Predicting resident clinical performance with in-training examinations.

Yearly oral in-training examinations that assess resident performance in the three domains of professional competence (cognitive, psychomotor, and affective) given over a seven year period correlated highly with subsequent resident clinical performance and also predicted with a high degree of significance, sensitivity, and specificity those "problem" interns whose clinical performance placed them in the lower 10% of interns. Scores received on written in-training examinations were not significantly correlated with clinical performance and did not identify "problem" residents.