General Internal Medicine Exam: Redefining Our Identity and Revalidation
Bibliographic record
Abstract
I had to be patient. If I didn’t allow my eyes to wander, I could briefly catch a glimpse of one taking the jump. I saw three: amazing. I had never seen the salmon run before, nor did I know it was in my backyard. For 16 years I lived in this city in two separate spans of my life. Only today did I take a walk along the Humber River and witness the salmon run, thanks to a chance encounter with our course administrator who taught me about this yearly ritual. It was a welcome distraction from the weight of anxiety about the exam I was here to write in less than 24 hours. I checked myself into the Old Mill for a quiet night’s sleep. My kids thought it was the most curious thing that their mom was studying. After all, I had already finished university and had a job. Why would I need to study? I spent the last few months trying to explain why I would voluntarily subject myself to hours of studying, missing precious hours at the pool or on the lake during family vacation time. Last year, I submitted my application to write the first Royal College of Physicians and Surgeons of Canada (RCPSC) General Internal Medicine (GIM) certification exam. I was a true skeptic. I did not buy into the idea that GIM was unique from Internal Medicine (IM), so how could there be a valid exam distinguishing the two specialties? “You should write the exam, ” was the advice from my senior colleague in the upper echelons of our college. I perceived a conflict of interest. Or was it a warning that ultimately my career and billings would depend on having this new designation of General Internist to validate my credentials? No one knew. But I do know that I won’t do something “just because. ” Nor did I believe I would suddenly lose my job because I didn’t have the new certification. If I did not write and pass, however, I would have to order new business cards that reflected my new identity, dropping the “General ” from General Internist. However, if my family and friends are any indication, my patients are equally unaware of the distinction between IM and GIM, and so whether I would
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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 | 0.040 | 0.090 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.025 | 0.031 |
| Scholarly communication | 0.024 | 0.018 |
| Open science | 0.003 | 0.031 |
| Research integrity | 0.011 | 0.043 |
| Insufficient payload (model declined to judge) | 0.012 | 0.006 |
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".