Are specific residency program characteristics associated with the pass rate of graduates on the ABFM certification examination?

Background And Objectives: Board certification has become an accepted measure of physician quality. The effect of both non-curricular and curricular residency program characteristics on certification rates has not been previously studied. The purpose of this study is to evaluate the effect of various program characteristics on first-time American Board of Family Medicine (ABFM) pass rates.

Methods: Using information from the American Academy of Family Physicians (AAFP), National Resident Matching Program (NRMP), and FREIDA®, program characteristics were obtained. Three-year and 5-year aggregate ABFM board pass rates were calculated. Descriptive statistics were used to summarize the data. The relationship between program characteristics, initial Match rates, and non-Accreditation Council for Graduate Medical Education (ACGME) required activities (NRCA), and first-time Board pass rates were analyzed using chi-square. Significance was defined as P<.05 level of confidence.

Results: Fifty-two percent of residency programs have ABFM board pass rates ? 90%. Both 3- and 5-year aggregate Board pass rates were significantly associated with regional location, program size, accreditation cycle length, and any NRCA, specifically including international experiences and curriculum in alternative medicine. Location type (urban, suburban, rural, or inner city), program structure, salary, moonlighting, available tracks, and P4 participation were not associated.

Conclusions: The percent of first-time takers successfully completing the ABFM examination is associated with several residency program characteristics, including regional location, program size, accreditation cycle length, opportunities for international experiences, and training in alternative medicine.