inservice exam
- Thread starter APACHE3
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You're an intern, right?
From what I understand, you're not technically supposed to study for the in-service. It is an institutionally-designed test that examines your knowledge of different subjects for the purpose of helping you find out where you are weak. If you are anything like me, then you feel a bit incompetent in pretty much everything. The idea is that as you go through the program you're supposed to do better each year as you become more comfortable managing a wider variety of stuff.
That's at least how I understand it working up here in my hood.
Best of luck!
DS
From what I understand, you're not technically supposed to study for the in-service. It is an institutionally-designed test that examines your knowledge of different subjects for the purpose of helping you find out where you are weak. If you are anything like me, then you feel a bit incompetent in pretty much everything. The idea is that as you go through the program you're supposed to do better each year as you become more comfortable managing a wider variety of stuff.
That's at least how I understand it working up here in my hood.
Best of luck!
DS
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Thats what I was told too, but PD's are human and obviously there will be sonewone with the high score (not me) and a low score (hopefully not me). How they will interpret this as we advance, I'm not sure. Do get extra pimped at morning report??🙂 Cant worry about it now, just curious. Good luck to you.
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As an intern, the in-service exam is essentially only reflective of how well your medical school prepared you for internship. As such, I don't imagine that most programs really care how interns do when it's only been about 3 months since you started. Plus, you're so busy as an intern that they shouldn't expect you to be studying for it.
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I respectfully disagree that this is a measurement of how well your medical school prepared us for internship. How one does on paper does not always (and perhaps often) translate into clinical acumen and practical ability. I do agree that studying for this thing so early on is not the norm. The test is just a gauge for board preparedness, and most interns are not exactly thinking about passing the boards right now as much as we are thinking about how we cannot wait for internship to be over.
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I can still remember when I took it as an intern and as a second year resident (can't take it this year, unfortunately... it's optional in my program.) I will say that even though it's "optional" in my program and is not supposed to mean anything, the results do go into my folder. At least in my personal experience, people do look at these things and take notice. In my program, my PD made a big deal out of it during our bi-annual meeting saying how well I did (something like 91th percentile as an intern and 93 percentile as a 2nd year nationally), and sent out these letters to us that tells us what percentile we are compared to the nation and compared to people in our class, and tells us our strongest 3 and weakest 3 topics in medicine. There is a couple friends of mine one class behind me who didn't do quite as well, and they told me that the PD asked them what they use to read, and recommended them to read MKSAP. So while I agree overall in my experience the inservice a helpful thing, to say that it will have completely no bearing on the faculty's perception of you is likely to be untrue.
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I know I sound ignorant about this,But could someone tell how many q are asked and the format of the exams ?
has such a thing been heard where an intern gets say 50 to 75 percentile and made it to cardiology/gastro fellowship?or is that bad a performance unheard of?
also pardon me if this sounds to naive ,but we do get breaks between the q dont we?is it like the usmle steps where you have limited time to take breaks or u can take breaks only between the sections,
also could some one tell me the format of all the sections?and roughly how well /bad do interns score?I have had a lot of trouble adjusting as an intern ,that I havnt had the time /mood to study and i Cant finish anything in 2 weeks .so please help me.
has such a thing been heard where an intern gets say 50 to 75 percentile and made it to cardiology/gastro fellowship?or is that bad a performance unheard of?
also pardon me if this sounds to naive ,but we do get breaks between the q dont we?is it like the usmle steps where you have limited time to take breaks or u can take breaks only between the sections,
also could some one tell me the format of all the sections?and roughly how well /bad do interns score?I have had a lot of trouble adjusting as an intern ,that I havnt had the time /mood to study and i Cant finish anything in 2 weeks .so please help me.
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It's paper and pencil, multiple choice board style questions, should run 1 entire day, you have average of slightly over 1 min per q. I had the actual scoring report from the exam and they report both how many % of q's you answer right in each category (ie. 70% in cardiology) and a percentile score for that subspecialty (ie 90th percentile). Then you have an overall % and overall percentile.
For those who are worried about numbers: I think if I remember correctly, nationally, interns get around 50% of the q's right overall. In my intern year, even with a score of 70% (ie 7 out of 10 q's right) will put you in the 90 percentile range nationally almost on the dot. As a 2nd year I got 75% and was 93 percentile. And I heard that there is a correlation that if you score over 50 percentile on the exam correlate with a 90+% probability of passing the real deal. Not sure if this is a rumor or fact.
To be honest, I think that there are many things that are way more important that goes into fellowships than these scores which are designed to help you rather than screen people out. I am sure there are people with even below average shelf scores that goes into cards or GI every year.
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Actually, the inservice score is between the resident and the PD/faculty only - it is not supposed to be used externally under ANY circumstances.
