title: Military and academic programs outperform community programs on the American Board of Surgery Examinations.
abstract: BACKGROUND
  There is a paucity of American Board of Surgery (ABS) Qualifying Examination (QE) and Certifying Examination (CE) outcomes comparing residency programs by academic, community, or military affiliation. We hypothesize that the larger academic programs will outperform the smaller community programs.
  
  
  METHODS
  In this retrospective study from 2002 to 2012, examination performance on the ABS QE and CE were obtained from the ABS for all of the general surgery residency programs. Programs were categorized by academic, community, and military affiliation. Both nonparametric and parametric statistics were used for comparison, using an α = 0.05.
  
  
  RESULTS
  There were 137/235 (58.3%) academic programs, 90/235 (38.3%) community programs, and 8/235 (3.4%) military programs that satisfied inclusion criteria for this study. The Mann-Whitney U tests showed that the military programs outperformed academic and community programs on the ABS QE and the ABS CE, and had a higher proportion of examinees passing both examinations on the first attempt (all p≤0.02). One-tailed Student t-tests showed that academic programs had higher pass rates than community programs on the ABS QE (85.4%±9.5% vs. 81.9%±11.5%), higher pass rates on the ABS CE (83.6%±8.3% vs. 80.6%±11.0%), and a higher proportion of examinees passing both examinations on the first attempt (0.73±0.12 vs. 0.68±0.15) (all p≤0.01). The chi-square and Fisher exact tests showed that examinees performed highest in military programs, followed by academic programs, and lowest in community programs on the ABS QE and ABS CE (all p≤ 0.01).
  
  
  CONCLUSIONS
  Military programs have the highest degrees of success on all of the ABS examinations. Academic programs outperform community programs. These results have the potential to affect application patterns to established general surgery residency programs.
authors.affiliation: University of Pittsburgh School of Medicine, University of Pittsburgh Medical Center, Department of Surgery, Pittsburgh, Pennsylvania. Electronic address: falconej@upmc.edu.
authors.forename: John L
authors.initials: JL
authors.lastname: Falcone
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Charles
mesh_terms: D002568:Certification / Q000706:statistics & numerical data*; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000592:standards*; D012189:Retrospective Studies
keywords: Interpersonal and Communication Skills; Medical Knowledge; Patient Care; academic program; certifying examination; community program; general surgery; qualifying examination; residency