Study shows board certification exam scores predict patient outcomes for newly trained physicians

A study published in JAMA on May 6 shows the role that board certification exams play in predicting patient outcomes for newly trained physicians. Led by researchers from Harvard Medical School and the American Board of Internal Medicine, the study analyzed the performance of internal medicine patients under the care of newly trained physicians, revealing a significant correlation between high board certification exam scores and improved patient survival rates and reduced hospital readmissions.

The study, led by Bradley Gray and senior author Bruce Landon, delved into the effectiveness of board certification exams in gauging physicians' abilities to deliver high-quality patient care. The findings highlighted a previously underexplored aspect of physician assessment: the impact on patient outcomes. By scrutinizing the patient outcomes of nearly 70,000 hospitalist physicians treating Medicare beneficiaries over a two-year period, researchers were able to draw compelling conclusions about the relationship between exam scores and patient well-being.

Patients under the care of physicians who scored in the top 25% on the board certification exam exhibited an 8% lower risk of dying within seven days of hospital admission compared to those treated by physicians in the bottom 25%. This correlation underscores the significance of board certification exams in identifying physicians who possess the knowledge and skills necessary to deliver superior patient care, according to the researchers.

While the study focused primarily on the predictive power of board certification exams, it also examined the utility of ACGME's milestone ratings, which evaluate resident competency throughout the course of residency training. Despite their role in providing feedback to trainees, milestone ratings did not correlate with patient outcomes, suggesting a discrepancy in their effectiveness as a measure of physician performance, according to the study.

Researchers say the implications of these findings extend beyond individual physician assessment. They underscore the importance of evidence-based approaches in medical training and education. By understanding the relationship between testing tools and real-world outcomes, medical educators can refine their methodologies to better prepare future practitioners for the challenges they will face in clinical practice.

Landon stated, "This type of evidence-based assessment of our own testing tools provides valuable insights on which types of tests work for what purpose, which informs how they should be deployed in educating our future practitioners and leaders of medicine."