Norm Tables 15

Medical Knowledge Self-Assessment Program

Performance Interpretation Guidelines with Norm Tables

MKSAP 15

Copyright 2010 American College of Physicians

MKSAP 15 Performance Interpretation Guidelines with Norm Tables Section I. How Do You Compare to Your Peers?....................................... 6 Section II. Participant Groups ..................................................................... 9 Section III. What You Need to Know About Your Scores .......................... 9

A. Introduction.................................................................................. 9 B. Content Validity ......................................................................... 10 C. Reliability (Rel) .......................................................................... 11 D. Standard Error of Measurement (SEM) .................................... 12

Section IV. Norm Tables........................................................................... 13 Section V. Answer Key and Percentage Answering Correctly ................. 16 Part A

Cardiovascular Medicine ............................................................... 16 Gastroenterology and Hepatology................................................. 18 Hematology and Oncology ............................................................ 20 Neurology....................................................................................... 22 Rheumatology................................................................................ 23

Part B Dermatology .................................................................................. 24 Endocrinology and Metabolism...................................................... 25 General Internal Medicine.............................................................. 27 Infectious Disease ......................................................................... 29 Nephrology..................................................................................... 31 Pulmonary and Critical Care Medicine .......................................... 32

Section VI. Self-Scoring Instructions ........................................................ 34

Principal Staff Deputy Executive Vice President, Senior Vice President, Medical Education and Publishing

Steven E. Weinberger, MD, FACP Vice President, Medical Education

D. Theresa Kanya, MBA Director, Self-Assessment Programs

Sean McKinney Managing Editor

Margaret Wells

Program Administrator and CME Coordinator Valerie Dangovetsky

Senior Staff Editors

Katie Idell Becky Krumm, ELS Ellen McDonald, PhD, ELS

Staff Editor

Karen Nolan, MA Production Administrator/Editor

Randy Hendrickson, MS, MPP Assistant Editors

John Haefele Megan Zborowski

Developed by the American College of Physicians

Acknowledgements

Computer scoring and reporting are being done by ACT, Iowa City, Iowa.

Continuing Medical Education

The American College of Physicians is accredited by the Accreditation

Council for Continuing Medical Education (ACCME) to provide continuing

medical education for physicians.

The American College of Physicians designates this educational activity

for a maximum of 166 AMA PRA Category 1 Credits. Physicians should

only claim credit commensurate with the extent of their participation in the

activity.

The American Medical Association has determined that physicians not

licensed in the United States who participate in this CME activity are

eligible for AMA PRA Category 1 Credit.

Credit is available from July 31, 2009 to July 31, 2012.

Learning Objectives

The learning objectives of the Medical Knowledge Self-Assessment

Program are to:

Close gaps between actual care in your practice and preferred standards of care, based on best evidence

Diagnose disease states that are less common and sometimes overlooked and confusing

Improve management of comorbidities that can complicate patient care

Determine when to refer patients for surgery or care by subspecialists

Pass the ABIM certification examination Pass the ABIM maintenance of certification examination

Target Audience

General internists and primary care physicians Subspecialists who need to remain up-to-date in internal medicine Residents preparing for the certifying examination in internal

medicine

Physicians participating in maintenance of certification in internal medicine (recertification)

Educational Disclaimer

The editors and publisher of Medical Knowledge Self-Assessment

Program 15 recognize that the development of new material offers many

opportunities for error. Despite our best efforts, some errors may persist in

print. Drug dosage schedules are, we believe, accurate and in accordance

with current standards. Readers are advised, however, to ensure that the

recommended dosages in MKSAP 15 concur with the information

provided in the product information material. This is especially important in

cases of new, infrequently used, or highly toxic drugs.

The primary purpose of MKSAP 15 is educational. Information presented,

as well as publications, technologies, products, and/or services discussed,

are intended to inform subscribers about the knowledge, techniques, and

experiences of the contributors. A diversity of professional opinion exists,

and the views of the contributors are their own and not those of the ACP.

The ACP disclaims any and all liability for damages and claims, which may

result from the use of information, publications, technologies, products,

and/or services discussed in MKSAP 15.

Publishers Information

Copyright 2010 American College of Physicians, Inc. All rights reserved.

This publication is protected by copyright. No part of this publication may

be reproduced, stored in a retrieval system, or transmitted in any form or

by any means, electronic or mechanical, including photocopy, without the

express consent of the ACP.

Important copyright information from the ACP: Unauthorized reproduction

of this publication is unlawful. The ACP prohibits reproduction of this

publication in its entirety in any form either for individual use or for

distribution.

The ACP will consider granting an individual permission to reproduce only

limited portions of this publication for his or her own exclusive use. Send

requests in writing to MKSAP Permissions, American College of

Physicians, 190 N. Independence Mall West, Philadelphia, PA 19106-

1572.

Printed in the United States of America.

