Differences in Canadian and US Medical Student Preparation for Family Medicine

BACKGROUND AND OBJECTIVES: Despite their similarities, differences exist in the way Canadian and US medical schools prepare students for graduate medical education. The purpose of this study is to use American Board of Family Medicine (ABFM) In-Training Examination (ITE) scores as a proxy to determine whether Canadian medical students are better prepared for entry into family medicine training than US medical students. METHODS: We used a cross-sectional study examining the performance of US medical school graduates (USMG [n=7,016]) and international medical school graduates (IMG [n=3,512]) enrolled in Accreditation Council for Graduate Medical Education (ACGME)-accredited family medicine residency programs and 508 residents in Canadian family medicine programs who sat for the 2014 ABFM ITE. RESULTS: The PGY-1 Canadian cohort outperformed both the PGY-1 ACGME IMG and USMG cohorts; however, the PGY-3 AC-GME USMG cohort outperformed the PGY-2 Canadian cohort, but there was not a statistically significant difference between the PGY-2 Canadian cohort and the PGY-3 ACGME IMG cohort. CONCLUSIONS: Canadian medical students entering their first year of training in Canadian family medicine residencies performed better on the ABFM ITE than their US counterparts. This effect vanishes by the second year of training. The ability of US programs to successfully prepare their trainees to practice family medicine appears to be independent of the location of medical education as evidenced by the parallel improvement in mean scores for both USMGs and IMGs.