Do shorter work hours have an impact on internal medicine training


Category : Medical Rants


Certification Examination in Internal Medicine: 2008-2012 First-Time Taker Pass Rates

Year 2008 2009 2010 2011 2012
First takers 7194 7226 7335 7337 7303
Pass rate 91% 88% 87% 84% 85%




We have decreased work hours.  We have decreased continuity and ownership.  We have increased handoffs.

We have more "non-educational" rotations like night float.  We have worse attendance at conferences.

Our residents do not sleep any more (according to surveys).

Things sure are better!


Comments (4)

Like Marriage:
Not better, different.

And a colleague of mine from college and medical school writes questions for the ABIM and he told me they are dumbing down the exam so these numbers are really worse than they are.
If you read about clinical reasoning to develop good illness scripts you have to read books and have clinical experience to enhance the book knowledge of disease. So we are cutting back class time in med school, when residents are off they arent reading, and we are reducing clinical time…..Hmmmm loooks like the system is giving us just what it was designed to do.
Amazing how that happens.

[…] colleague of mine (DB) has a great blog ( He posted ( an excellent observation that ABIM pass rates are declining since the work hour restrictions have […]

Versus what a number of program directors told me last year on the interview trail is that the ABIM decided several years ago that the pass rate of >90% was too high, and has been actively working to lower it to be on par with several of the other medical boards (ABP has always hovered around 80% for example).
Not to mention that your data is 2008-2012, a period of time that includes individuals who would have been interns c. 2004-2008/9, during which there were absolutely no changes to work hours. The 80 hr workweek came out in 2003, and the changes to intern work hours came out in 2010.

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