For order information in the US or Canada call 800-523-1546, extension

2600. All other countries call 215-351-2600. Fax inquiries to 215-351-

2799, or email to [email protected].

SECTION I. HOW DO YOU COMPARE TO YOUR PEERS?

Welcome to the new Medical Knowledge Self-Assessment Program

(MKSAP) Performance Interpretation Guidelines with Norm Tables. The

NORM TABLES were based on the results of pre-publication test-takers

who did not have access to the syllabus, test answers, and critiques. The

goal of this approach was to record test scores that realistically reflected

physicians knowledge.

This supplement will help you interpret your scores on the multiple-choice

questions from the 15th edition of MKSAP, and, in conjunction with your

performance report, can help you plan an individualized program of

continuing education. MKSAP 15 can also help you identify strengths or

weaknesses in specific subspecialty areas of internal medicine, enhance

your general knowledge, keep you abreast of new developments, and

prepare you for future examinations.

MKSAP 15 was composed of three program components, referred to as

Parts A, B, and C. The first two components, Parts A and B, included

Syllabi, Bibliographies, and Multiple-Choice Questions for 11 internal

medicine subspecialty books. Part A was composed of five subspecialty

test sections, and Part B was composed of six subspecialty test sections.

After publication of the program, Individual Performance Reports for each

part are sent to purchasers of the program who submit answer sheets to

ACT, the American College of Physicians (ACP) scoring vendor, for CME

credit. Individual Performance Reports are cumulative, presenting the total

percent correct score and number of CME credits earned for each new

subspecialty test completed as well as all previously completed subspecialty

tests. The test question numbers of all questions answered incorrectly in

the most recent test are listed with the score in each Individual Performance

Report. These reports can aid you in determining your particular strengths

and weaknesses. Parts A and B also included the Answers, Critiques,

Educational Objectives, and Bibliographies for Multiple-Choice Questions.

Part C is this supplement, Performance Interpretation Guidelines with Norm

Tables.

If you have not received individual performance reports, you may score your

own tests by using the answer keys provided in the MKSAP 15 books and

Section V of this supplement and the Self-Scoring Instructions provided in

Section VI. Self-scoring instructions are also provided at the beginning of

the self-assessment section of each subspecialty book.

To achieve the maximum educational benefit from Parts A and B of

MKSAP 15, you should rely on the materials listed below:

1. Syllabus and Multiple-Choice Questions

2. Answers, Critiques, and Bibliographies

3. Your Individual Performance Reports, after submitting tests for CME

credit

4. This supplement, Performance Interpretation Guidelines with Norm

Tables

This supplement contains five additional sections.

SECTION II. PARTICIPANT GROUPS. This section describes

participants who submitted their tests for the analysis of data and

norm groups.

SECTION III. WHAT YOU NEED TO KNOW ABOUT YOUR

SCORES. This section describes the steps taken to ensure the

validity of the test questions and the scores. It also describes how

the accuracy of the scores was evaluated and why this information is

important.

SECTION IV. NORM TABLES. This section contains norm data for

participants and instructions for using the norm tables.

SECTION V. ANSWER KEY, AND PERCENTAGE ANSWERING

CORRECTLY. This section contains an answer key for each

subspecialty section and defines the percentage of participants

answering each test question correctly.

SECTION VI. SELF-SCORING INSTRUCTIONS. This information

will help you compute your percent correct score.

SECTION II. PARTICIPANT GROUPS

Before you interpret the statistics provided in Section III and use the NORM

TABLES, consider which participants' scores were used to develop the

data. Groups were defined on the basis of information provided by

participants in online question modules. These pre-publication participants,

recruited through emails sent to ACP members and notices posted on the

ACP Web site, were asked to use their existing knowledge to answer

questions, without accessing clinical reference material. As part of a pre-test

screening process, physicians were asked to identify their primary

subspecialty and were excluded from accessing tests related to their

primary area of expertise.

SECTION III. WHAT YOU NEED TO KNOW ABOUT YOUR SCORES

A. INTRODUCTION

Participants in MKSAP 15 may note that their scores vary greatly from the

NORM TABLES scores. There may be a variety of reasons for this

discrepancy. One, of course, is that some participants are significantly

more knowledgeable or less knowledgeable than other participants.

Other factors that could contribute to score variance:

Participants who read the syllabus and soon thereafter answer the questions will do better on the test than someone who answers the

questions without having read the syllabus.

Those who read the test questions just before studying the syllabus and then answer the questions may also score higher.

Some participants take the test as a "closed book" exercise; others do not.

Some participants seek consultation from content experts; others attend educational group meetings before completing the tests.

Your own scores may be influenced by such factors.

B. CONTENT VALIDITY

The validity of the scores relied on the expertise of distinguished clinicians

and educators who selected the content presented in each syllabus.

Syllabus content emphasized recent significant medical developments.

Test questions reflected primarily the material presented in each syllabus.

