Completing Self-Assessment Modules during Residency is Associated with Better Certification Exam Results

Background and objectives: Family medicine residents were recently required to complete Self-Assessment Modules (SAMs), part of the American Board of Family Medicine’s (ABFM) Maintenance of Certification for Family Physicians (MC-FP). We studied whether completing SAMs was associated with initial certification exam performance. Methods: We used ABFM administrative data to identify all family medicine residency graduates who took the ABFM certification exam between 2010 and 2012. We used descriptive statistics to characterize resident and residency demographics by SAM participation. We used both multilevel linear and logistic regression to test for differences in score and pass rate controlling for resident and residency characteristics. Results: A total of 8,348 graduates took the certification exam between 2010 and 2012. The first time pass rate was 90.4%, and the mean score was 484.2 (SD=80.4). In unadjusted analysis, mean exam score and passing rates were similar regardless of SAM completion (490.7 versus 483.6 and 90.6% versus 90.4%, respectively). Using multilevel logistic and linear regression models, we found that completion of a SAM was associated with a 62% increased odds of passing the exam (OR=1.62 [95% CI=1.05, 2.50]) and an 18.76 score increase. Residents in residencies where greater than 10% of residents fail the examination were less likely to pass (OR=0.63 [CI=0.44, 0.89]), controlling for resident characteristics. Conclusions: Prior to the new requirements, residents who completed a SAM had higher board scores and exam passing rates. Likelihood of passing initial board certification may be improved by requiring resident participation in MC-FP.