title: Do early career indicators of clinical skill predict subsequent career outcomes and practice characteristics for general internists?
abstract: OBJECTIVE
  To study relationships between clinical skill measures assessed at the beginning of general internists' careers and their career outcomes and practice characteristics.
  
  
  METHODS
  General Internist Community Tracking Study Physician Survey respondents (2000-2001, 2004-2005) linked with residency program evaluations and American Board of Internal Medicine board certification examination score records; n = 2,331.
  
  
  METHODS
  Cross-sectional regressions of career outcome and practice characteristic measures on board examination scores/success, residency evaluations interacted with residency type, and potential confounding variables.
  
  
  RESULTS
  Failure to achieve board certification was associated with $27,206 (18 percent, p < .05) less income and 14.9 percent more minority patients relative to physicians scoring in the bottom quartile on their initial examination who eventually became certified (p < .01). Other skill measures were not associated with income. Scoring in the top rather than bottom quartile on the board certification examination was associated with 9 percent increased likelihood of reporting high career satisfaction (p < .05). Among physicians trained in community hospital residency programs, lower evaluations were associated with 14.5 percent higher share of minority patients (p < .05). Both skill measures were associated with practice type.
  
  
  CONCLUSIONS
  There are associations between early career skill measures and career outcomes. In addition, minority patients are more likely to be treated by physicians with lower early career clinical skills measures than nonminority patients.
authors.affiliation: American Board of Internal Medicine, Philadelphia, PA, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Gray
authors.forename: James
authors.initials: J
authors.lastname: Reschovsky
authors.forename: Eric
authors.initials: E
authors.lastname: Holmboe
authors.forename: Rebecca
authors.initials: R
authors.lastname: Lipner
mesh_terms: D002568:Certification / Q000706:statistics & numerical data; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D004521:Educational Measurement; D005260:Female; D006801:Humans; D007182:Income / Q000706:statistics & numerical data*; D007388:Internal Medicine / Q000191:economics* / Q000706:statistics & numerical data*; D007396:Internship and Residency / Q000706:statistics & numerical data*; D007588:Job Satisfaction; D008297:Male; D011364:Professional Practice; D044469:Racial Groups; D012111:Residence Characteristics / Q000706:statistics & numerical data