Research ArticleOriginal Research

Community Size and Organization of Practice Predict Family Physician Recertification Success

Bradley M. Schulte, David M. Mannino, Kenneth D. Royal, Sabrina L. Brown, Lars E. Peterson and James C. Puffer
The Journal of the American Board of Family Medicine May 2014, 27 (3) 383-390; DOI: https://doi.org/10.3122/jabfm.2014.03.130016

Article Figures & Data

Figures

  • Figure 1.
    Figure 1.

    Examination results of family physicians taking the American Board of Family Medicine recertification examination in July 2009 stratified by rural definition. *Moderate rural definition: rural ≤ 25,000 in community, metropolitan ≥ 500,000 in community. †Conservative rural definition: rural ≤ 10,000 in community, metropolitan ≥ 1,000,000 in community.

  • Figure 2.
    Figure 2.

    Plot of the odds ratios for regression analyses for prediction of likelihood of passing American Board of Family Medicine Maintenance of Certification for Family Physicians examination using moderate rural definition (rural ≤ 25,000 in community, metropolitan ≥ 500,000 in community).

  • Figure 3.
    Figure 3.

    Plot of the odds ratios for regression analyses for prediction of likelihood of passing American Board of Family Medicine Maintenance of Certification for Family Physicians examination using conservative rural definition (rural ≤ 10,000 in community, metropolitan ≥ 1,000,000 in community).

Tables

  • Table 1. Demographics of Family Physicians taking the American Board of Family Medicine Recertification Examination in July 2009 (n = 8361)
    DemographicsPhysicians
    Mean age (SD), years52.2 (±8.69)
    Organization of practice
        Group3692 (44.2)
        Independent (solo)1561 (18.7)
        Other3108 (37.1)
    Sex
        Male5465 (65.4)
        Female2896 (34.6)
    Examination result
        Pass7145 (85.5)
        Fail1216 (14.5)
    Medical training
        United States and Canada7167 (85.7)
        International1194 (14.3)
    Degree
        MD7704 (92.1)
        DO657 (7.9)
    Academic appointment
        None6088 (72.8)
        Yes, full-time409 (4.9)
        Yes, part-time1864 (22.3)
    Any other certification held
        Yes223 (2.7)
        No8138 (97.3)

    • Data are n (%) unless otherwise indicated.

    • SD, standard deviation.

  • Table 2. Demographics of Family Physicians taking the American Board of Family Medicine Recertification Examination in July 2009, Stratified by Rural Definition
    DemographicsModerate Definition*Conservative Definition†
    Rural (n = 2117)Metropolitan (n = 1613)P ValueRural (n = 1099)Metropolitan (n = 1009)P Value
    Mean age (SD), years52.87 (±8.61)52.13 (±8.70).00952.86 (±8.56)51.9 (±8.73).011
    Organization of practice<.001<.001
        Group996 (47.0)626 (38.8)518 (47.1)356 (35.3)
        Independent (solo)458 (21.6)281 (17.4)221 (20.1)181 (17.9)
        Other663 (31.4)706 (43.8)360 (32.8)472 (46.8)
    Sex<.001<.001
        Male1519 (71.8)995 (61.7)782 (71.2)642 (63.6)
        Female598 (28.2)618 (38.3)317 (28.8)367 (36.4)
    Examination result<.001<.001
        Pass1886 (89.1)1354 (83.9)990 (90.1)837 (83)
        Fail231 (10.9)259 (16.1)109 (9.9)172 (17)
    Medical training<.001<.001
        United States and Canada1942 (91.7)1330 (82.4)1012 (92.1)821 (81.4)
        International175 (8.3)283 (17.5)87 (7.9)188 (18.6)
    Degree.001.010
        MD1933 (91.3)1521 (94.3)1001 (91.1)949 (94.1)
        DO184 (8.7)92 (5.7)98 (8.9)60 (5.9)
    Academic appointment<.001<.001
        None1586 (74.9)1102 (68.3)816 (74.2)677 (67.1)
        Yes, full-time30 (1.4)146 (9.1)14 (1.3)98 (9.7)
        Yes, part-time501 (23.7)365 (22.6)269 (24.5)234 (23.2)
    Any other certification held.009.007
        Yes44 (2.1)56 (3.5)21 (1.9)39 (3.9)
        No2073 (97.9)1557 (96.5)1078 (98.1)970 (96.1)

    • Data are n (%) unless otherwise indicated.

    • ↵* Moderate rural definition: rural ≤ 25,000 in community, metropolitan ≥ 500,000 in community.

    • ↵† Conservative rural definition: rural ≤ 10,000 in community, metropolitan ≥ 1,000,000 in community.

    • SD, standard deviation.

  • Table 3. Adjusted Associations between Physician Characteristics and Odds of Passing the July 2009 American Board of Family Medicine Recertification Examination by Two Rural Definitions
    CharacteristicsModerate Definition*Conservative Definition†
    Rurality
        RuralReferenceReference
        Metropolitan0.67 (0.54–0.83)0.56 (0.42–0.74)
    Organization of practice
        GroupReferenceReference
        Independent (solo)0.45 (0.35–0.58)0.48 (0.34–0.68)
        Other0.98 (0.77–1.26)1.11 (0.80–1.54)
    Sex
        MaleReferenceReference
        Female0.82 (0.66–1.03)0.81 (0.60–1.10)
    Age, per year increase0.95 (0.93–0.96)0.94 (0.93–0.96)
    Medical training
        United States and CanadaReferenceReference
        International0.21 (0.17–0.27)0.23 (0.17–0.32)
    Degree
        MDReferenceReference
        DO0.28 (0.20–0.39)0.31 (0.20–0.48)
    Academic appointment
        NoneReferenceReference
        Yes, full-time1.42 (0.81–2.49)1.61 (0.79–3.31)
        Yes, part-time1.19 (0.93–1.54)1.26 (0.90–1.76)
    Any other certification held
        NoReferenceReference
        Yes1.40 (0.74–2.68)1.04 (0.49–2.24)

    • Data are odds ratios (95% confidence intervals).

    • ↵* Moderate rural definition: rural ≤25,000 in community, metropolitan≥ 500,000 in community.

    • ↵† Conservative rural definition: rural ≤10,000 in community, metropolitan ≥1,000,000 in community.

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