Original Article

Association between Orthopaedic In-Training Examination Subsection Scores and ABOS Part I Examination Performance

Authors: Brent Ponce, MD, Jay Savage, MD, Amit Momaya, MD, Jacob Seales, MD, James Oliver, MD, Gerald McGwin, PhD, Steven Theiss, MD


Objectives: The Orthopaedic In-Training Examination (OITE) is administered yearly to assess a resident’s progression, compare his or her performance with that of other residents, and evaluate the educational structure of a residency program. The American Board of Orthopaedic Surgery (ABOS) Part I examination is used to ensure competence in orthopedic knowledge and must be passed to achieve certification. Previous studies have correlated OITE and ABOS performance, but analysis between OITE subsection performance and ABOS Part I examination performance has not been reported. The purpose of this study was to evaluate the relation between individual OITE subsection performance and overall ABOS Part I performance.

Methods: Performance on the 12 subsections comprising the OITE from 1999 to 2009 was evaluated and compared with overall ABOS Part I examination performance. Spearman correlation coefficients (SCCs) were used to quantify the association between OITE subsection and overall ABOS percentile ranks.

Results: The OITE subsections of musculoskeletal trauma (SCC 0.29; P = 0.0002), hip and knee reconstruction (SCC 0.21; P = 0.0064), spine (SCC 0.16; P = 0.04), orthopedic science (SCC 0.17; P = 0.03), and orthopedic disease (SCC 0.18; P = 0.02) correlated with ABOS percentile ranks. Five of the top seven subsections by question volume on the OITE were found to correlate with ABOS performance.

Conclusions: OITE subsections with greater representation and breadth of subject matter had stronger performance correlations with ABOS Part I examination performance. These findings may allow residency training programs to better predict ABOS Part I performance of their residents by evaluating particular subsections on the OITE in addition to overall OITE performance.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. DeRosa GP. How to pass the American Board of Orthopaedic Surgery certifying examinations. J Bone Joint Surg Am 2002;84:2309-2311.
2. Risner B, Nyland J, Crawford CH 3rd, et al. Orthopaedic in-training examination performance: a nine-year review of a residency program database. South Med J 2008;101:791-796.
3. Mankin HJ. The Orthopaedic In-Training Examination (OITE). Clin Orthop Relat Res 1971;75:108-116.
4. Mankin HJ, Carter RM, Krawczyk M. The effect of permissive environment on scoring of the orthopaedic in-training examination. J Bone Joint Surg Am 1973;55:1100-1111.
5. Dougherty PJ, Walter N, Schilling P, et al. Do scores of the USMLE Step 1 and OITE correlate with the ABOS Part I certifying examination? A multicenter study. Clin Orthop Relat Res 2010;468:2797-2802.
6. Herndon JH, Allan BJ, Dyer G, et al. Predictors of success on the American Board of Orthopaedic Surgery examination. Clin Orthop Relat Res 2009;467:2436-2445.
7. Klein GR, Austin MS, Randolph S, et al. Passing the Boards: can USMLE and Orthopaedic in-Training Examination scores predict passage of the ABOS Part-I examination? J Bone Joint Surg Am 2004;86-A:1092-1095.
8. Swanson D, Marsh JL, Hurwitz S, et al. Utility of AAOS OITE scores in predicting ABOS Part I outcomes AAOS exhibit selection. J Bone Joint Surg Am 2013;95:e84.
9. Frassica FJ, Papp D, McCarthy E, et al. Analysis of the pathology section of the OITE will aid in trainee preparation. Clin Orthop Relat Res 2008;466:1323-1328.
10. Lackey WG, Jeray KJ, Tanner S. Analysis of the musculoskeletal trauma section of the Orthopaedic In-Training Examination (OITE). J Orthop Trauma 2011;25:238-242.
11. Papp DF, Ting BL, Sargent MC, et al. Analysis of the pediatric orthopedic surgery questions on the Orthopaedic In-Training Examination, 2002 through 2006. J Pediatr Orthop 2010;30:503-507.
12. Seybold JD, Srinivasan RC, Goulet JA, et al. Analysis of the orthopedic in-training examination (OITE) musculoskeletal trauma questions. J Surg Educ 2012;69:8-12.
13. Srinivasan RC, Seybold JD, Kadakia AR. Analysis of the foot and ankle section of the Orthopaedic In-Training Examination (OITE). Foot Ankle Int 2009;30:1060-1064.
14. Srinivasan RC, Seybold JD, Salata MJ, et al. An analysis of the Orthopaedic In-Training Examination sports section: the importance of reviewing the current orthopaedic subspecialty literature. J Bone Joint Surg Am 2010;92:778-782.
15. Accreditation Council for Graduate Medical Education. Orthopaedic surgery case logs. https://www.acgme.org/acgmeweb/Portals/0/ORSNatData1213.pdf. Published September 2013. Accessed November 7, 2014.
16. Buckwalter JA, Schumacher R, Albright JP, et al. Use of an educational taxonomy for evaluation of cognitive performance. J Med Educ 1981;56:115-121.