Comparing the Performance of Allopathically and Osteopathically Trained Physicians on the American Board of Family Medicine’s Certification Examination.

Background: Two medical specialty boards offer certification in family medicine: the American Board of Family Medicine (ABFM) and the American Osteopathic Board of Family Physicians (AOBFP). The AOBFP certification is offered only to graduates of osteopathic colleges; however, graduates of both osteopathic and allopathic medical schools who have successfully completed a residency program accredited by ACGME may seek ABFM certification. Some family medicine residency programs are accredited by both the ACGME and the AOA, which qualifies their residents to seek certification from either or both certification boards. The performance of the following are addressed herein: (1) first-time candidates on the ABFM certification examination; (2) candidates from allopathic and osteopathic colleges; and (3) candidates from allopathic and osteopathic colleges who completed dually accredited residency programs. Issues of attrition are also considered. Methods: This study used a natural groups design with a matching variable in some cases to test for differences in performance on the ABFM certification examination between osteopathically and allopathically trained physicians. The participants in this study were first-time candidates for ABFM certification who tested in 2007 and 2008. Using an independent samples t-test, the scaled scores and pass rates for MDs and DOs were compared twice, first considering the entire cohort and second considering only the subset from the dually accredited programs. Results: With regard to the scaled scores, the allopathically trained physicians outperformed the osteopathically trained physicians by 13 to 20 points. Although this difference was larger than what could be attributed to chance, it did not always translate to a difference in pass rate that was statistically significant. After controlling for differences in the quality and selectivity of the residency programs by considering only the dually accredited residency programs, the statistical differences vanished. Conclusions: This information is useful because it provides a context and baseline for other related research endeavors, especially as related to slots for residency programs and explaining changes in the candidate ability distribution on certification examinations in light of changing demographic trends. The following is appended: Residency Programs that are Accredited by Both ACGME and AOA