This includes letters for fellowships and for future jobs; it is not to be used for this purpose. Furthermore, the regulatory agencies are now sending "Cease and Desist" letters to PD's that break the rules and report intraining exam scores.
It is to help you see where you stand for the ABIM exam - nothing more, nothing less. It does break down your 'strengths' and 'weaknesses' down to the specific subspecialty topic ['Recognize appropriate workup for malabsorption', for example] - which is quite helpful for residents for choosing areas of study.
We do not recommend that our residents study - that way it is a true reflection of their strengths and weaknesses.
This includes letters for fellowships and for future jobs; it is not to be used for this purpose. Furthermore, the regulatory agencies are now sending "Cease and Desist" letters to PD's that break the rules and report intraining exam scores.
It is to help you see where you stand for the ABIM exam - nothing more, nothing less. It does break down your 'strengths' and 'weaknesses' down to the specific subspecialty topic ['Recognize appropriate workup for malabsorption', for example] - which is quite helpful for residents for choosing areas of study.
We do not recommend that our residents study - that way it is a true reflection of their strengths and weaknesses.
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Wing it baby, wing it!!!
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Yeah, med/peds here and I'm currently in the NICU and just got brutalized on that exam. Chest pain? Arthritis? Knee pain? Testicular problems? Yeah...ummm where were the questions on good ole' otitis media and intussusception? My program director told me all it shows if you were bad "ehh, I guess it just means your med school sucked" and he laughed. No worries about how you do your intern year. All everyone has told me is you need to show improvement, so bomb it your first year and the only way you can go is up when you take it again next year.
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Results come back usually in early January. There was some talk at the last PD meeting about the ITE reporting results electronically, which would speed up the return rate, but I don;t know if they plan to do that this cycle (I expect not). I tell my residents to enjoy their holiday break, and we'll review their ITE results on their return.
As far as passing the boards, my experience (and logic) is this:
1. The exact same people who take the IM ITE (i.e. medicine residents) also take the ABIM boards.
2. The ABIM boards have an absolute pass rate -- i.e. you have to get a certain number of questions correct to pass. Theoretically, everybody could pass one year.
3. However, the ABIM pass percentile is always between 20-25% (at least it has been for the last 5+ years). Usually it's at the 22nd percentile.
4. Thus, in my program, residents who score >30th percentile almost always pass, those that score <20th percentile almost always fail, and those 20-30 are a coin toss, often passing or failing by a few questions.
There are some major differences between the ABIM boards and the ITE -- mainly that you get much more time on the ABIM exam (60 Q's in 2 hours) compared to the 90 Q's in 3.5 hours for the ITE. So, if time is a big factor for someone, I've seen them do better on the ABIM boards than the ITE would suggest.
As far as passing the boards, my experience (and logic) is this:
1. The exact same people who take the IM ITE (i.e. medicine residents) also take the ABIM boards.
2. The ABIM boards have an absolute pass rate -- i.e. you have to get a certain number of questions correct to pass. Theoretically, everybody could pass one year.
3. However, the ABIM pass percentile is always between 20-25% (at least it has been for the last 5+ years). Usually it's at the 22nd percentile.
4. Thus, in my program, residents who score >30th percentile almost always pass, those that score <20th percentile almost always fail, and those 20-30 are a coin toss, often passing or failing by a few questions.
There are some major differences between the ABIM boards and the ITE -- mainly that you get much more time on the ABIM exam (60 Q's in 2 hours) compared to the 90 Q's in 3.5 hours for the ITE. So, if time is a big factor for someone, I've seen them do better on the ABIM boards than the ITE would suggest.
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Can you clarify that? Did you take two inservice exams?
So that's ~74 seconds per question, right about where my ITE's were.
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I don't remember how long you have on the inservice per question or on the boards, but you definately have more time on the boards.
The inservice is supposed to be a way to help you know where you are at in your training. Some pd's use it to see if you improve as you progress in your training. It isn't supposed to be used outside of that. Also, the report you get will tell you the topics of which questions you missed. I used this as a tool to help me study for the boards.
The scores aren't back for this year's boards, but so far, I think the boards were easier than the inservice exams.
The inservice is supposed to be a way to help you know where you are at in your training. Some pd's use it to see if you improve as you progress in your training. It isn't supposed to be used outside of that. Also, the report you get will tell you the topics of which questions you missed. I used this as a tool to help me study for the boards.
The scores aren't back for this year's boards, but so far, I think the boards were easier than the inservice exams.
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Hello.
I am currently a resident who recently appeared for the exam(October 2006)
Scored a little over 65%.Very disappointed with result!!!!!
I have heard that in certain IM programs,old ITE questions are made available to residents for Board preparation.
Unfortunately my program does not comply with this.
