GeneralVeers said:
The in-service is a voluntary test programs can choose to participate in. It's offered by the ABEM which is the credentialling society for EM. It's taken once during each year of training. Every year they publish a graph showing the correlation between in-service and board scores. Supposedly a raw score of about 70% is needed to pass your written board.
Programs who are weak academically (like mine) tend to overemphasize it so that it makes them look like they are actually teaching if students do well. If your program takes it seriously you can be placed on academic probation if you score poorly (no moonlighting, etc).
General and Cman:
1. I don't think it's voluntary, all programs must participate.
2. The graph is useful in determining who among the residents is more likely to be in trouble on their boards. Thus I use it to determine who gets put in an intensive study program. Residents who are marginal can usually greatly improve their performance if prodded.
3. You're right Cman, It's not about grades at this level. You're in competition with yourselves at this point. You owe it to your patients to be the best docotr that you can. That includes study.
4. General, it's not about whether the program is teaching, it about whether the residents are learning. And I doubt if it's only the "weak" programs. Do badly on this test at any residency and you'll have a discussion with your boss.
BTW, I have nothing to do with this test, but it's written by EM content experts and administered by Statistical experts. I'll claim journeyman status for both of those fields. The test apears to me to be valid and and a useful tool in tracking your progress as a EP in training.
BTW2 Cman, I understand you are tired of tests, however the way things are going, you can expect it never to end for the rest of your career. The major thrust at the residency level now is to develop valid measures of the general competencies, specialty competencies and other stuff. The general competencies are medical knowledge, patient care, interpersonal and communication skills, system-based practice, practice-based learning, and professionalism. Our specialty competencies are chief complaint, resuscitation and procedure. Start memorizing them, it looks bad if you can't recite them when the RRC comes to town.
After you graduate and pass your boards (part 1 and 2), you'll have to take a small open book test on twenty designated articles every year and a big test every ten years to keep your certification.
All this comes from a number of things coming together.
1. Public perception of widespread incompetence in healthcare. The IOM report based on the Harvard Malpractice studies hurt us badly even though the former was politcally based nonsense that latter were methodologically criminal.
2. Good data that suggests physicians continue to practice the medicine they were taught in residency for 30 -40 years. This despite the fact that medical info is exploding and the halflife for medical info is about 5 years.
So the plan is to train every physician to self-learn and develop the EBM and literature habits that the best academics have. It's possible, there is no difference in abilities between the town and gown.
