The Impact of the Hospital Volume on the Performance of Residents on the General Medicine In-Training Examination: A Multicenter Study in Japan

Abstract

Objective Although several studies have been conducted worldwide on factors that might improve residents' knowledge, the relationship between the hospital volume and the internal medicine residents' knowledge has not been fully understood. We conducted a cross-sectional study to compare the relationships of the hospital volume and hospital resources with the residents' knowledge assessed by the In-training Examination. Methods We conducted a retrospective survey and a clinical knowledge evaluation of postgraduate year 1 and 2 (PGY-1 and -2) resident physicians in Japan by using the General Medicine In-training Examination (GM-ITE) in 2014. We compared the ITE score and the hospital volume. Results A total of 2,015 participants (70.6% men; age, 27.3±2.9 years old) from 208 hospitals were retrospectively analyzed. Generalized estimating equations were used, and the results revealed that an increasing number of hospitalizations, decreasing staff number, decreasing age and PGY-2 were significantly associated with higher GM-ITE scores. Conclusion The hospital volume, such as the number of hospitalizations, is thus considered to have a positive impact on the GM-ITE scores.

Impact of general medicine rotation training on the in-training examination scores of 11, 244 Japanese resident physicians: a Nationwide multi-center cross-sectional study

“…The Japan Organization of Advancing Medical Education Program (JAMEP), a non-profit organization, has been implementing the GM-ITE since 2011 as an objective evaluation of the basic clinical competency of junior resident physicians (postgraduate years PGY-1 and PGY-2) [5][6][7][8][9]. The GM-ITE is a multiple-choice knowledge test.…”

Educational environment and the improvement in the General Medicine In‐training Examination score

“…Data from the 2013 GM‐ITE showed that appropriate emergency department (ED) workload, inpatient caseload, and online learning resource were associated with greater clinical knowledge 2. In addition, in 2014, we found that factors affecting hospital volume, including the number of hospitalizations, had a positive impact on GM‐ITE scores 3. While our team have been extensively studied factors related to the performance of the GM‐ITE, because previous studies were analyzing cross‐sectional data, we could not evaluate the improvement in GM‐ITE score over time.…”

“…2 In addition, in 2014, we found that factors affecting hospital volume, including the number of hospitalizations, had a positive impact on GM-ITE scores. 3 While our team have been extensively studied factors related to the performance of the GM-ITE, because previous studies were analyzing cross-sectional data, we could not evaluate the improvement in GM-ITE score over time. In this context, we investigate how educational environment of hospitals is related to the improvement in GM-ITE score using the longitudinal data obtained during two consecutive years.…”

Hospital characteristics preferred by medical students for their residency programs: A nationwide matching data analysis

“…In 2016, Mizuno et al 17 reported the performance of 2015 junior resident physicians (postgraduate years 1 and 2) working in 208 Japanese hospitals nationwide in the General Medicine In‐Training Examination (GM‐ITE). GM‐ITE scores were generally higher for residents working at training sites with a greater volume of patient admissions and a lower number of nonresident physicians.…”