The first decade of the American Board of Internal Medicine certification in critical care medicine: An overview of examinees and certificate holdersfrom 1987 through 1996

Overview: This study reviews the first decade of critical care medicine (CC M) certification by the American Board of Internal Medicine (1987-1996), In cluded are the characteristics of examinee and certificate-holder groups; e xamination performances from different underlying disciplines of internal m edicine, with or without formal CCM training; and the influence of backgrou nd and a training program as correlates of examination performance. Data Sources: The CCM certification examination has been offered biennially since November 1987, Performance data on the American Board of Internal Me dicine examinations in internal medicine and its subspecialties and added q ualifications were available for candidates taking the CCM examinations. Fo r examinees with formal CCM training, residency program director ratings, a nd information regarding the program characteristics of size and percentage of United States and Canadian medical graduates were also available. Study Selection: All examinees who ever attempted certification were includ ed in this study. The study cohort for each of the five examination adminis trations consists of all first-time takers. Conclusions: Cohort sizes have decreased since formal training became an ad mission requirement in 1993, Percentages of International Medical Graduates and women attempting and achieving certification have increased steadily. Examination performance was positively associated with formal training, int ernal medicine examination performance, recent medical training, and pulmon ary disease certification. For those with formal training, performance was also positively associated with training program director ratings of overal l clinical competence and completion ct a training program with a higher pr oportion of United States and Canadian medical graduates.