In Training Exam

[mrs_doc]

Do you guys know of anyone that did poorly on ITE, but was able to finish their residency without been fired or put on probation?
Just got my results and I am scared to death...Will meet with PD after the holidays

---

Members don't see this ad.

 

[jdh71]

Do you guys know of anyone that did poorly on ITE, but was able to finish their residency without been fired or put on probation?
Just got my results and I am scared to death...Will meet with PD after the holidays

It's my understanding that in training exams are to be used as a general guide to your eventual ability to pass boards when you are done. I'm not sure why they would be used to punish by themselves. At my institution people who do poorly find themselves in structured review/study courses, and if they fail to do what is asked or improve at that point then the residency review people might take action.

 

[mrs_doc]

ohhh ok, so I shouldn't worry too much then

 

[JackADeli]

ohhh ok, so I shouldn't worry too much then

You NEED to worry. Each program is different in how they ultimately evaluate its residents. The one constant is that numeric score is what it is... The interpretation and weight applied to it can change. Your PD can change. You can have an unfortunate patient outcome.... with attendings & PD then looking at that score as a red flag or indicator. If you program has some residents ahead of you fail their boards, the PD may suddenly make a 180 turn and make the in service exam the deciding factor on resident continuation in the program.... here is a link/quotes of another thread on similar topic:

...With the exception of the exceedingly rare minority, all residents are adults. ...The score on that exam [in-service]can be your shield or it can be your PD's axe. The choice is yours....

...I never understood how presumably smart people, presumably the upper end of intelligence and education, presumably folks that have spent years and years developing study habits and test taking skills.... suddenly get into residency and become "dumb". Your need to study does NOT end when you start residency. At the very least it INCREASES. You are now a physician. Your patient's lives now depend on you having read and having the right answers.

The level of responsibility changes exponentially when you go from medical student to MD/DO. That exponential change continues when you go from trainee license to "unrestricted" license. It further continues when you go from trainee/rsident to ATTENDING. Do NOT fall for the trap or take the bait of... "being a nice guy/gal" is what is most important.

You need to be a good doctor first....a "nice guy/gal" at bedside that doesn't know what they should is dangerous...

Please, please, please..... continue to study. It is the right thing to do for you and most importantly your patient/s.

....have some pride too. I don't understand how someone that maintained 4.0 status in undergrad, went AOA in med-school, etc would accept below average test performance in residency. It should be very, very embarassing.

When you go to see your PD, you need to come prepared to tell him/her your plan to improve your fund of knowledge and in-service exam score.

 

[dragonfly99]

I agree with the above.
However, I think it's important to realize that for any standardized test, there are going to be people on the lower end because the thing is curved. In other works, SOMEONE is going to be at the 15th percentile, the 20th percentile, etc.
But if you are scoring that level overall on the ITE, then you might have trouble with boards and you need to study more.
That said, I didn't do so hot on some subjects on the medicine ITE and kicked tail on USMLE and did OK on medicine boards too...but I wasn't too happy w/some of my ITE scores and I did study harder because of them. However, I think a lot of the ITE and medicine boards is based on rote memorization of stuff...and in the real world a lot of the stuff could be looked up...and the ITE doesn't test a lot of important stuff, like whether you can do ongoing management of stuff like diabetes, HTN and CHF and COPD that is the bread and butter of outpatient IM.

But the OP should realize that he/she needs to study, and also dno't want to give the PD ammo to use against you should he/she want to in the future.

 

[maxheadroom]

I agree with JAD. The ITE is a gauge of your testable fund of knowledge. Most specialties make old tests available for study. With the repetition of questions, it shouldn't be too hard to boost your score. Go into your meeting the your PD with a plan for an aggressive reading schedule.

 

[ranmyaku]

What is considered a 'bad' score on the ITE? and how does that correlate to board performance...if u are 30th percentile then you have x chance of passing the boards...

and likewise, what would be a 'good' score on the ITE?

 

[DrMom]

In my program, being below the mean for your PGY is considered a red flag.

 

[jdh71]

What is considered a 'bad' score on the ITE? and how does that correlate to board performance...if u are 30th percentile then you have x chance of passing the boards...

and likewise, what would be a 'good' score on the ITE?

For IM I think >~60%ile is considered likely to pass boards, and at my program if you are below 30%ile, you get to do some structured studying

 

[medicinesux]

Some people will downplay ITE as being "for your benefit". This is hogwash. ITE scores are another set of ammunition that can be used against you in malignant programs. Vindictive PD's have been known to put residents with low scores on probation. Even the slightest mistake (which all residents make) can then lead to immediate dismissal. If you are in a malignant residency program you must score above the mean on ITE in order to protect yourself from being "set up". Though this is no guarantee you will not be ejected at some point (like being accused of being mentally incompetent- ring a bell?), it is one less thing they can use against you. If anything, by scoring really well you can make it harder for a PD who has an axe to grind to get rid of you and you can also find it easier to lateral your ass out of that program into a less malignant one.

