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Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

ABSTRACT: BACKGROUND:The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates. METHODS:We conducted retrospective analyses of admissions and certification data to determine the factors associated with success of international medical graduate residents on the certification examinations. International medical graduates who entered an Ontario residency program between 2005 and 2012 and had written a certification examination by the time of the analysis (2015) were included in the study. Data available at the time of admission for each resident, including demographic characteristics, previous experiences and previous professional experiences, were collected from each of the 6 Ontario medical schools and matched with certification examination results provided by The CFPC and the RCPSC. We developed logistic regression models to determine the association of each factor with success on the examinations. RESULTS:Data for 900 residents were analyzed. The models revealed resident age to be strongly associated with performance across all examinations. Fluency in English, female sex and the Human Development Index value associated with the country of medical school training had differential associations across the examinations. INTERPRETATION:The findings should contribute to an improved understanding of certification success by international medical graduates, help residency programs identify at-risk residents and underpin the development of specific educational and remedial interventions. In considering the results, it should be kept in mind that some variables are not amenable to changes in selection criteria.

SUBMITTER: Grierson LEM

PROVIDER: S-EPMC5741432 | biostudies-literature | 2017 Nov

REPOSITORIES: biostudies-literature

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Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

Grierson Lawrence E M LEM Mercuri Mathew M Brailovsky Carlos C Cole Gary G Abrahams Caroline C Archibald Douglas D Bandiera Glen G Phillips Susan P SP Stirrett Glenna G Walton J Mark JM Wong Eric E Schabort Inge I

CMAJ open 20171101 4

<h4>Background</h4>The failure rate on certification examinations of The College of Family Physicians of Canada (CFPC) and the Royal College of Physicians and Surgeons of Canada (RCPSC) is significantly higher for international medical graduates than for Canadian medical school graduates. The purpose of the current study was to generate evidence that supports or refutes the validity of hypotheses proposed to explain the lower success rates.<h4>Methods</h4>We conducted retrospective analyses of a ...[more]

PMID: 29183879

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Project description:ImportanceOral health care faces ongoing workforce challenges that affect patient access and outcomes. While the Medicare program provides an estimated $14.6 billion annually in graduate medical education (GME) payments to teaching hospitals, including explicit support for dental and podiatry programs, little is known about the level or distribution of this public investment in the oral health and podiatry workforce.ObjectiveTo examine Medicare GME payments to teaching hospitals for dental and podiatry residents from 1998 to 2018, as well as the distribution of federal support among states, territories, and the District of Columbia.Design, setting, and participantsThis cross-sectional study was conducted using data from 1252 US teaching hospitals. Data were analyzed from May through August 2020.ExposuresDental and podiatry residency training.Main outcomes and measuresMedicare dental and podiatry GME payments were examined.ResultsAmong 1252 teaching hospitals, Medicare provided nearly $730 million in dental and podiatry GME payments in 2018. From 1998 to 2018, the number of residents supported more than doubled, increasing from 2340 residents to 4856 residents, for a 2.1-fold increase, while Medicare payments for dental and podiatry GME increased from $279 950 531 to $729 277 090, for a 2.6-fold increase. In 2018, an estimated 3504 of 4856 supported positions (72.2%) were dental. Medicare GME payments varied widely among states, territories, and the District of Columbia, with per capita payments by state, territory, and district population ranging from $0.05 in Puerto Rico to $14.24 in New York, while 6 states received no support for dental or podiatry residency programs.Conclusions and relevanceThese findings suggest that dental and podiatry GME represents a substantial public investment, and deliberate policy decisions are needed to target this nearly $730 million and growing investment to address the nation's priority oral and podiatry health needs.

Project description:Using the data from graduate surveys, this study aims to analyze which factors related to teaching and learning at the Freiburg Faculty of Medicine can influence study success.Study success and the factors influencing it have long been the subject of investigation, with study success being measured in terms of easily quantifiable indicators (final grades, student satisfaction, etc.). In recent years, it has also frequently been assessed in terms of graduate competency levels. Graduate surveys are considered suitable instruments for measuring these dimensions of study success.Data from three Freiburg graduate surveys conducted one and a half years after graduation were drawn upon for the analysis. Study success was operationalized using four indicators: results on the written section of the M2 exam, self-assessment of medical expertise and scientific expertise, and student satisfaction. Using multiple regression analyses, the predictive power was calculated for selected variables, also measured by the graduate surveys, for the different study success indicators.It was possible to identify models that contribute slightly or moderately to the prediction of study success. The score earned on the university entrance qualification demonstrated itself to be the strongest predictor for forecasting the M2 written exam: R(2) is between 0.08 and 0.22 for the three surveys. Different variables specific to degree program structure and teaching are helpful for predicting medical expertise (R(2)=0.04-0.32) and student satisfaction (R(2)=0.12-0.35). The two variables, structure and curricular sequencing of the degree program and combination of theory and practice, show themselves to be significant, sample-invariant predictors (β-weight(Structure)=0.21-0.58, β-weight(Combination)=0.27-0.56). For scientific expertise, no sample-independent predictors could be determined.Factors describing teaching hardly provide any assistance when predicting the written M2 exam score, which makes sense to the extent that teaching goes far beyond the heavily knowledge-based content of the written M2 exam. The lack of predictability for scientific expertise is most likely explained in that these have been only rarely included in the curriculum and often inexplicitly so. The variable combination of theory and practice appears to be significant for imparting medical expertise and the development of student satisfaction. The extent to which these relationships are practically relevant needs to be explored in further studies. A specific limitation is that the measurement of expertise and skill is based solely on self-assessments.

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Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

Publications

Admission factors associated with international medical graduate certification success: a collaborative retrospective review of postgraduate medical education programs in Ontario.

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