1. Association between licensing examination scores and resource use and quality of care in primary care practice.
Physicians with higher licensing examination scores referred more of their patients for consultation, prescribed to elderly patients fewer inappropriate medications, and more disease-specific medications relative to symptom-relief medications, and referred more women aged 50-69 years for mammography screening.
2. Association between licensure examination scores and practice in primary care.
Physicians achieving higher scores on both examinations had higher rates of mammography screening and consultation. Higher scores of drug knowledge were predictive of a lower rate of contraindicated prescribing for MCCQE. Scores achieved on certification examinations and licensure examination taken at the end of medical school show a sustained relationship over 4-7 years, with indices of preventative care and acute and chronic disease management in primary care practice.
3. Disciplinary action by medical boards and prior behavior in medical schools.
Disciplinary action by a medical board was strongly associated with prior unprofessional behavior in medical schools for a population attributable risk of disciplinary action of 26%. The types of unprofessional behavior most strongly linked with disciplinary action were severe irresponsibility and severely diminished capacity for self-improvement. Disciplinary action my a medical board was also associated with low scores on the MCAT and poor grades in the first two ears of medical school but association with these variables was less strong.
4. Physician scores on a national clinical skills examination as predictors of complaints to medical regulatory authorities.
Scores achieved in patient-physician communication and clinical decision making on a national licensing examination predicted complaints to medical regulatory authorities.
6. Predictive validity of certification by the American Board of Internal Medicine
Physicians certified by the American Board of Internal Medicine had significantly higher scores on the written exam than the noncertified physicians. Ratings of clinical skills by professional associates were significantly higher for certified internists and also correlated highly with ABIM certification examination.
7. A survey of sued and nonsued physicians and suing patients
Results suggested that claims or threats of malpractice suits had a negative impact on physicians’ practices and emotional well-being; this negative impact was more pronounced when the sued physician had been more personally involved with his patient prior to the malpractice claim and that the understanding of the relationship between the suing patient and the sued physician significantly differed.