchers write:​

"In the family medicine category, graduates with higher levels of
debt were more likely to be board certified. However, in the
obstetrics/gynecology category, graduates with higher levels of debt were less
likely to be board certified.

Compared with whites, underrepresented
minorities in all specialty categories except family medicine were less likely
to be board certified, as were Asians/Pacific Islanders in the surgery/surgical
specialties category.

Women in the obstetrics/gynecology,
surgery/surgical specialties, and other non-generalist specialties categories
were less likely to be board certified."

On U.S. Medical
Licensing Examination Step 2 Clinical Knowledge, those in all eight specialty
categories with passing scores on their first-attempt in the highest tertile
(versus first-attempt failing scores) were more likely to be board certified.

Regarding the discoveries on the connection between race/ethnicity and
board certification, the authors explain that because they:
​

"..observed these differences in a sample that included only
graduates who reported specialty board certification intentions at graduation,
there may be factors after graduation that disproportionately and negatively
affect non-white - particularly underrepresented minority - medical school
graduates' timely advancement along the postgraduation medical education
continuum to board certification.

Further research is warranted to
identify factors after graduation that are associated with board certification
and amenable to intervention so that these observed disparities in board
certification can be eliminated."

They concluded:
​

"(our) findings can inform an understanding of factors contributing
to U.S. medical school graduates' advancement along the medical education
continuum to board certification, an outcome of interest for medical school
graduates, their patients, and the relevant professional organizations involved
in undergraduate medical education, GME, and board certification."

Source : Factors That Influence Medical Students' Likelihood Of Becoming Board Certified​