Conducting an objective structured clinical examination under COVID-restricted conditions.

Background: The administration of performance assessments during the coronavirus disease of 2019 (COVID-19) pandemic posed many challenges, especially for examinations employed as part of certification and licensure. The National Assessment Collaboration (NAC) Examination, an Objective Structured Clinical Examination (OSCE), was modified during the pandemic. The purpose of this study was to gather evidence to support the reliability and validity of the modified NAC Examination.

A validity study of COMLEX-USA Level 3 with the new test design.

Context: The National Board of Osteopathic Medical Examiners (NBOME) administers the Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA), a three-level examination designed for licensure for the practice of osteopathic medicine. The examination design for COMLEX-USA Level 3 (L3) was changed in September 2018 to a two-day computer-based examination with two components: a multiple-choice question (MCQ) component with single best answer and a clinical decision-making (CDM) case component with extended multiple-choice (EMC) and short answer (SA) questions. Continued validation of the L3 examination, especially with the new design, is essential for the appropriate interpretation and use of the test scores.

Clinical competence, communication ability and adherence to choosing wisely recommendations for lipid reducing drug use in older adults.

Background: Although lipid-lowering drugs are not recommended for primary prevention in patients 75+, prevalence of use is high and there is unexplained variation in prescribing between physicians. The objective of this study was to determine if physician communication ability and clinical competence are associated with prescribing lipid-lowering drugs for primary and secondary prevention.

Methods: We used a cohort of 4,501 international medical graduates, 161,214 U.

Do clinical and communication skills scores on credentialing exams predict potentially inappropriate antibiotic prescribing?

Background: There is considerable variation among physicians in inappropriate antibiotic prescribing, which is hypothesized to be attributable to diagnostic uncertainty and ineffective communication. The objective of this study was to evaluate whether clinical and communication skills are associated with antibiotic prescribing for upper respiratory infections and sinusitis.

Methods: A cohort study of 2,526 international medical graduates and 48,394 U.

Medical Council of Canada Qualifying Examinations and performance in future practice.

The purpose of medical licensing examinations is to protect the public from practitioners who do not have adequate knowledge, skills, and abilities to provide acceptable patient care, and therefore evaluating the validity of these examinations is a matter of accountability. Our objective was to discuss the Medical Council of Canada's Qualifying Examinations (MCCQEs) Part I (QE1) and Part II (QE2) in terms of how well they reflect future performance in practice. We examined the supposition that satisfactory performance on the MCCQEs are important determinants of practice performance and, ultimately, patient outcomes.

Comparison of Bedside and Video-Based Capillary Refill Time Assessment in Children.

Objectives: Capillary refill time (CRT) to assess peripheral perfusion in children with suspected shock may be subject to poor reproducibility. Our objectives were to compare video-based and bedside CRT assessment using a standardized protocol and evaluate interrater and intrarater consistency of video-based CRT (VB-CRT) assessment. We hypothesized that measurement errors associated with raters would be low for both standardized bedside CRT and VB-CRT as well as VB-CRT across raters.

International Medical Graduates in the United States Psychiatry Workforce.

Objective: This study describes the supply, distribution, and characteristics of international medical graduate (IMG) psychiatrists who provide services in the USA.

Methods: Cross-sectional study design, using descriptive statistics based on combined data from the American Medical Association (2020 Physician Masterfile) and the Educational Commission for Foreign Medical Graduates.

Results: International medical graduates continue to make significant contributions to the US physician workforce.

Associations between initial American Board of Internal Medicine certification and maintenance of certification status of attending physicians and in-hospital mortality of patients with acute myocardial infarction or congestive heart failure: a retrospective cohort study of hospitalisations in Pennsylvania, USA.

Objective: To determine whether internists' initial specialty certification and the maintenance of that certification (MOC) is associated with lower in-hospital mortality for their patients with acute myocardial infarction (AMI) or congestive heart failure (CHF).

Design: Retrospective cohort study of hospitalisations in Pennsylvania, USA, from 2012 to 2017.

Setting: All hospitals in Pennsylvania.

A Concordance Study of COMLEX-USA and USMLE Scores.

Background: Under the single GME accreditation system, residency programs receive applicants from MD- and DO-granting medical schools, each of which have their own set of licensing examinations, making concordance studies increasingly relevant. Previous studies comparing Comprehensive Osteopathic Medical Licensing Examination of the United States (COMLEX-USA) and United States Medical Licensing Examination (USMLE) scores have been limited in sample size and examinee composition and have yielded comparisons that may not be generalizable across all applicants. Some osteopathic medical students take USMLE in addition to COMLEX-USA, often at considerable cost and effort, with the aim of making themselves more desirable to potential residency programs.

Making the grade: licensing examination performance by medical school accreditation status.

Background: Accreditation systems strive to ensure the quality of undergraduate (basic) medical education and encourage ongoing improvements. Despite increasing global emphasis on quality assurance activities, there is limited research linking accreditation of medical education to improved student and graduate outcomes. The purpose of this study is to compare the United States Medical Licensing Examination® (USMLE®) performance of students and graduates who attended international medical schools accredited by an agency recognized by the World Federation of Medical Education (WFME) to individuals who attended schools that did not meet this criterion.

