PULMONARY SECTION DEVELOPMENT INFLUENCES GENERAL MEDICAL HOUSE OFFICER INTERESTS AND ABIM CERTIFYING EXAMINATION PERFORMANCE

To determine whether sectional development in pulmonary and critical c are medicine influences medical house officers' (HO) interests and kno wledge about respiratory medicine, we reviewed HO performance on the A merican Board of Internal Medicine (ABIM) certifying examination durin g 4 years before and 5 years after reorganization of our section. Afte r major changes in the program and introduction of new educational opp ortunities, HOs more often selected pulmonary consultation electives ( 68.6% vs 47.8%; p=0.009) and entered pulmonary fellowships after compl etion of residency training (12% vs 3%; p=0.047). Total ABIM examinati on score did not change, but performance on its respiratory disease co mponent improved from a median national percentile score of 48.5% (198 6 to 1989) to 80.0% (1990 to 1994) (p=0.0365). In relation to other sp ecialty component scores, the rank of the respiratory disease percenti le improved from the lowest specialty score to the highest. ABIM exami nation scores correlated with the cumulative faculty effort directed t oward HO teaching (r=0.70; p=0.04) and the total number of clinical te achers (faculty and fellows) interacting with HOs (r=0.73; p=0.02). Ac ademic development in pulmonary/critical care faculty has an important influence on medical HO interests in and knowledge of that discipline . Plans for the future structure of academic pulmonary/critical care s ections must take into account this impact on the training of generali sts. Although institutional priorities; resources, and shifting extern al forces will define how, where, and by whom respiratory medicine wil l be taught, an appropriate number of faculty members and sufficient c ommitment of their time to HO education must be preserved.