A comprehensive examination for senior surgical residents

Background: Two complimentary examinations designed to comprehensively assess competence for surgical practice have been developed. The Objective Structured Assessment of Technical Skill (OSATS) evaluates a resident’s operative skill, and the Patient Assessment and Management Examination (PAME) evaluates clinical management skills. Methods: Twenty-four postgraduate year (PGY)-4 and PGY-5 general surgery residents from four training programs were examined. Each examination had eight stations, with a total of 6 hours of testing time. Results: Interstation reliability for the OSATS was 0.64, for the PAME was 0.71, and for the total test was 0.74. Examination scores discriminated between PGY-4 and PGY-5 residents for the OSATS (t = 4.39, P <.01), the PAME (t = 1.86, P <.05), and the total examination (t = 3.90, P <.01). Year of training accounted for 40%, of the variance of scores. Conclusions: This comprehensive examination is a reliable and valid method of assessing critical skills in senior surgical residents and may be useful for the formal assessment of readiness for practice.