 

[dragonfly99]

jdh,
people at risk for failing the IM boards are people who score more like less that 20th or 30th %ile on the ITE for their PGY, not 60th percentile. 60th %ile wouldn't be close to being at risk.

 

[dragonfly99]

I always thought the IM ITE was stupid because after we took the test, months later we'd get some score sheet saying how we did on each subject, but never got to see the questions we missed or what the correct answers were (!).
Also, I believe there are no old exams to study, because it is not allowed to give out the old tests for people to study from. So I don't see how it helps that much...except to identify very generally what your areas of weakness are (i.e. if I scored low on renal section,then study that are).

 

[jdh71]

jdh,
people at risk for failing the IM boards are people who score more like less that 20th or 30th %ile on the ITE for their PGY, not 60th percentile. 60th %ile wouldn't be close to being at risk.

I didn't say 60%ile was "at risk"

 

[smq123]

Also, I believe there are no old exams to study, because it is not allowed to give out the old tests for people to study from. So I don't see how it helps that much...except to identify very generally what your areas of weakness are (i.e. if I scored low on renal section,then study that are).

It may be specialty dependent. The AAFP releases old in training exams, so there's no reason why you can't use those to study.

I was surprised, though, to see you say in another thread that ITEs can't be used for fellowship. I had always thought that your ITE scores DO matter for the fellowship match, and that if you wanted to do something competitive like GI or cards, you had better do well on the ITE. Perhaps that's only true for surgery or OB/gyn, though?

 

[jdh71]

It may be specialty dependent. The AAFP releases old in training exams, so there's no reason why you can't use those to study.

I was surprised, though, to see you say in another thread that ITEs can't be used for fellowship. I had always thought that your ITE scores DO matter for the fellowship match, and that if you wanted to do something competitive like GI or cards, you had better do well on the ITE. Perhaps that's only true for surgery or OB/gyn, though?

ITE is not like surgery's ABSITE, which is reported for fellowship. The ITE is NOT, at least not formally. Some people who do really, really well, have the PD talk about it in their PD letter when applying. Or word of mouth between a residency PD and a fellowship PD might occur.

 

[bigdan]

I, too, think the ITE matters.

In my program (large university anesthesiology), getting below a certain set score will land you on a structured study program. Moreover, a bar has been set (using the ITE score) that rules you in (or out if too low) for being allowed to moonlight. We do have access to old (very old) test questions. After the exam, at some point, we're sent a list of "keywords", which are essentially topics that we have missed on the exam...so we aren't exactly shown the question we miss, but are given a keyword/topic that we did answer correctly on. Additionally, in anesthesiology, some programs are asking for ITE scores on fellowship applications.

I know very little anectodally as an intern, but the way I see it is this: we've had standardized testing as our benchmark for our entire lives. We will continue to have it as such - or at least as a big part of how we are evaluated - for years to come. We need to do as well as possible; the unfortunate fact is that SOMEONE has to be at the bottom of that ol' bell curve.

To the OP, I hope things improve for you, and that your meeting is benign. To all, best wishes for the holidays!

dc

 

[mrs_doc]

Thanks all for all the input.
I scored more than 30 % though but still...

 

[mrs_doc]

By the way, what does a mentor do?

At this stage, I think I need one, someone I can call or page anytime, someone with experiences in residency who can quiz me and help me with study materials, medical questions, advices, study plan etc....whatever it takes to graduate.
I want to try everything to secure my spot.
I am in FP and prefer R3 or attending. PM me and we will discuss about payment etc.....

Thanks.

 

[JackADeli]

...I am in FP and prefer R3 or attending. PM me and we will discuss about payment etc...

Sounds like you are looking for a tutor......

 

[mrs_doc]

Sounds like you are looking for a tutor......

If it is what it's called....

 

[dragonfly99]

ABIM exam scores aren't use to select people for medicine fellowships, as the ABIM I believe has mandated that the scores can't be released and used in that way. However, I think that in general word of mouth can happen between a PD and cards fellowship program director, so there's no absolute guarantee it wouldn't get out...or at least some general range of how one did.

USMLE scores, on the other hand, are used by some IM fellowships to choose candidates. However, other programs (even high powered academic ones) specifically don't use the USMLE scores and sometimes state that they don't want applicants to submit them.