Medical Knowledge Acquisition during a Pandemic: Pediatric Subspecialty In-Training Examination and Board Certification Exam Passing Rate

OBJECTIVE: The COVID-19 pandemic resulted in training programs restructuring their curricula. Fellowship programs are required to monitor each fellow’s training progress through a combination of formal evaluations, competency tracking, and measures of knowledge acquisition. The American Board of Pediatrics administers Subspecialty In-Training Examinations to pediatric fellowship trainees annually and board certification exams at the completion of fellowship. The objective of this study was to compare SITE scores and certification exam passing rates before and during the pandemic. METHODS: In this retrospective observational study, we collected summative data on SITE scores and certification exam passing rates for all pediatric subspecialties from 2018 to 2022. Trends over time were assessed using ANOVA analysis to test for trends across years within one group and t-test analysis to compare groups before and during the pandemic. RESULTS: Data were obtained from 14 pediatric subspecialties. Comparing pre-pandemic to pandemic scores, Infectious Diseases, Cardiology, and Critical Care Medicine saw statistically significant decreases in SITE scores. Conversely, Child Abuse Pediatrics and Emergency Medicine (PEM) saw increases in SITE scores. PEM saw a statistically significant increase in certification exam passing rates, while Gastroenterology and Pulmonology saw decreases in exam passing rates. CONCLUSION: The COVID-19 pandemic resulted in restructuring didactics and clinical care based on the needs of the hospital. There were also societal changes affecting patients and trainees. Subspecialty programs with declining scores and certification exam passing rates may need to assess their educational and clinical programs and adapt to the needs of trainees’ learning edges. WHAT’S NEW: This retrospective observational study is the first to look at summative pediatric subspecialty in-training exam scores and board certification passing rates for first-time test takers, specifically analyzing differences in pre-pandemic and pandemic scores. Program directors can follow trends to consider if adaptions need to be made to their curriculum.