After the questions were written, they passed through a series of editorial

procedures designed to ascertain clarity, conciseness, and freedom from

technical flaws. Even after the tests were administered, questions with

unusual statistical performance were reviewed again by content experts.

Questions in these tests that were determined to be flawed, too ambiguous,

or too subspecialized were excluded from scoring. These questions are not

counted toward CME credit. The excluded questions include:

Cardiovascular Medicine: questions 67, 93, 118 Gastroenterology & Hepatology: question 63 Neurology: questions 43, 50 Rheumatology: question 62 Dermatology: question 21 General Internal Medicine: questions 58, 91 Infectious Disease: questions 31, 60 Pulmonary and Critical Care Medicine: questions 23, 36

C. RELIABILITY (REL)

It is important that test scores provide reliable estimates of ability. The

reliability (REL) coefficient was a measure of internal consistency that

provided an estimate of the accuracy or stability of the scores. An

examination was reliable to the extent that, if the ACP were to re-examine

participants with a comparable form of the test, scores would be about the

same on the second test as on the first. The reliability coefficient may range

from 0.00 to 1.00.

When scores are used to provide educational feedback for the assessment

of strengths and weaknesses, as they are for MKSAP 15, it is

recommended that the reliability be .70 or higher. The table below shows

the reliability for each subspecialty section.

SUBSPECIALTY SECTION REL Cardiovascular Medicine .94 Gastroenterology and Hepatology .94 Hematology and Oncology .95 Neurology .93 Rheumatology .89 Dermatology .80 Endocrinology and Metabolism .95 General Internal Medicine .93 Infectious Disease .93 Nephrology .90 Pulmonary and Critical Care Medicine .94

D. STANDARD ERROR OF MEASUREMENT (SEM)

Ideally, the ACP would like to create tests that provide perfectly accurate

measurements of participants' knowledge. In practice, however, scores are

never completely free of error; they are estimates of what might be called

"true ability." The standard error of measurement (SEM) is an index that

indicates how much error there is in test scores.

Using the SEM, it is possible to define a score interval that indicates how far

a test score is likely to stray from a participant's true ability. The interval is

found by adding the SEM to a score and subtracting it from that score.

Observed scores are expected to fall within one SEM of the true ability of

participants two times out of three, or approximately 67% of the time. A

participant whose true ability was 70 would usually receive a score between

65 and 75 (70 - 5 and 70 + 5) in a test. The table below shows the SEM for

each subspecialty test.

SUBSPECIALTY SECTION SEM Cardiovascular Medicine 4.62 Gastroenterology and Hepatology 4.43 Hematology and Oncology 4.17 Neurology 3.98 Rheumatology 3.71 Dermatology 2.68 Endocrinology and Metabolism 4.58 General Internal Medicine 4.75 Infectious Disease 4.56 Nephrology 3.68 Pulmonary and Critical Care Medicine 4.59

SECTION IV. NORM TABLES

The NORM TABLES are useful for determining your standing relative to that

of participants who completed tests before the program was published.

Norm data are provided for each group of participants. The first column

contains PERCENT CORRECT SCORES. The remaining columns contain

PERCENTILE RANKS. The percentile rank indicates the percentage of the

group that scores lower than the corresponding percent correct score.

To use the NORM TABLES, first choose a percent correct score from either

your Individual Performance Report or your own hand score computations.

Then select the table for the norm group with which you would like to

compare yourself. In the first column, locate your PERCENT CORRECT

SCORE. Then read across the table to find your PERCENTILE RANK.

For example, suppose that your score was 83% or 84% correct in

Cardiovascular Medicine. At the percent correct scores of 83-84 on the

NORM TABLE, read across the page to find your percentile rank of 90.6.

Your percentile rank means that 90.6 of the group scored lower than you in

Cardiovascular Medicine.

For each norm table, the N under the subspecialty section indicates the

number of participants who completed tests for that subspecialty before the

program was published.

NORM TABLES FOR MKSAP 15

Percent Correct Score

Cardiovascular Medicine (N=160)

Gastroenterology and Hepatology

(N=132)

Hematology and Oncology (N=115)

Neurology (N=120)

Rheumatology (N=132)

99 and above 96.3 96.2 97.4 97.5 97.0 97-98 95.0 95.7 96.2 95-96 93.9 96.7 93-94 93.8 93.9 93.0 94.2 91-92 93.1 89-90 93.2 91.3 93.3 95.5

87-88 90.4 94.7 85-86 91.9 91.7 88.7 93.2 83-84 90.6 87.8 90.8 92.4 81-82 87.1 86.1 88.3 90.9 79-80 88.1 84.9 82.6 87.5 89.4

77-78 85.6 83.3 79.1 85.8 84.9 75-76 83.8 79.6 77.4 80.8 82.6 73-74 79.4 75.0 71.3 75.0 78.8 71-72 75.6 67.4 63.5 73.3 72.0 69-70 70.6 64.4 56.5 64.2 67.4

