AATS: Certification failure rates rise post 80-hour work week

Failure rates for residents taking the American Board of Thoracic Surgery (ABTS) examination overall took a hit since implementation of the 80-hour residency work week, according to a presentation May 7 at the annual American Association for Thoracic Surgery (AATS) meeting in Minneapolis.

Susan Moffatt-Bruce, MD, PhD, a cardiothoracic surgeon at the Ohio State Medical Center in Columbus, and colleagues analyzed data on certificates awarded by the ABTS between 2000 and 2011. The period spans the introduction of rules by the Accreditation Council for Graduate Medical Education that restricted the residency work week to 80 hours. To assess pass rates, they used pre- and post-change periods: 2000 to 2005 and 2006 to 2011. They looked at both written and oral boards.

Between 2000 and 2011, the number of certificates awarded decreased from 126 in 2000 to 93 in 2011. The failure rate for written exams rose from 2006 to 2009 and then dropped—but never to the level seen before implementation of the 80-hour work week requirement.

The failure rate for oral exams rose continuously at what the researchers described as “an alarming rate,” from 20 percent in 2005 to 35 percent in 2011.

A decline in experiential learning may be impacting residents’ ability to achieve certification, according to the researchers. They recommended developing strategies to increase the numbers of trainees and improve their learning experience with precertification programs such simulation training, mock patient interactions and competency assessments.