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MP35-20 EIGHTEEN-YEAR REVIEW OF RESIDENT PERFORMANCE ON THE AMERICAN UROLOGICAL ASSOCIATION IN-SERVICE EXAMINATION

INTRODUCTION AND OBJECTIVES: We aimed to analyze trends in national performance of urology residents on the American Urological Association In-Service Examination (ISE) over the last 18 years of administration and highlight areas of poorer subject performance. METHODS: National average scores--recorded as percent correct--on the ISE were collected for exams administered between 2000 and 2017. Mean and standard error were calculated for total exam performance and subject-specific performance for each year of residency (Pre-Uro, Uro-1, Uro-2, Uro-3 and Uro-4) across that time. Regression analysis was used to model trends in examination performance as a function of residency year. RESULTS: There was no significant difference in total exam performance within each residency year over the study period. There was an overall improvement in total ISE scores on average with each additional year of residency, but the rate of improvement began to taper at Uro-2. Year-over-year improvement in total exam performance was 23% between Pre-Uro/Uro-1, 15% between Uro-1/Uro-2, 7% between Uro-2/Uro-3 and only 3% between Uro-3/Uro-4 years. There were, generally, significant differences in subject-specific performance between each resident year from Pre-Urol to Uro-3. One exception to this was in Core Competencies which saw no significant year-to-year improvement in scores across the entire resident career (p > 0.05). Interestingly, between the Uro-3 and Uro-4 years, only performance on the Infection & Inflammatory Disease and Neoplasm sections demonstrated significant improvement (p = 0.016 and 0.025, respectively). Largest absolute improvement in performance from Pre-Uro to Uro-4 was in the subjects of Urinary Diversion (41.7 to 73.3; difference = 76%), Obstructive Uropathy (40.3 to 70.4; difference = 75%) and Neoplasm (41.3 to 71.5; difference = 73%). Scores in Sexual Dysfunction, Endocrinopathy, Fertility Problems (mean ± SE = 56.8 ± 4.81) and Congenital Anomalies, Embryology, Anatomy (mean ± SE = 57.2 ± 4.01) were consistently lower than all other subjects, regardless of year of training. CONCLUSIONS: There was general improvement in overall ISE scores as residents progressed through their training, but the rate of improvement diminished after Uro-2, with no significant difference in scores between Uro-3 and Uro-4 years, indicating a “saturation” in resident knowledge. Additionally, the difference in ISE score improvement between certain subjects (e.g. Sexual Dysfunction versus Neoplasm) suggests a disparity in education focus in residency curriculums. Source of Funding: None