The ASN In-Training Examination Needs More Time, Not a New Paradigm

[摘要] Until last year, the nephrology community had but a single uniform measure of competency achieved as the result of nephrology fellowship training: The American Board of Internal Medicine (ABIM) subspecialty examination, which can be taken only after completion of nephrology subspecialty training. There had also been little published recently regarding current national nephrology fellowship training practices and outcomes. We now have a nephrology in-training examination (ITE) and several recent articles addressing nephrology training in the United States (1–5). Specific details of the ITE, first administered in 2009, were recently published (6). In this issue of CJASN, an experienced clinician and training program director criticizes several aspects of both the ITE and the ABIM certifying examinations (7). The criticisms of the ITE are mainly twofold; first, on average, only approximately 70% of questions on the ITE were answered correctly, and, second, the specific questions on the ITE are not revealed to program directors and trainees. Dr. Brown also expresses concern that the scores of second-year fellows at his program did not “accurately depict their excellent clinical knowledge” and notes a relatively small increase in scores between first- and second-year fellows around the United States. Because others have recently written about ABIM examinations and the maintenance of certification process (8–13), I confine my comments to the ITE examination.

[学科分类] 泌尿医学

[关键词] Bone marrow necrosis;Sickle cell disease;Hyperhemolysis syndrome