Do ABFM Board Pass Rates or Additional Curriculum ...

[Pages:6]ORIGINAL

ARTICLES

Do ABFM Board Pass Rates or Additional Curriculum Activities Affect Match Rates for Family Medicine Residency Programs?

Lisa D. Mims, MD; Arch G. Mainous III, PhD; Svetlana Chirina, MS; Peter J. Carek, MD, MS

BACKGROUND AND OBJECTIVES: While standard characteristics, such as location and size of family medicine residency programs, have been found to be significantly associated with initial Match rates, the association of characteristics potentially related to quality or non-Accreditation Council of Graduate Medical Education (ACGME) required curricular activities (NRCA) with initial Match rates has not been previously studied. The aim of this study is to examine the association between initial program Match rates and previously uninvestigated measures of potential quality and curriculum.

METHODS: Using information from the American Academy of Family Physicians (AAFP), American Medical Association's (AMA) FRIEDA Online? database, and National Resident Matching Program (NRMP), program-specific information was obtained. Fiveyear aggregate initial Match rates and American Board of Family Medicine (ABFM) board pass rates were calculated. The relationship between program quality characteristics, such as accreditation cycle length, ABFM examination pass rate, and participation in NRCA (ie, specialized tracks, Preparing the Personal Physician for Practice (P4) initiative, integrative or alternative medicine curriculum, and opportunities for additional training through international experiences or training beyond accredited length), and initial program Match rates were analyzed.

RESULTS: Fifty-two percent of residency programs have ABFM board pass rates 90%. The initial Match rate for programs was significantly associated with regional location and program size. No significant difference in initial Match rates was found between programs with board pass rates or < 90% or those with reported additional curricula.

CONCLUSIONS: The selected measures of program quality and reported non-ACGME required curricular activities, as listed in the AMA FRIEDA Online? database, are not associated with initial Match rates.

(Fam Med 2014;46(4):276-81.)

276 APRIL 2014 ? VOL. 46, NO. 4

T he American Academy of Family Physicians (AAFP) annually reports initial Match results from the National Residency Matching Program (NRMP). This data has resulted in numerous studies regarding program characteristics that may affect initial Match rates.1-9 Geographic location has repeatedly been found to be the most commonly cited reason for selection of a particular program.1,3,4,6-9

Other variables that influence initial Match results include the number of positions in the first year, opportunities for procedural training, and the degree to which a program depends on international medical graduates to fill its slots.10-12 Skinner13 found that certain program characteristics (eg, Western region, larger program size, and community hospital affiliation) were associated with higher initial Match rates. However, only 7%?19% of the variance was explained by these variables. King14 did not find an association between the proportion of interns who had every third night call at family medicine residency programs and initial Match outcomes. In addition, Carek15 noted that a research requirement in a

From the Department of Famly Medicine, Medical University of South Carolina (Dr Mims and Ms Chirina); and Department of Famly Medicine, University of Florida (Drs Carek and Mainous).

FAMILY MEDICINE

ORIGINAL ARTICLES

family medicine residency program also does not significantly affect initial Match rates in the NRMP. Other modifiable factors such as house officer satisfaction, interview day experience, program reputation, quality of residents and faculty, and curriculum are also recognized as important factors in students' decisions regarding choice of residency program.1-9

The impact of program characteristics that could potentially be used as quality measures such as the pass rate of graduates on the American Board of Family Medicine (ABFM) certification examination or the accreditation cycle length as designated by the Accreditation Council for Graduate Medical Education (ACGME) Review Committee for Family Medicine (RC-FM) on initial Match rates has not been examined. Additionally, the association between an individual program's nonACGME required curricular activities (NRCA) and Match rates has yet to be studied.

The aim of this study is to examine the association between initial program Match rates and previously uninvestigated measures of possible quality and various selected curricular activities.

Methods

A list of programs with their associated characteristics was obtained from the AAFP Family Medicine Residency Program Directory.16 Standard characteristics such as regional location, location type, program affiliation, number of postgraduate year one (PGY-1) positions offered, and salary (PGY-1) were obtained.

Programs were clustered into six geographic regions (Table 1). Programs were also categorized as either community-based or medical school-based structure as defined by their listings in the AAFP Program Directory and on size, based on the number of first-year positions offered in the Match, with less than six positions listed as "small", six to 10 positions as "medium," and greater than 10 positions as "large."

Accreditation cycle length and pass rate of first-time takers on the ABFM examination were selected as potential measures of program quality. Accreditation cycle length information was recorded for all programs as listed in the ACGME Accredited Programs and Sponsor Search.17 The ABFM Residency Program Certification Performance Summary was also obtained, and initial pass rates for each program were recorded from 2007 through 2011.18

Additional curricular activities (ie, available tracks, integrative medicine curriculum, international experience, alternative medicine curriculum, and additional training beyond accredited length) were obtained through the American Medical Association's (AMA) FRIEDA Online? database.19 The chosen activities included all of the "Educational Features" listed and a selection of "Educational Benefits" listed in FRIEDA Online?, excluding those that are ACGME requirements for family medicine residency training. The specific curriculum offered by each program was recorded as well as whether the program had at least one NRCA. In addition, program

participation in the P4 initiative was also noted. Programs were categorized as having any additional curricular activities if they offered any of the five previous listed activities or participated in the P4 program.

Finally, NRMP initial Match results were obtained and recorded with their corresponding program from 2001 through 2012.20 A 5-year aggregate Match rate was calculated.

For analysis, programs were grouped based on a 5-year aggregate initial Match rate ................
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