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J Gen Intern Med. 1993 Sep;8(9):497-501.

A core component of the certification examination in internal medicine.

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  • 1American Board of Internal Medicine, Philadelphia, Pennsylvania.



To develop and test the psychometric characteristics of an examination of core content in internal medicine.


A cross-sectional pilot test comparing the core examination with the 1988 certifying examination and two pretest examinations.


The 1988 certifying examination of the American Board of Internal Medicine.


A random sample of 2,975 candidates from 8,968 candidates who took the 1988 certifying examination were given the core examination; similarly drawn samples were each given one of two pretests of traditional questions.


A framework for developing an examination of core internal medicine questions was designed and used to develop a 92-question core test with an absolute pass/fail standard.


Candidates answered 74% of core internal medicine questions, compared with 64%, 52%, and 53% of traditional questions on the 1988 certifying examination and the two pretests. The discriminating ability of the core internal medicine examination was lower than that of the certifying examination (r-values were 0.28 and 0.34, respectively). The pass rate was 83% for the core internal medicine examination and 57% for the certifying examination; 27% passed the core examination and failed the certifying examination; 1% passed the certifying examination and failed the core examination.


Core internal medicine questions were easier than but almost as discriminating as traditional questions of the certifying examination. A small percentage of candidates passed the certifying examination but failed the core examination.

[PubMed - indexed for MEDLINE]
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