Analysis of performance and predictors of success in the final fellowship examination of the College of Intensive Care Medicine

Objectives: To analyse the performance and predictors of success in the final fellowship examination of the College of Intensive Care Medicine (CICM), and to compare the outcomes of international medical graduates (IMGs) attempting the CICM fellowship exam with those of local trainees, defined as those from Australia, New Zealand and Hong Kong (ANZ-HK). To compare the performance of IMGs from countries with comparable health care systems (CHS) with those from other countries (non-CHS). Design, setting and participants: Analysis of six exam presentations collected prospectively between 2009 and 2011. Main outcome measures: Pass rates in the final fellowship exam. Results: Between 2009 and 2011, 233 candidates presented to the exam 334 times, and 73% were IMGs. ANZ-HK trainees performed better at the exam (79% v 46%, P < 0.0001). IMG trainees from CHS performed better than trainees from non-CHS (60% v 40%, P < 0.01). Any candidate completing an ANZ primary exam performed better than non-ANZ primary candidates (74% v 41%, P < 0.0001). IMG candidates successful at a postgraduate exam from a CHS country performed better than candidates from a non-CHS country (56% v 34%, P =0.005). The success rate of IMGs improved to 64% after obtaining an ANZ primary. Candidates taking the exam while working in an intensive care unit had a pass rate of 57% compared with 48% of candidates working in non-ICU posts (P = 0.23). This was not statistically significant. Conclusions: A significant proportion of candidates appearing for the CICM fellowship examination are IMGs. Pass rates for trainees who have graduated from the ANZ- HK systems have a higher success rate in the fellowship examination. IMGs from a CHS country, or those who completed an ANZ primary have a much higher success rate compared with other IMGs