title: The importance of residency program size and location on American Osteopathic Board of Surgery In-Training Examination outcomes.
abstract: BACKGROUND
  The American Osteopathic Board of Surgery In-Training Examination (AOBSITE) is administered to general surgery residency training programs. Based on findings in allopathic training, we hypothesize that larger programs will outperform smaller programs and that Southern programs will perform lower than other geographic regions.
  
  
  METHODS
  In this retrospective study, the performance on the AOBSITE was obtained for all of the osteopathic general surgery programs from 2008 to 2012. To test if program size was related to AOBSITE performance, simple linear regression was performed. Geographic differences in median performance between states and US Census Bureau regions were evaluated using Kruskal-Wallis tests. Nonparametric statistics were performed using an α = 0.05.
  
  
  RESULTS
  From 2008 to 2012, there were 49 general surgery residency training programs and 2278 examinees evaluated. The median raw performance by general surgery residency training program was 168.0 (IQR [161.8-177.7]). The weighted median standardized performance by general surgery residency training program was 487.8 (IQR [462.8-528.0]). Simple linear regression analyses showed that the slope of the least-square regression line was greater than zero for raw performance (P = 0.048) and standardized performance (P = 0.005). A Kruskal-Wallis test showed that there were no differences in raw performance or standardized performance by US Census Bureau Region or by state (all P > 0.05).
  
  
  CONCLUSIONS
  Overall, larger general surgery residency training programs outperform smaller programs on the AOBSITE and that there are no geographical differences in performance by state or region.
authors.affiliation: Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania 15213, USA. falconej@upmc.edu
authors.forename: John L
authors.initials: JL
authors.lastname: Falcone
authors.forename: Marc E
authors.initials: ME
authors.lastname: Rosen
mesh_terms: D002568:Certification / Q000592:standards*; D004521:Educational Measurement; D013502:General Surgery / Q000193:education* / Q000592:standards; D005843:Geography; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration* / Q000592:standards; D016014:Linear Models; D010021:Osteopathic Medicine / Q000193:education* / Q000592:standards; D055360:Osteopathic Physicians / Q000193:education* / Q000592:standards; D012189:Retrospective Studies; D013044:Specialty Boards / Q000592:standards; D014481:United States
keywords: Educational measurement; Geographic factors; Osteopathic Medicine; Specialty Board; Surgery; Training