67-68 62.5 56.8 53.9 57.5 60.6 65-66 56.3 53.0 51.3 50.8 51.5 63-64 48.8 46.2 47.0 45.0 40.9 61-62 41.3 41.7 42.6 38.3 37.1 59-60 36.9 32.6 33.0 32.5 31.8

57-58 31.3 31.1 30.4 25.8 28.0 55-56 21.9 25.8 28.7 20.8 24.2 53-54 20.6 20.5 25.2 20.0 17.4 51-52 18.1 18.2 17.4 19.2 15.9 49-50 16.3 13.6 15.7 15.8 14.4

47-48 12.5 13.9 10.6 45-46 11.3 12.9 12.2 9.1 43-44 10.6 11.4 11.3 15.0 41-42 10.0 10.6 12.5 6.8 39-40 9.4 9.9 10.0 6.1

37-38 6.9 8.3 9.6 9.2 3.0 35-36 6.3 7.6 7.5 33-34 5.0 6.8 8.7 31-32 4.4 5.3 5.0 2.3 29-30 3.8 4.6 4.4

27-28 2.5 2.3 3.3 1.5 25-26 0.6 1.5 3.5 0.8 23-24 1.7 21-22 0.9 0.8

Below 20

NORM TABLES FOR MKSAP 15 (continued)

Percent Correct Score

Dermatology (N=135)

Endocrinology and

Metabolism (N=132)

General Internal

Medicine (N=150)

Infectious Disease (N=132)

Nephrology (N=144)

Pulmonary and Critical Care

Medicine (N=148)

99 and above 98.5 97.7 98.7 98.5 99.3 97-98 98.0 97.7 95-96 97.0 97.0 96.7 96.2 99.3 98.7 93-94 95.5 95.3 97.9 98.0 91-92 96.3 93.9 94.7 95.5 96.5 97.3 89-90 94.7 94.4 96.6

87-88 94.8 92.4 94.0 93.9 85-86 91.1 88.6 93.3 92.4 93.1 93.9 83-84 92.0 92.4 93.2 81-82 88.2 87.1 88.7 91.7 90.3 89.9 79-80 86.7 86.4 86.7 89.4 89.2

77-78 80.7 82.6 84.7 87.1 87.2 75-76 79.6 77.3 84.9 88.2 84.5 73-74 77.8 77.3 72.0 81.1 86.8 81.1 71-72 75.6 71.2 65.3 76.5 83.3 75.7 69-70 72.6 65.9 60.7 74.2 81.9 71.0

67-68 65.9 59.1 55.3 69.7 75.0 61.5 65-66 49.2 46.7 57.6 72.2 55.4 63-64 60.0 47.0 39.3 53.0 63.2 50.0 61-62 54.8 43.2 34.0 46.2 59.7 43.2 59-60 47.4 37.1 23.3 36.4 54.9 40.5

57-58 32.6 18.7 31.1 48.6 34.5 55-56 37.8 28.8 14.0 26.5 46.5 28.4 53-54 30.4 22.7 9.3 21.2 36.8 21.6 51-52 25.9 21.2 7.3 17.4 35.4 17.6 49-50 20.0 18.9 6.7 14.4 25.7 14.2

47-48 17.4 5.3 12.1 24.3 13.5 45-46 14.8 15.9 4.7 11.4 20.8 43-44 7.4 14.4 4.0 10.6 16.7 41-42 5.2 12.9 8.3 13.9 12.8 39-40 10.6 6.1 9.7 11.5

37-38 9.9 3.3 9.0 10.8 35-36 9.1 2.7 5.3 7.6 10.1 33-34 4.4 5.3 2.0 3.8 6.9 9.5 31-32 3.0 4.6 2.3 5.6 8.8 29-30 3.8 1.3 0.8 4.9 6.8

27-28 0.7 3.0 4.2 4.1 25-26 2.3 3.5 2.7 23-24 1.5 2.1 21-22 0.7 0.7 1.4

Below 20

(Columns continued on next page) Page 16 (Columns continued on next page)

SECTION V. ANSWER KEY AND PERCENTAGE ANSWERING

CORRECTLY

This section contains an answer key for each subspecialty section and the

percentage of pre-publication test-takers who answered each test

question correctly. As noted previously, subspecialists were excluded

from taking tests in their primary areas of expertise to ensure a more

realistic measurement of the general knowledge of all participants.

