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Performance on the Plastic Surgery In-Service Examination Can Predict Success on the American Board of Plastic Surgery Written Examination

Girotto, John A., M.D., M.M.A.; Adams, Nicholas S., M.D.; Janis, Jeffrey E., M.D.; Brandt, Keith E., M.D.; Slezak, Sheri S., M.D.

Plastic and Reconstructive Surgery: May 2019 - Volume 143 - Issue 5 - p 1099e–1105e
doi: 10.1097/PRS.0000000000005536
Plastic Surgery Focus: Special Topics

Background: Originally developed for resident self-assessment, the Plastic Surgery In-Service Examination has been administered for over 45 years. The Accreditation Council for Graduate Medical Education requires that at least 70 percent of graduates pass the American Board of Plastic Surgery Written Examination on their first attempt. This study evaluates the role of In-Service Exam scores in predicting Written Exam success.

Methods: In-Service Exam scores from 2009 to 2015 were collected from the National Board of Medical Examiners. Data included residency training track, training year, and examination year. Written Exam data were gathered from the American Board of Plastic Surgery. Multivariate analysis was performed and receiver operating characteristic curves were used to identify optimal In-Service Exam score cut-points for Written Exam success.

Results: Data from 1364 residents were included. Residents who failed the Written Exam had significantly lower In-Service Exam scores than those who passed (p < 0.001). Independent residents were 7.0 times more likely to fail compared with integrated/combined residents (p < 0.001). Residents who scored above the optimal cut-points were significantly more likely to pass the Written Exam. The optimal cut-point score for independent residents was the thirty-sixth percentile and the twenty-second percentile for integrated/combined residents.

Conclusions: Plastic Surgery In-Service Exam scores can predict success on the American Board of Plastic Surgery Written Exam. Residents who score below the cut-points are at an increased risk of failing. These data can help identify residents at risk for early intervention.

Grand Rapids, Mich.; Columbus, Ohio; St. Louis, Mo.; and Baltimore, Md.

From the Division of Pediatric Plastic Surgery and Dermatology, Helen DeVos Children’s Hospital; Spectrum Health/Michigan State University Plastic Surgery Residency; the Department of Plastic Surgery, The Ohio State University Wexner Medical Center; the Division of Plastic Surgery, Washington University School of Medicine; and the Division of Plastic Surgery, University of Maryland School of Medicine.

Received for publication April 26, 2018; accepted October 26, 2018.

Presented at Plastic Surgery The Meeting 2017, Annual Meeting of the American Society of Plastic Surgeons, in Orlando, Florida, October 5 through 10, 2017; the 30th Biennial Meeting of the Michigan Academy of Plastic Surgeons, in Mackinac Island, Michigan, June 22 through 25, 2018; and Plastic Surgery The Meeting 2018, Annual Meeting of the American Society of Plastic Surgeons, Senior Residents’ Conference, in Chicago, Illinois, September 28 through October 1, 2018.

Disclosure:Dr. Janis has served as a consultant for LifeCell, Bard, Daiichi Sankyo, Pacira, and Allergan within the last 12 months prior to submission of this article but has no active conflicts of interest; he receives royalties from Thieme Publishing. The other authors have no financial interest to declare in relation to the content of this article.

John A. Girotto, M.D., M.M.A., 35 Michigan Street NE, Suite 5201, Grand Rapids, Mich. 49503,

©2019American Society of Plastic Surgeons