title: Specialty Certification Status, Performance Ratings, and Disciplinary Actions of Internal Medicine Residents.
abstract: OBJECTIVE
  Little is known about the attrition of physicians trained in internal medicine (IM). The authors sought to examine career paths, disciplinary actions, and American Board of Medical Specialties (ABMS) certification status of IM residents.
  
  
  METHODS
  Three datasets were combined to study 66,881 residents in Accreditation Council for Graduate Medical Education-accredited IM residency programs nationwide from 1995 to 2004. Group differences (among an American Board of Internal Medicine [ABIM]-certified cohort; an ABMS-certified cohort (but not ABIM-certified); and a noncertified cohort) in IM residency performance ratings, specialty certification status, year of initial IM training, and medical board disciplinary actions were examined. Analyses included chi-square tests, analysis of variance, pairwise comparisons, and logistic regressions.
  
  
  RESULTS
  Ninety-five percent of IM residents obtained ABIM certification; 1.6% received ABMS certification in another specialty; 3.4% received no ABMS specialty certification, of which 74.3% have a current medical license; and 66.6% self-reported IM as their primary specialty. During residency, the ABIM cohort performed better than those who never obtained ABIM certification. Disciplinary actions were lowest for the ABIM cohort (1.2%), 2.4% for the ABMS cohort, and highest and more severe for the noncertified cohort (6.0%).
  
  
  CONCLUSIONS
  Only 5% of IM residents do not achieve IM certification. IM resident attrition minimally impacts physician supply, though those without certification appear to contribute disproportionately to poor physician performance indicators. Improved tracking of the U.S. physician workforce could aid policy makers in predicting manpower shifts in certain specialty areas, both during and after residency training.
authors.affiliation: R.S. Lipner is senior vice president, Assessment and Research, American Board of Internal Medicine, Philadelphia, Pennsylvania. A. Young is assistant vice president, Research and Data Integration, Federation of State Medical Boards, Euless, Texas. H.J. Chaudhry is president and chief executive officer, Federation of State Medical Boards, Euless, Texas. L.M. Duhigg is research associate, American Board of Internal Medicine, Philadelphia, Pennsylvania. M.A. Papadakis is associate dean of students and professor of medicine, University of California, San Francisco, and staff physician, Veterans Administration Medical Center, San Francisco, California.
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Lipner
authors.forename: Aaron
authors.initials: A
authors.lastname: Young
authors.forename: Humayun J
authors.initials: HJ
authors.lastname: Chaudhry
authors.forename: Lauren M
authors.initials: LM
authors.lastname: Duhigg
authors.forename: Maxine A
authors.initials: MA
authors.lastname: Papadakis
mesh_terms: D000328:Adult; D002568:Certification; D002983:Clinical Competence; D015331:Cohort Studies; D004647:Employee Discipline; D005260:Female; D006801:Humans; D007388:Internal Medicine / Q000193:education*; D007396:Internship and Residency; D008297:Male; D014481:United States; D055815:Young Adult