CARDIOVASCULAR MEDICINE QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 D 80 61 B 49 2 A 87 62 A 49 3 C 57 63 B 87 4 D 95 64 C 50 5 B 72 65 C 72 6 D 54 66 E 64 7 C 29 67 EXCLUDED 8 D 65 68 B 66 9 A 84 69 A 53

10 C 41 70 C 36 11 D 57 71 C 44 12 B 68 72 C 72 13 E 51 73 B 71 14 A 81 74 B 56 15 C 86 75 C 64 16 D 85 76 A 43 17 B 70 77 B 77 18 A 63 78 B 61 19 C 85 79 D 44 20 A 77 80 B 83 21 D 94 81 D 57 22 C 56 82 B 60 23 C 59 83 C 29 24 E 69 84 B 74 25 B 94 85 A 63 26 D 76 86 B 74 27 E 70 87 A 87 28 C 55 88 D 63 29 D 65 89 B 88 30 B 51 90 D 64 31 C 38 91 A 52 32 B 77 92 D 59

CARDIOVASCULAR MEDICINE (continued)

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

33 B 26 93 EXCLUDED 34 A 43 94 A 58 35 D 69 95 B 53 36 B 81 96 B 85 37 B 42 97 D 59 38 B 12 98 B 54 39 C 61 99 E 49 40 C 69 100 B 76 41 E 59 101 B 72 42 D 82 102 D 42 43 C 89 103 A 57 44 A 60 104 D 29 45 D 76 105 D 70 46 D 41 106 B 29 47 D 82 107 A 59 48 A 81 108 D 51 49 D 74 109 A 75 50 B 83 110 B 55 51 E 84 111 C 72 52 D 48 112 A 33 53 B 53 113 D 81 54 A 62 114 D 63 55 B 33 115 B 38 56 B 61 116 B 40 57 D 57 117 B 70 58 D 74 118 EXCLUDED 59 B 76 119 A 56 60 C 69 120 D 36


GASTROENTEROLOGY AND HEPATOLOGY

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 B 67 56 B 47 2 D 51 57 D 69 3 D 65 58 D 83 4 C 89 59 B 89 5 C 84 60 E 68 6 A 42 61 E 49 7 A 80 62 D 80 8 D 39 63 EXCLUDED 9 B 73 64 C 81

10 B 79 65 A 30 11 A 41 66 D 61 12 D 67 67 C 86 13 B 73 68 B 70 14 C 34 69 B 61 15 A 82 70 C 69 16 D 70 71 A 74 17 A 58 72 E 70 18 B 45 73 B 58 19 D 22 74 C 54 20 E 79 75 C 78 21 E 69 76 C 66 22 A 76 77 A 72 23 B 36 78 D 47 24 C 36 79 C 78 25 D 73 80 A 54 26 B 45 81 B 84 27 C 77 82 B 84 28 D 89 83 B 54 29 B 63 84 D 57 30 A 85 85 B 48 31 C 55 86 A 89 32 D 71 87 A 61 33 C 51 88 D 70 34 B 76 89 E 71 35 B 55 90 B 60 36 D 40 91 B 38 37 C 31 92 C 72 38 D 83 93 B 78 39 D 67 94 B 56 40 D 63 95 C 73 41 B 23 96 B 55 42 B 72 97 B 56 43 B 56 98 C 36 44 A 22 99 C 82

GASTROENTEROLOGY AND HEPATOLOGY (continued) QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

45 A 51 100 D 73 46 D 64 101 E 35 47 B 81 102 B 54 48 A 66 103 B 61 49 D 61 104 D 88 50 B 51 105 B 73 51 B 82 106 C 40 52 D 61 107 B 92 53 A 69 108 B 56 54 D 58 109 C 80 55 D 49 110 B 59


HEMATOLOGY AND ONCOLOGY QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 C 30 51 B 63 2 A 66 52 D 39 3 A 83 53 A 76 4 C 49 54 C 94 5 E 66 55 A 62 6 D 70 56 B 56 7 E 90 57 D 49 8 A 65 58 A 83 9 C 93 59 D 50

10 A 41 60 A 57 11 C 79 61 C 57 12 A 43 62 B 46 13 B 70 63 C 68 14 D 87 64 A 74 15 C 43 65 E 43 16 B 48 66 B 50 17 D 74 67 E 65 18 A 35 68 B 45 19 D 37 69 D 94 20 B 78 70 A 63 21 D 64 71 C 46 22 D 76 72 D 61 23 D 48 73 A 72 24 B 43 74 E 56 25 C 61 75 D 52 26 B 45 76 D 67 27 C 74 77 A 63 28 A 68 78 D 64 29 D 85 79 D 80 30 C 80 80 B 49 31 A 43 81 B 41 32 D 82 82 B 88 33 B 75 83 C 63 34 C 70 84 B 62 35 C 33 85 B 65 36 A 40 86 C 64 37 D 63 87 C 82 38 C 68 88 E 83 39 C 65 89 C 45 40 B 63 90 C 90 41 E 72 91 A 22 42 C 87 92 D 56 43 B 95 93 C 41 44 B 81 94 B 65 45 B 25 95 C 87

HEMATOLOGY AND ONCOLOGY (continued) QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

