Predicting Performance in the Physical Medicine and Rehabilitation Part II Certification Oral Examination Based on Milestone Ratings

The Accreditation Council for Graduate Medical Education introduced the Milestones to document learner development within a competency-based framework. On the other hand, board certifying examinations serve as a summative evaluation of a learner's readiness for independent medical practice. Scores in Part I of the American Board of Physical Medicine and Rehabilitation examination, which measures medical knowledge, has been shown to correlate only with Milestones ratings in medical knowledge. We hypothesized that combined ratings of various Milestone competencies can predict subsequent performance in related American Board of Physical Medicine and Rehabilitation Part II certifying examination domains. Milestones data and American Board of Physical Medicine and Rehabilitation Part II Examination scores of trainees in 3-yr PM&R residency programs in the United States from academic years 2014-2016 who sat for the American Board of Physical Medicine and Rehabilitation Parts I and II Examinations, immediately after completion of training, were reviewed. Regression analysis showed that Milestone subcompetencies, alone or in combination, did not correlate with Part II domain scaled scores. Medical Knowledge was the only Milestone subcompetency that was correlated with performance in the American Board of Physical Medicine and Rehabilitation Part I certifying examination. This current study found that no similar association exists between any of the Milestones Competencies and the American Board of Physical Medicine and Rehabilitation Part II certifying examination, suggesting that the two assessment tools measure different attributes.