ABSITE Scores

[robotsonic]

Are a program's ABSITE scores indicative of the quality of didactics at the program? I know it won't be true in every case, but do low ABSITE scores generally mean that a program doesn't put much emphasis on didactics?
Thanks.

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[fourthyear]

There are a lot of factors - one is the program may be choosing residents who have already traditionally done well on usmle and med school tests, so they are good students/good test takers to start with. Another is individual study habits or how much people prepare for the test individually. I suppose some really good didactics sessions could help a lot if they are focused towards absite topics, but I don't think that alone would make you do well on the test.

 

[Winged Scapula]

I agree with 4th year...

the personal factor is likely the most important. Therefore, residents who have always done well on standardized tests are likely to do better on the ABSITE and residents who spend time studying outside of program didactics who also fare well.

From personal perspective, we're pretty weak on didactics but we have people who score > 90% every year -these are the residents who spend a great deal of time reading outside of work hours and maximize reading opps during work hours.

 

[galactica2001]

There are a lot of factors - one is the program may be choosing residents who have already traditionally done well on usmle and med school tests, so they are good students/good test takers to start with. Another is individual study habits or how much people prepare for the test individually. I suppose some really good didactics sessions could help a lot if they are focused towards absite topics, but I don't think that alone would make you do well on the test.

This is way off topic, but...do you think good test taking ability is actually a good measure for how smart/good/[optional "good" adjective] doctor you can be?
I somehow don't. And it's a bit freaky to me that this (scores) decides, whether you'll ever get to be what you wish (like very hard or so). One of our professors mentioned the other day that it shouldn't be all about grades anyway. It seems she had a resident who went into that field (very competetive) only b/c it's cool and respected, but not out of real genuine interest...I just wish we could all be what we wished hard to be (and work hard for it as well of course )

 

[Winged Scapula]

This is way off topic, but...do you think good test taking ability is actually a good measure for how smart/good/[optional "good" adjective] doctor you can be?
I somehow don't. And it's a bit freaky to me that this (scores) decides, whether you'll ever get to be what you wish (like very hard or so). One of our professors mentioned the other day that it shouldn't be all about grades anyway. It seems she had a resident who went into that field (very competetive) only b/c it's cool and respected, but not out of real genuine interest...I just wish we could all be what we wished hard to be (and work hard for it as well of course )

Absolutely not. There are lots of people whom I think are great physicians (attentive, detail oriented, good technical skills, etc.) but perhaps aren't the smartest or don't do as well on standardized tests. Unfortunately, scores do matter to programs because they want some assurance you'll become Board Certified which reflects well on them, allowing them to attract more candidates in the years that follow (because students look at things like Board pass rates and ABSITE scores too to ascertain program quality).

 

[Selznick]

Absolutely not. There are lots of people whom I think are great physicians (attentive, detail oriented, good technical skills, etc.) but perhaps aren't the smartest or don't do as well on standardized tests. Unfortunately, scores do matter to programs because they want some assurance you'll become Board Certified which reflects well on them, allowing them to attract more candidates in the years that follow (because students look at things like Board pass rates and ABSITE scores too to ascertain program quality).

I doubt that. People who aren't smart make crappy doctors, no matter how hard they try. Unless by "smart" you just mean scholarly, in which case I'll bet you're right. In fact, this exception you mention may well be something of a rule. I'm noticing a relation between scholarliness and sub-par clinical skill.

More on topic. Results on standardized tests are all about how much of your own time you put into preparing for them. If you're not doing a lot of independent reading, then program didactics won't make much difference to your scores. Program averages definately more the most part obey the 'garbage in - garbage out' rule.

 

[surg]

ABSITE score cutoffs correlate reasonably well with passage of the Qualifying exam (written portion) for the American Board of Surgery. Don't have the data at my fingertips, but I think that the cutoff is ~30%ile give or take. Below that puts you at serious risk of non-passage.

With that in mind, I think that ABSITEs and Board Exams probably are not a great indicator of how "good" a surgeon you might be or become. They test your ability to come up with the "board answer" which as anyone can attest to is often only 1 of many ways to tackle a problem. Each person is an individual and those with only one answer in mind will mistreat some patients by following the book. Having said that, the board answer typically represents either a "safe answer" or a consensus answer and shouldn't be tossed away lightly. When in doubt, the board answer will generally at least steer you in the right direction.

Getting back to the original poster's question: do ABSITE scores predict the quality of didactics? I would say on average, no. I have come across a few programs (primarily community programs in my limited experience) have have intensive ABSITE review plans for their residents that do pay off in extraordinarily high scores, but those are the exception rather than the rule. Ironically, amongst my friends, we often did the worst on the stuff that we knew the best (the future oncologist getting cancer questions wrong, future CT surgeon getting cardiac questions wrong, etc.) because we rebelled against the "board answer" because we had learned way too much about a specific topic to be able to ever answer "C."

To evaluate didactics, I would look for a few things.
Availability: Some type of structured plan for covering all the topics over the course of a reasonable amount of time (e.g. 2 years if not atypical). A mock oral exam for at least the more senior residents. A reasonable schedule of case conferences where more difficult cases are discussed. Ideally, these would be a mix of multi-disciplinary conferences such as tumor board or endovascular conference, and surgeon only conferences.

Emphasis on attendance: How often can residents get to their conferences? Is there any protection/expectation that conference comes first in the priority list (besides coding patients, etc.)? Be wary of programs that residents say they typically don't get to conference much and that they are happy about that. It indicates either a bad conference so they are avoiding it, or overwork on the part of the residents.

ABSITE scores should really only be a major issue in my opinion if the program consistently has very poor scores (<25%ile) among multiple residents of multiple levels and/or board passage rates are low (nationally ~75% of those taking the writtens pass on the 1st try, ideally your program does better than that). The other time it should be an issue is if they have a policy such as all those <50%ile are on probation, and then don't provide you the resources to keep your scores up in the form of good didactics.

 

[Winged Scapula]

I doubt that. People who aren't smart make crappy doctors, no matter how hard they try. Unless by "smart" you just mean scholarly, in which case I'll bet you're right. In fact, this exception you mention may well be something of a rule. I'm noticing a relation between scholarliness and sub-par clinical skill.

Perhaps you are reading too much into my statement. I didn't say they weren't smart, but rather weren't the "smartest".

But I still firmly believe that anyone with average intelligence and memory skills can obtain the information needed to be a physician. I do not believe you have to be "smart" in the "above average intelligence/as measured by standardized IQ tests" to be a physician or a good one at that.

However, I will agree that some of the most "textbook" smart individuals I've met have also been the worst clinicians.