title: Pass rates on the American Board of Family Medicine Certification Exam by residency location and size.
abstract: BACKGROUND
  The Accreditation Council for Graduate Medical Education (ACGME) sets residency performance standards for the American Board of Family Medicine Certification Examination. This study aims are to describe the compliance of residency programs with ACGME standards and to determine whether residency pass rates depend on program size and location.
  
  
  METHODS
  In this retrospective cohort study, residency performance from 2007 to 2011 was compared with the ACGME performance standards. Simple linear regression was performed to see whether program pass rates were dependent on program size. Regional differences in performance were compared with χ(2) tests, using an α level of 0.05.
  
  
  RESULTS
  Of 429 total residency programs, there were 205 (47.8%) that violate ACGME performance standards. Linear regression showed that program pass rates were positively correlated and dependent on program size (P < .001). The median pass rate per state was 86.4% (interquartile range, 82.0-90.8. χ(2) Tests showed that states in the West performed higher than the other 3 US Census Bureau Regions (all P < .001).
  
  
  CONCLUSIONS
  Approximately half of the family medicine training programs do not meet the ACGME examination performance standards. Pass rates are associated with residency program size, and regional variation occurs. These findings have the potential to affect ACGME policy and residency program application patterns.
authors.affiliation: Department of Surgery, University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA 15213, USA. falconej@upmc.edu
authors.forename: John L
authors.initials: JL
authors.lastname: Falcone
authors.forename: Donald B
authors.initials: DB
authors.lastname: Middleton
mesh_terms: D000068:Accreditation; D002568:Certification / Q000706:statistics & numerical data*; D004521:Educational Measurement; D005194:Family Practice / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards* / Q000706:statistics & numerical data; D016014:Linear Models; D011647:Puerto Rico; D012189:Retrospective Studies; D013044:Specialty Boards / Q000592:standards; D014481:United States
keywords: Certification; Education; Educational Measurement; Family Practice; Geographic Factors; Residency; Specialty Boards