Evaluation of the Orthopaedic In-Training Examination: spine questions.

Background The annual Orthopaedic In-Training Examination (OITE) is an objective evaluation administered annually to all residents by the American Academy of Orthopaedic Surgeons. To our knowledge, there are no guidelines for the type of material included on the examination; therefore, it is difficult for many academic centers to develop education programs directed toward improving resident performance on the OITE. Our goals were to determine the most commonly tested subjects in the spine portion of the OITE and to help direct development of an associated teaching program. Methods We analyzed the number, type, anatomic focus, subject matter, and visual diagnostic modalities of spine questions on the OITEs from 2002 through 2007 and identified the most commonly referenced journals. Results The average annual number of spine questions was 23.1 (8.4% of the examination). The most common types of spine questions related to knowledge (44.5%), evaluation and decision making (29.1%), and diagnosis (26.3%); the most common subject matters were trauma (15.1%) and anatomy (13.7%). The most frequently examined anatomic locations were the cervical (30.9% of questions) and lumbar (17.4%) spines. General spine information (no anatomic focus) accounted for 31.6% of questions. The most commonly referenced journals were Spine and The Journal of Bone and Joint Surgery, American Volume . Conclusions Developing a study plan focusing on these journals and the most commonly tested topics and question types will better prepare orthopedic residents for the spine questions on the OITE.