The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination

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Background  In 2003, the Accreditation Council for Graduate Medical Education (ACGME) instituted requirements that limited the number of hours residents could spend on duty, and in 2011, it revised these requirements.

Objective  This study explored whether the implementation of the 2003 and 2011 duty hour limits was associated with a change in emergency medicine residents' performance on the American Board of Emergency Medicine (ABEM) Qualifying Examination (QE).

Methods  Beginning with the 1999 QE and ending with the 2014 QE, candidates for whom all training occurred without duty hour requirements (Group A), candidates under the first set of duty hour requirements (Group C), and candidates under the second set of duty hour requirements (Group E) were compared. Comparisons included mean scores and pass rates.

Results  In Group A, 5690 candidates completed the examination, with a mean score of 82.8 and a 90.2% pass rate. In Group C, 8333 candidates had a mean score of 82.4 and a 90.5% pass rate. In Group E, there were 1269 candidates, with a mean score of 82.5 and an 89.4% pass rate. There was a small but statistically significant decrease in the mean scores (0.04, P < .001) after implementation of the first duty hour requirements, but this difference did not occur after implementation of the 2011 standards. There was no difference among pass rates for any of the study groups (χ2 = 1.68, P = .43).

Conclusions  We did not identify an association between the 2003 and 2011 ACGME duty hour requirements and performance of test takers on the ABEM QE.



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