46 B 54 96 C 86 47 A 58 97 E 58 48 D 76 98 B 90 49 C 63 99 C 83 50 A 57 100 B 57

NEUROLOGY QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 B 84 46 D 60 2 A 87 47 B 68 3 B 15 48 C 83 4 C 71 49 D 81 5 D 63 50 EXCLUDED 6 B 79 51 C 66 7 E 31 52 C 65 8 C 67 53 D 54 9 A 84 54 A 65

10 C 44 55 A 42 11 A 75 56 C 86 12 D 57 57 A 71 13 A 38 58 D 76 14 C 52 59 B 90 15 C 74 60 C 73 16 B 79 61 C 60 17 C 28 62 A 45 18 B 80 63 D 57 19 A 50 64 D 46 20 C 53 65 C 78 21 E 51 66 B 50 22 B 46 67 D 56 23 A 29 68 A 83 24 D 85 69 C 75 25 C 86 70 A 70 26 A 66 71 C 44 27 C 38 72 D 84 28 B 66 73 C 84 29 B 49 74 C 79 30 D 67 75 B 72 31 A 39 76 A 38 32 D 84 77 C 88 33 C 40 78 B 48 34 D 52 79 A 65 35 B 72 80 C 68 36 A 73 81 B 52 37 D 89 82 C 63 38 C 85 83 C 66 39 C 65 84 B 49 40 C 85 85 D 48 41 A 61 86 A 61 42 D 42 87 C 36 43 EXCLUDED 88 B 56 44 C 83 89 B 32 45 A 45 90 A 71

RHEUMATOLOGY QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 D 82 41 B 58 2 A 33 42 D 65 3 A 93 43 D 89 4 E 62 44 D 73 5 D 45 45 D 56 6 C 72 46 A 40 7 A 92 47 C 82 8 B 89 48 A 58 9 D 84 49 B 49 10 D 92 50 D 18 11 A 72 51 E 33 12 A 79 52 E 51 13 B 88 53 D 61 14 A 74 54 A 17 15 A 51 55 B 48 16 A 73 56 D 75 17 D 83 57 B 43 18 B 60 58 A 77 19 D 96 59 B 39 20 A 66 60 A 84 21 B 53 61 B 67 22 B 27 62 EXCLUDED 23 B 85 63 E 60 24 B 65 64 A 47 25 D 68 65 C 76 26 B 70 66 D 55 27 D 31 67 A 83 28 D 85 68 D 33 29 D 32 69 B 42 30 A 80 70 D 84 31 C 77 71 A 33 32 C 51 72 A 65 33 D 81 73 A 77 34 A 73 74 D 55 35 A 84 75 C 67 36 A 48 76 C 81 37 D 78 77 B 76 38 D 72 78 A 46 39 C 52 79 A 44 40 B 36

DERMATOLOGY QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 A 64 2 B 76 3 B 93 4 A 83 5 D 53 6 C 67 7 C 51 8 C 36 9 A 14

10 C 50 11 D 56 12 D 73 13 C 82 14 C 81 15 C 51 16 A 72 17 C 53 18 C 57 19 A 27 20 D 48 21 EXCLUDED 22 D 33 23 D 48 24 E 84 25 D 58 26 E 57 27 A 51 28 A 86 29 A 66 30 B 30 31 B 33 32 C 69 33 E 41 34 D 79 35 B 52 36 A 78 37 C 65 38 A 58 39 C 89 40 C 93


ENDOCRINOLOGY AND METABOLISM

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 D 73 59 D 83 2 A 59 60 C 75 3 C 71 61 A 63 4 E 50 62 D 75 5 D 59 63 B 80 6 C 90 64 C 60 7 D 80 65 D 64 8 B 75 66 D 74 9 A 68 67 C 84

10 C 45 68 D 52 11 D 69 69 B 66 12 D 74 70 C 80 13 C 53 71 D 49 14 C 83 72 C 52 15 D 29 73 B 71 16 A 72 74 D 67 17 B 87 75 D 36 18 D 52 76 A 88 19 A 78 77 B 76 20 C 32 78 D 69 21 B 90 79 C 49 22 C 58 80 D 67 23 D 67 81 B 45 24 B 67 82 D 55 25 E 54 83 C 61 26 A 76 84 D 80 27 D 58 85 B 60 28 C 42 86 B 61 29 B 37 87 C 73 30 B 92 88 A 70 31 C 36 89 D 83 32 B 45 90 D 77 33 D 70 91 B 22 34 A 53 92 B 74 35 C 60 93 D 52 36 A 64 94 C 59 37 D 55 95 B 42 38 D 86 96 C 68 39 B 64 97 C 77 40 B 81 98 D 55 41 A 25 99 C 44 42 C 60 100 C 66 43 C 88 101 C 56 44 A 67 102 E 61 45 D 71 103 B 80 46 C 63 104 C 47