If anyone has such previous exam questions,please e-mail me at:
[email protected]
We could arrange som kind of trade.
Thank you.
I am currently a resident who recently appeared for the exam(October 2006)
Scored a little over 65%.Very disappointed with result!!!!!
I have heard that in certain IM programs,old ITE questions are made available to residents for Board preparation.
Unfortunately my program does not comply with this.
If anyone has such previous exam questions,please e-mail me at:
[email protected]
We could arrange som kind of trade.
Thank you.
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So simple question: What purposes can/can't the IM inservice exam be used for, and whom is permitted to view an individual resident's results?
I hear/read all kinds of rumors that the scores can't be used for promotion or denial of promotion, or similar. Also that the results are intended for the purpose of the resident's own personal judgement of where they are in preparation for ABIM.
That being said, who is acceptable to view results on an individual. I believe it is not permissible for PD's to ask for inservice score when considering upper level resident's new to a program. So is it acceptable for an entire staff of attending physicians to be personally given a copy of each resident's individual scores WITHOUT the resident's approval??
To me, this seems like a violation similar to that of HIPAA in the patient care world.
I've searched all over ACGME for the info, so any references would also be most appreciated.
I hear/read all kinds of rumors that the scores can't be used for promotion or denial of promotion, or similar. Also that the results are intended for the purpose of the resident's own personal judgement of where they are in preparation for ABIM.
That being said, who is acceptable to view results on an individual. I believe it is not permissible for PD's to ask for inservice score when considering upper level resident's new to a program. So is it acceptable for an entire staff of attending physicians to be personally given a copy of each resident's individual scores WITHOUT the resident's approval??
To me, this seems like a violation similar to that of HIPAA in the patient care world.
I've searched all over ACGME for the info, so any references would also be most appreciated.
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I would recommend studying a bit for the ITE, simply because other residents and interns do study, and despite what some PD's say, my experience was it is used to evaluate you. I also am reasonably sure that intern year ITE exam scores were used to help select the chief residents @my program. HOWEVER, I was never asked, and am 99% sure that program did not supply, ITE scores to any fellowship program. The ITE also isn't supposed to be used to decide promotion. However, my experience was the PD told us not to study and then made a big deal of the score reports when he got my scores...actually I had an above average score but probably not above average for my residency program. My PD was trying to tell me I might have trouble with the boards but since I outscored 50% of other house staff even as an intern I was trying to figure out how that was true...I think he was just thinking he should threaten me b/c he felt like I must not be studying enough.
The USMLE will be more important in fellowship selection, since some programs may ask for your USMLE scores. they won't ask for ITE scores because they aren't allowed to. My experience with the ITE was that there was a lot more time pressure than on the actualy IM boards. The ITE was somewhat similar to the IM boards, but the difference was the board questions seems a little longer/more involved and a bit better written, and we had more time per question. I believe at the time I was taking the ITE, the medicine programs were allowed to give us a variable amount of time to take the exam...our program gave us less time than some other IM programs, and I did have trouble finishing the exam, particularly when I was an intern. My USMLE scores were also better than my IM ITE scores, perhaps because I studied a little more but also I think b/c medicine ITE is more based on memorization and USMLE is more general patient management stuff.
The best way to study for the ITE is to study with MKSAP. MedStudy would be another option, but I think MKSAP is a bit closer in format. If you just want to get a decent score, then doing MKSAP practice questions might be the most helpful, especially ifyou are time crunched. To study for actual boards it would be good to read Medstudy and/or MKSAP so that you actually learn/retain the stuff, but for sheer scoring purposes the questions may help more simply because they tend to be repeats/similar from year to year.
The USMLE will be more important in fellowship selection, since some programs may ask for your USMLE scores. they won't ask for ITE scores because they aren't allowed to. My experience with the ITE was that there was a lot more time pressure than on the actualy IM boards. The ITE was somewhat similar to the IM boards, but the difference was the board questions seems a little longer/more involved and a bit better written, and we had more time per question. I believe at the time I was taking the ITE, the medicine programs were allowed to give us a variable amount of time to take the exam...our program gave us less time than some other IM programs, and I did have trouble finishing the exam, particularly when I was an intern. My USMLE scores were also better than my IM ITE scores, perhaps because I studied a little more but also I think b/c medicine ITE is more based on memorization and USMLE is more general patient management stuff.
The best way to study for the ITE is to study with MKSAP. MedStudy would be another option, but I think MKSAP is a bit closer in format. If you just want to get a decent score, then doing MKSAP practice questions might be the most helpful, especially ifyou are time crunched. To study for actual boards it would be good to read Medstudy and/or MKSAP so that you actually learn/retain the stuff, but for sheer scoring purposes the questions may help more simply because they tend to be repeats/similar from year to year.
