Changes over time in the knowledge base of practicing internists

Article Abstract:

The performance and knowledge of medical students are observed and tested time and again. Likewise, the medical skills and knowledge of resident physicians are constantly being tested. However, once a physician is turned out into the community, there is little or no further testing, although continuing education is often required. A study was conducted to evaluate the knowledge of internists in the years following their initial passing of the board examinations for certification in internal medicine. A test consisting of 82 questions was used to test the knowledge of 289 internists who were certified from five to 15 years previously. The questions were taken from an actual board certifying examination. It was found that the more time that had elapsed since passing the boards, the poorer the performance of an internist was likely to be on the test. Furthermore, it was found that specialists such as cardiologists or gastroenterologists were more likely to have forgotten general medical knowledge not directly related to their subspecialty. It should be mentioned, however, that these tests were not required for any sort of certification or recertification, and so it is likely the participants did not study as hard as someone who was preparing for the actual board examination. Nevertheless, in the present study over two thirds of the internists who had passed their boards 14 or 15 years previously would have failed if the present test actually counted. (Consumer Summary produced by Reliance Medical Information, Inc.)

Standards, Laws, regulations and rules, Practice, Internal medicine, American Board of Internal Medicine, Internists

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Use of peer ratings to evaluate physician performance

Article Abstract:

Peer ratings may be a practical means of assessing physicians' clinical performance, especially their humanistic qualities and communication skills. Professional associates including nurses and fellow physicians rated 318 physicians on their clinical skills and factors including medical knowledge, problem-management, compassion and integrity. There was fairly strong agreement between physician-associates and nurse-associates in their rating of the physicians. Reliable ratings were obtained when at least eleven associates responded. All physicians identified an adequate number of associates to meet this requirement. Of 263 physicians surveyed, 84% thought that ratings by physician-associates should be used to evaluate physicians for credentialing and license recertification. About 75% of them felt that ratings by physician-associates should be used to evaluate physicians' humanistic qualities and communication skills.

Evaluation, Physicians, Medical professions, Peer review

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