ENDOCRINOLOGY AND METABOLISM (continued) QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

47 D 54 105 A 68 48 B 30 106 D 85 49 C 62 107 B 69 50 E 22 108 A 55 51 C 58 109 A 61 52 D 67 110 D 73 53 A 68 111 B 47 54 C 24 112 D 48 55 C 18 113 C 73 56 D 73 114 D 55 57 D 78 115 B 47 58 B 23 116 D 82


GENERAL INTERNAL MEDICINE

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 A 97 68 D 55 2 A 61 69 D 67 3 D 74 70 D 79 4 A 96 71 E 36 5 A 76 72 A 47 6 B 74 73 B 42 7 B 21 74 D 92 8 A 41 75 D 86 9 A 37 76 B 59

10 E 69 77 C 71 11 B 45 78 D 75 12 D 69 79 A 32 13 B 43 80 D 37 14 E 30 81 B 84 15 C 82 82 E 76 16 C 82 83 C 72 17 B 28 84 B 60 18 C 60 85 E 19 19 E 67 86 D 65 20 B 86 87 D 36 21 D 66 88 B 87 22 D 45 89 A 90 23 A 81 90 E 65 24 E 75 91 EXCLUDED 25 E 57 92 A 79 26 B 67 93 D 61 27 C 69 94 D 97 28 A 64 95 B 47 29 B 70 96 D 56 30 C 86 97 B 72 31 A 83 98 B 58 32 A 61 99 A 51 33 C 51 100 C 75 34 C 44 101 D 23 35 A 91 102 D 66 36 C 45 103 D 81 37 B 65 104 B 88 38 D 91 105 E 73 39 C 77 106 C 83 40 E 75 107 E 93 41 E 77 108 D 44 42 A 69 109 E 55 43 C 49 110 B 66

GENERAL INTERNAL MEDICINE (continued) QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

44 C 21 111 A 55 45 D 84 112 A 95 46 B 85 113 A 37 47 D 49 114 D 77 48 C 77 115 D 40 49 A 85 116 C 95 50 C 83 117 D 47 51 C 62 118 D 29 52 C 91 119 E 74 53 A 92 120 A 79 54 C 86 121 A 66 55 C 45 122 D 47 56 E 89 123 B 90 57 C 69 124 B 60 58 EXCLUDED 125 D 77 59 A 41 126 A 77 60 B 47 127 A 87 61 B 95 128 D 70 62 A 51 129 D 81 63 B 85 130 A 67 64 C 34 131 D 53 65 A 63 132 B 72 66 C 76 133 E 50 67 C 91


INFECTIOUS DISEASE

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 C 77 60 EXCLUDED 2 A 89 61 C 77 3 D 17 62 B 83 4 C 77 63 A 73 5 C 53 64 D 19 6 B 28 65 D 24 7 D 85 66 C 52 8 D 32 67 B 71 9 A 93 68 D 64

10 A 88 69 B 89 11 C 56 70 B 75 12 C 34 71 D 61 13 B 80 72 C 44 14 B 90 73 D 44 15 C 33 74 C 70 16 E 11 75 E 57 17 D 90 76 A 55 18 D 74 77 B 61 19 E 44 78 D 81 20 A 48 79 B 87 21 D 76 80 C 89 22 D 26 81 A 65 23 C 40 82 B 80 24 B 76 83 C 49 25 E 36 84 C 81 26 E 61 85 D 65 27 D 42 86 A 51 28 B 75 87 D 95 29 A 86 88 B 50 30 E 39 89 B 61 31 EXCLUDED 90 A 69 32 D 81 91 C 66 33 B 65 92 A 71 34 A 54 93 D 83 35 B 69 94 B 45 36 C 60 95 E 70 37 C 39 96 A 67 38 C 78 97 C 88 39 B 26 98 A 83 40 D 61 99 D 31 41 C 33 100 B 67 42 A 55 101 C 55 43 B 89 102 A 59 44 D 76 103 C 75 45 C 28 104 B 80 46 C 65 105 A 64

INFECTIOUS DISEASE (continued) QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

47 D 29 106 D 74 48 B 56 107 B 56 49 B 64 108 B 49 50 A 67 109 D 41 51 A 68 110 D 69 52 D 73 111 A 83 53 A 56 112 A 52 54 B 80 113 B 26 55 E 66 114 E 70 56 C 78 115 C 66 57 C 65 116 D 33 58 A 67 117 C 65 59 D 77 118 C 64

NEPHROLOGY

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 B 76 37 D 44 2 C 73 38 A 41 3 B 68 39 A 70 4 A 70 40 C 49 5 D 63 41 B 37 6 C 86 42 B 40 7 B 74 43 B 45 8 D 34 44 C 57 9 A 72 45 C 65

