AGA Gastroenterology Training Exam (GTE): A Progress Report

Subspecialty fellowship program directors (PDs) are keenly interested in monitoring and enhancing their trainees’ academic progress throughout their fellowship experience. In addition to assessing trainee clinical acumen and knowledge base, PDs are required to demonstrate growth in clinical performance to validate advancement to subsequent training years, for which training programs have been confronted with increasing requirements by the Accreditation Council for Graduate Medical Education (ACGME). The ACGME has established core competency domains under which trainee progress can be objectively evaluated (medical knowledge, patient care, practice-based learning and improvement, systems-based practice, interpersonal and communication skills, and professionalism). These assessments potentially identify strengths and weaknesses at the individual level, prompting additional study and clinical exposures in these domains. Further, these evaluations facilitate the PDs’ identification of potential strengths and deficiencies in fellowship training at the institution, such that one can optimize the focus of future didactic lectures, faculty and program development, and potentially even strategic faculty recruitment. The standardized training examination addresses both educational development of the individual trainee, and resources in imparting training and education on the part of the training program. Therefore, the goal of such an examination needs to be formative, that is, to perform an assessment that will provide feedback to the trainee and PD which can be used to inform future teaching and learning opportunities. This is in contrast to American Board of Internal Medicine (ABIM) certification, which functions as a summative examination and is intended to evaluate clinical proficiency and competence for licensing purposes. Given the objective of the GTE, gastroenterology fellows are encouraged to not dedicate formal “study” in anticipation of taking the GTE.