Women's health content validity of the family medicine in-training examination

Background: Women's health is the field of medicine that addresses the special health care needs of women. It includes conditions more common, different, or unique to women. The primary means of knowledge assessment for family medicine residents is the Family Medicine In-training Examination (FMITE). This study describes the degree to which the FMITE tests residents for knowledge of women's health. Methods: This was a content validity study using item analysis to identify FMITE women's health questions. The curriculum standard was the 2004 American Academy of Family Physicians (AAFP) Women's Health Curriculum Guidelines. Two independent reviewers verified the method of identifying women's health questions. The test sample included 3,460 questions (1996-2005 FMITEs). Results: Women's health questions made up 23% of the sample. Content areas and topics from the AAFP curriculum were sampled unevenly. The exam emphasized reproductive health and failed to assess knowledge of older women's health. Discussion: The FMITE does test resident knowledge of the traditional subjects of obstetrics and gynecology but does not provide an adequate assessment of the breadth of knowledge of women's health.