Assessing the Linking Between the Orthopaedic In-Training Examination and the American Board of Orthopaedic Surgery Part I Certification Examination

INTRODUCTION: Since 2020, the American Academy of Orthopaedic Surgeons (AAOS) and American Board of Orthopaedic Surgery (ABOS) have collaborated to link the AAOS Orthopaedic In-Training Examination (OITE) and the ABOS part I Certification Examination, allowing the identification of a minimum score on each annual OITE that corresponds to a minimum passing part I score. The purpose of this study is to assess the performance of this examination linking over these past 3 years.

METHODS: From 2020 to 2022, the AAOS provided each graduating resident's OITE score; from 2021 to 2023, the ABOS provided each examinee's ABOS part I pass-fail result. Examination scores were matched at the individual level and deidentified for data analysis.

RESULTS: A total of 2,247 subjects took both the OITE and the ABOS during the same cycle, during the 3-year study period. The ABOS part I pass rates in 2021, 2022, and 2023 were 92.9%, 98.1%, and 98.4%, respectively, for those taking the OITE the prior year. The positive predictive value of achieving the minimum passing score on the OITE for passing part I increased from 95.1% in 2021 to 99.8% and 99.7% in 2022 and 2023, respectively. The negative predictive value of not achieving the minimum passing score on the OITE for failing part I decreased from 24.7% in 2021 to 5.3% in 2022 and 10.1% in 2023.

DISCUSSION: This study is the first of its kind and demonstrates the initial results of the examination linking between the OITE and the ABOS part I Examination. This information can be helpful for residents and residency program directors. Moreover, the examination linking provides a step toward obtaining a standardized assessment of knowledge throughout all 5 years of residency.