10 B 77 46 D 77 11 D 40 47 C 49 12 A 31 48 B 79 13 C 78 49 D 73 14 B 50 50 C 29 15 D 22 51 D 78 16 B 35 52 A 71 17 D 81 53 B 53 18 C 61 54 D 79 19 A 30 55 B 63 20 A 38 56 A 78 21 B 74 57 C 39 22 A 69 58 D 85 23 B 71 59 A 53 24 C 19 60 B 49 25 B 38 61 D 21 26 C 80 62 C 71 27 C 48 63 C 46 28 D 56 64 C 52 29 D 70 65 D 20 30 C 41 66 B 35 31 C 18 67 C 44 32 D 69 68 C 76 33 B 59 69 B 78 34 C 81 70 D 65 35 D 44 71 D 51 36 D 85 72 A 58


PULMONARY AND CRITICAL CARE MEDICINE

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

1 C 76 59 C 73 2 A 66 60 E 77 3 A 33 61 B 57 4 E 15 62 C 85 5 C 38 63 A 55 6 E 59 64 E 35 7 D 82 65 D 65 8 A 53 66 C 82 9 E 72 67 E 65

10 D 71 68 B 63 11 A 63 69 A 63 12 A 76 70 C 69 13 B 85 71 A 80 14 D 80 72 A 62 15 B 47 73 B 73 16 C 37 74 D 71 17 A 51 75 B 88 18 A 43 76 B 47 19 A 84 77 D 30 20 A 59 78 D 53 21 D 22 79 C 52 22 A 85 80 C 58 23 EXCLUDED 81 E 72 24 A 64 82 B 47 25 E 74 83 A 36 26 D 86 84 D 74 27 D 66 85 E 68 28 A 81 86 A 78 29 C 32 87 D 43 30 D 36 88 C 34 31 D 59 89 B 72 32 D 22 90 C 45 33 B 77 91 D 76 34 A 72 92 B 47 35 B 80 93 E 74 36 EXCLUDED 94 A 45 37 C 74 95 D 67 38 B 80 96 B 70 39 D 59 97 C 32 40 A 34 98 A 76 41 A 69 99 A 86 42 B 59 100 B 70 43 C 80 101 C 58 44 A 29 102 D 79 45 C 61 103 D 31 46 C 45 104 E 41

PULMONARY AND CRITICAL CARE MEDICINE (continued) QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

QUESTION NUMBER

ANSWER KEY

PERCENT CORRECT

47 B 49 105 B 79 48 D 49 106 C 36 49 D 38 107 E 75 50 A 30 108 C 67 51 B 73 109 C 60 52 D 67 110 B 73 53 B 53 111 C 61 54 D 72 112 C 71 55 A 60 113 B 36 56 B 79 114 C 61 57 C 66 115 B 61 58 A 60 116 A 84

SECTION VI. SELF-SCORING INSTRUCTIONS

Compute your percent correct score as follows:

Step 1. Give yourself a point for each correct response to each question

in the test in which you are working.

Step 2. Divide the number of correct responses in Step 1 by the number

of accepted questions for the test in which you are working. The number

of accepted questions in each test is listed in the table at the bottom of

this page.

Step 3. Multiply the result by 100.

The final result will be your total percent score, which you can compare to

the Norm Tables under Section IV.

Example #1 Cardiovascular Medicine

Step 1: Record your points. 112 Step 2: Divide the result by 117, which is the total number of questions. 112 117

Step 3: Multiply result by 100. .957 x 100 Total percent correct score 95.70%

Subspecialty Section Number of Published Questions

Number of Excluded Questions

Number of Accepted Questions

Cardiovascular Medicine 120 3 117 Gastroenterology and Hepatology 110 1 109 Hematology and Oncology 100 0 100 Neurology 90 2 88 Rheumatology 79 1 78 Dermatology 40 1 39 Endocrinology and Metabolism 116 0 116 General Internal Medicine 133 2 131 Infectious Disease 118 2 116 Nephrology 72 0 72 Pulmonary and Critical Care Medicine 116 2 114

Performance Interpretation Guidelines with Norm TablesTable of ContentsSECTION I. HOW DO YOU COMPARE TO YOUR PEERS?SECTION II. PARTICIPANT GROUPSSECTION III. WHAT YOU NEED TO KNOW ABOUT YOUR SCORESSECTION IV. NORM TABLESSECTION V. ANSWER KEY AND PERCENTAGE ANSWERING CORRECTLYPart ACARDIOVASCULAR MEDICINEGASTROENTEROLOGY AND HEPATOLOGYHEMATOLOGY AND ONCOLOGYNEUROLOGYRHEUMATOLOGY

Part BDERMATOLOGYENDOCRINOLOGY AND METABOLISMGENERAL INTERNAL MEDICINEINFECTIOUS DISEASENEPHROLOGYPULMONARY AND CRITICAL CARE MEDICINE

SECTION VI. SELF-SCORING INSTRUCTIONS

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Norm Tables 15

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