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P5: Plenary Session 5

RS17 - Predictors of standardized exam outcomes in vascular surgery training

Friday, June 21, 2024
9:05 AM – 9:12 AM CT
Location: West Building, Level 3, Skyline Ballroom W375ab
Objectives: The Vascular Surgery In-Training Examination (VSITE) and Vascular Surgery Board Qualifying Exam (VQE) form the backbone of standardized testing for vascular surgery trainees. While multiple studies have evaluated predictors for exam outcomes, few have incorporated demographic and training specific metrics. The purpose of this study is to evaluate the impact of burnout and mistreatment on resident VSITE and program VQE performance.

Methods: Data was collected from a confidential, voluntary survey administered after the 2020-2023 VSITE as part of the SECOND trial. VSITE scores were calculated as percent correct then standardized. Program VQE pass rate was calculated as an average over five years. Multivariable linear regression was used to evaluate predictors of exam outcomes over time. Trainee demographics and program specific variables were considered in both analyses. Residencies and fellowships were considered separately in the program level VQE model. VSITE analyses were further stratified by integrated (VSR) and independent (VSF) training paradigms.

Results: A total of 1601 trainee responses were collected over three years (564 in 2020, 510 in 2021, 527 in 2022), roughly divided between integrated and traditional trainees (n=678 or 45% fellows, n=829 or 55% residents). Most trainees answered the burnout inventory (72% in 2020, 90% in 2021, 94% in 2022). On average, 45.6% of residents reported at least weekly burnout symptoms (44.6% in 2020, 46.0% in 2021, 46.4% in 2022). On unadjusted analysis, burnout symptoms correlated with a 14 point drop in VSITE score (95% confidence interval (CI) -23.62,-4.07, p=0.006). Burnout was no longer significant on adjusted analysis. Instead, significant positive predictors included more senior trainee level, being in a relationship, male gender, and among non-Hispanic white residents. (Table I) When stratifying by training paradigm, burnout was a significant predictor for VSF but not for VSR. (Table II)
A total of 473 program responses were evaluated over three years (125 in 2021, 171 in 2022, 177 in 2023). Program level burnout was not predictive of VQE pass rates on unadjusted or adjusted analysis. However, there has been a trend towards increasing average pass rates by 1.8% per year (p=0.02).

Conclusions: Despite high rates of burnout, trainees generally demonstrate resilience in gaining the medical knowledge necessary to pass the VSITE and VQE. Performance on standardized exams is reliably predicted by training level, gender, race, trainee support systems and training paradigm. VSF trainees experienced an association between burnout and scores on adjusted analysis.