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ABIM Board Pass rates --> Rank List --> the Match

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HPsiEPsi

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Oye, SDN Internists and Subspecialists:

In order of importance - How much weight should I place on ABIM board pass rates when ranking a program for the Match? I just found out that my second choice (a well known Univ. program) has lower pass rates than several of the community programs I interviewed at (!).

The criteria I'm trying to juggle is: Location, Quality of Training, Family needs, Research/Fellowship opportunities, Hospital Environment, Reputation/Name, %FMG's, and now Board pass rates. (kind of in that order).

(Sorry if this question has been posted earlier...couldn't find the exact thread in the archives).

Thanks,

~Rick.
 

Medikit

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I don't think there is much of a difference between 95 or 100% boards pass rate. However if a boards pass rate is much below 95 I think that is evidence of a problem. Either residents are working too hard and aren't learning what they need to learn, residents aren't seeing enough patients, or residents aren't being taught.
 

dragonfly99

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Agree with medikit.
Some of the cushy community programs have very high board pass rates because they "teach to the test" during morning report, and also if the house staff are less busy they have a lot of time to study. There's a lot of minutiae on the ABIM exam and you just have to memorize it...it's nothing to do with reading ECG's or CXR's, and there's basically nothing about managing ICU patients. The focus is outpatient medicine, so it's not suprising that residents from some community programs (some of them) might do well. Also, there are obviously weak community programs and ones that are stronger and have stronger house staff.

Even a strong uni. program might have a 95-96% board pass rate because if you have 30 residents a year or something, even if you have 1 or 2 house staff/year that suck at test taking or just didn't study, and somehow didn't pass the boards, that can bring down the overall pass rate for a year or two. I went to a good university program, and actually looked up my program once and was surprised that the board pass rate was only 96 or something...I was wondering who flunked the boards b/c I couldn't believe someone did. The very competitive academic programs (Harvard hospitals, UCSF, Duke, Wash U, etc.) do tend to have very very high board pass rates as well...I believe this reflects the people they take (great test takers and VERY driven) at least as much as the teaching, but probably some of both are at play.
 

WatchingWaiting

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Agree with medikit.
Some of the cushy community programs have very high board pass rates because they "teach to the test" during morning report, and also if the house staff are less busy they have a lot of time to study. There's a lot of minutiae on the ABIM exam and you just have to memorize it...it's nothing to do with reading ECG's or CXR's, and there's basically nothing about managing ICU patients. The focus is outpatient medicine, so it's not suprising that residents from some community programs (some of them) might do well. Also, there are obviously weak community programs and ones that are stronger and have stronger house staff.

Even a strong uni. program might have a 95-96% board pass rate because if you have 30 residents a year or something, even if you have 1 or 2 house staff/year that suck at test taking or just didn't study, and somehow didn't pass the boards, that can bring down the overall pass rate for a year or two. I went to a good university program, and actually looked up my program once and was surprised that the board pass rate was only 96 or something...I was wondering who flunked the boards b/c I couldn't believe someone did. The very competitive academic programs (Harvard hospitals, UCSF, Duke, Wash U, etc.) do tend to have very very high board pass rates as well...I believe this reflects the people they take (great test takers and VERY driven) at least as much as the teaching, but probably some of both are at play.

It's also worth noting that people coming out of university programs are in large numbers going to be doing fellowships right after training, and at least a few will also be fast-tracking (ie: only 2 years of medicine residency and then don't take the internal medicine boards until several years into their subspecialty training). In a program with 30 residents, it only takes one or two such people who happen to be on call as part of their fellowship training the day before the boards or just don't care and blow it off to get a low 90s pass rate.
 

HPsiEPsi

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Thanks for your input dragonfly and others...

What's troubling is that the most recent data shows this program's board pass rate to be 87%, several percentage points down from the majority of the other programs I interviewed at. In all other aspects, it seems great.

Interestingly, of the programs that I interviewed at, many of the ones I perceived to be inferior - based on (albeit) subjective criteria such as lack of univ. association or fellowships, hospital condition (which I thought might be due to funding issues), marginal EMR, low socioeconomic location, %FMG's (many of whom are brilliant) - ended up having almost perfect marks...

Frankly, I wouldn't mind teaching to the test during morning report, if it meant getting through the MKSAP series a few times over the course of the residency.

In the end it's a tough call, having to weigh so many factors.
 

panipuri

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board passing rates is nt the factor to be considered...
it totally depends on how smart the residents are not on the program...
go for univ prog...
some community prog offfers preamtches to many imgs wid 99 scores many of those are really brilliant...they are going to pass the boards..prog dont have to do anything

some of the univ prog esp low tier have many residents who are not that smart...if 3 out of 24 residents fail, its going to decrease board passing rate to <90%..

dont consider board passing rates as criteria...go to good program
 

dragonfly99

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I would be concerned about board pass rate of 87%...either some of the residents are not smart or the teaching sucks.

Panipuri is right about the intelligence of a lot of the IMG residents at unknown community programs though...these people are smart and good test takers, are not going to fail the boards no matter what.

If you want to do a fellowship then look @fellowship placement rates of the program, and realize that most university programs will place their residents in fellowship >> most community programs. I would still be a little concerned about the 87% board pass rate being low, but I don't think it trumps everything else. If you don't think you can get into another decent university program, then could overlook the 87% pass rate but it makes me wonder if the house staff...seriously the ABIM exam is not that hard to pass. And I agree with you OP, teaching to the test is not necessarily bad...it will help the residents do better on the inservice and ABIM exam.
 
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