A Pilot Study of the Generalizability of Preclinical Entrustment Assessments in Undergraduate Medical Education.

Purpose: The reproducibility and consistency of assessments of entrustable professional activities (EPAs) in undergraduate medical education (UME) have been identified as potential areas of concern. EPAs were designed to facilitate workplace-based assessments by faculty with a shared mental model of a task who could observe a trainee complete the task multiple times. In UME, trainees are frequently assessed outside the workplace by faculty who only observe a task once.

Association of clinical competence, specialty and physician country of origin with opioid prescribing for chronic pain: a cohort study.

Background: Although little is known about why opioid prescribing practices differ between physicians, clinical competence, specialty training and country of origin may play a role. We hypothesised that physicians with stronger clinical competence and communication skills are less likely to prescribe opioids and prescribe lower doses, as do medical specialists and physicians from Asia.

Methods: Opioid prescribing practices were examined among international medical graduates (IMGs) licensed to practise in the USA who evaluated Medicare patients for chronic pain problems in 2014-2015.

International Medical Graduate Resident Wellness: Examining Qualitative Data From J-1 Visa Physician Recipients.

Purpose: International medical graduates (IMGs), approximately 25% of the U.S. physician workforce, have unique needs as they enter residency programs.

Reliability of simulation-based assessment for practicing physicians: performance is context-specific.

Introduction: Even physicians who routinely work in complex, dynamic practices may be unprepared to optimally manage challenging critical events. High-fidelity simulation can realistically mimic critical clinically relevant events, however the reliability and validity of simulation-based assessment scores for practicing physicians has not been established.

Methods: Standardised complex simulation scenarios were developed and administered to board-certified, practicing anesthesiologists who volunteered to participate in an assessment study during formative maintenance of certification activities.

Medical School Accreditation Factors Associated With Certification by the Educational Commission for Foreign Medical Graduates (ECFMG): A 10-Year International Study.

Purpose: In 2024, international medical graduates seeking Educational Commission for Foreign Medical Graduates (ECFMG) certification will be required to graduate from an accredited medical school. This study's goal was to examine relationships between medical school accreditation variables and ECFMG certification for a global sample.

Method: Using ECFMG databases, the authors created a 10-year cohort (January 1, 2007-December 31, 2016) of certification applicants, defined as individuals who had attempted at least 2 examinations required for certification.

International Medical Graduates in the Pediatric Workforce in the United States.

Background And Objectives: To describe the supply, distribution, and characteristics of international medical graduates (IMGs) in pediatrics who provide patient care in the United States.

Methods: Cross-sectional study, combining data from the 2019 Physician Masterfile of the American Medical Association and the Educational Commission for Foreign Medical Graduates database.

Results: In total, 92 806 pediatric physicians were identified, comprising 9.

Canadians studying medicine abroad and their journey to secure postgraduate training in Canada or the United States.

Background: From national and international workforce perspectives, Canadians studying medicine abroad (CSAs) are a growing provider group. Some were born in Canada whereas others immigrated as children. They study medicine in various countries, often attempting both American and Canadian medical licensure pathways.

Competence in Decision Making: Setting Performance Standards for Critical Care.

Background: Health care professionals must be able to make frequent and timely decisions that can alter the illness trajectory of intensive care patients. A competence standard for this ability is difficult to establish yet assuring practitioners can make appropriate judgments is an important step in advancing patient safety. We hypothesized that simulation can be used effectively to assess decision-making competence.

Prevalence of International Medical Graduates From Muslim-Majority Nations in the US Physician Workforce From 2009 to 2019.

Importance: Historically, the US physician workforce has included a large number of international medical graduates (IMGs). Recent US immigration policies may affect the inflow of IMGs, particularly those who are citizens of Muslim-majority nations.

Objectives: To provide an overview of the characteristics of IMGs from Muslim-majority nations, including their contributions to the US physician workforce, and to describe trends in the number of applications for certification to the Educational Commission for Foreign Medical Graduates between 2019 and 2018, both overall and for citizens of Muslim-majority nations.

Reporting a Pass/Fail Outcome for USMLE Step 1: Consequences and Challenges for International Medical Graduates.

After extensive stakeholder discussion, the Federation of State Medical Boards and the National Board of Medical Examiners announced in February 2020 that United States Medical Licensing Examination Step 1 will transition to a pass/fail exam. Program directors have historically used Step 1 scores in deciding which residency applicants to interview. The lack of numerical scores will force changes to the residency selection process, which could have both positive and negative consequences for international medical graduates (IMGs).

Associations Between Medical Education Assessments and American Board of Family Medicine Certification Examination Score and Failure to Obtain Certification.

Purpose: Family medicine residency programs can be cited for low pass or take rates on the American Board of Family Medicine (ABFM) certification examination, and the relationships among standardized medical education assessments and performance on board certification examinations and eventual board certification have not been comprehensively studied. The objective of this study was to evaluate the associations of all required standardized examinations in medical education with ABFM certification examination scores and eventual ABFM certification.

Method: All graduates of U.