The In-Training Examination in Internal Medicine: An Analysis of Resident Performance over Time
Bibliographic record
Abstract
(IM-ITE) has been offered annually to all trainees in U.S. medical residency programs since 1988. Its purpose is to provide residents and program directors with an objective assessment of each res-ident’s personal performance on a written, multiple-choice exam-ination and the performance of the residency program compared with that of its peers. Objective: To analyze trends in the demographic characteristics and scores of examinees during the first 12 years of administra-tion of this examination. Design: Descriptive analysis over time. Setting: U.S. residency programs in internal medicine, 1988–2000. Participants: Residents at all levels of training in categorical, primary care, and medicine–pediatrics programs in the United States and Canada. The number of examinees increased from 7500 in 1988 to almost 18 000 in 2000. Measurements: After calibration of the scores for each exami-nation, test results were compared and analyzed for selected co-horts of residents over 12 years. Results: More than 80 % of residents in medicine training pro-grams participate in the IM-ITE, most on an annual basis through-out their period of training. Test performance improves at a pre-dictable rate with each year of training. Since 1995, international medical school graduates have persistently outperformed gradu-ates of U.S. medical schools. Test results were affected by the timing of the examination, the time that was available to com-plete the examination, and the actual time that residents spent in internal medicine training before each examination. Conclusions: The IM-ITE scores generally improve with year of training time spent in internal medicine training before the exam-ination and time permitted to complete the examination. These observations provide evidence that the IM-ITE is a valid measure of knowledge acquired during internal medicine training. Ann Intern Med. 2002;137:505-510. www.annals.org
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.007 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.003 | 0.002 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".