BACKGROUND: The National Medical Licensing Examination (NMLE) is the only objective, standardized metric to evaluate whether a medical student possessing the professional knowledge and skills necessary to work as a physician. However, the overall pass rate of NMLE in our hospital in 2021 was much lower than that of Peking Union Medical College Hospital, which was required to be further improved.
METHODS: To find the reasons for the unsatisfactory performance in 2021, the quality improvement team (QIT) organized regular face-to-face meetings for in-depth discussion and questionnaire, and analyzed the data by \"Plato analysis\" and \"Brainstorming method\". After finding out the reasons, the \"Plan-Do-Check-Action\" (PDCA) cycle was continued to identify and solve problems, which included the formulation and implementation of specific training plans by creating the \"Gantt charts\", the check of effects, and continuous improvements from 2021 to 2022. Detailed information about the performance of students in 2021 and 2022, and the attendance, assessment, evaluation and suggestions from our hospital were provided by the relevant departments, and the pass rate-associated data was collected online.
RESULTS: After the PDCA plan, the pass rate of NMLE in our hospital increased by 10.89% from 80.15% in 2021 to 91.04% in 2022 (P = 0.0109), with the pass rate of skill examination from 95.59% in 2021 to 99.25% in 2022 (P = 0.0581) and theoretical examination from 84.5% in 2021 to 93.13% in 2022 (P = 0.027). Additionally, the mean scores of all examinees increased with the theoretical examination score increasing from 377.0 ± 98.76 in 2021 to 407.6 ± 71.94 in 2022 (P = 0.004).
CONCLUSIONS: Our results showed a success application of the PDCA plan in our hospital which improved the pass rate of the NMLE in 2022, and the PDCA plan may provide a practical framework for future medical education and further improve the pass rate of NMLE in the next year.

OBJECTIVE: This paper examines the impact of a scholarship program on underprivileged students, drawing on data from a two-year monitoring and evaluation (M&E) process. The report identifies both enablers and barriers to academic success among scholarship beneficiaries.
METHODS: Data on program impact was collected through interviews with parents, teachers, and school records over two academic years.
RESULTS: Financial aid emerged as a crucial enabler, with scholarships allowing students to focus on their studies by alleviating pressure around basic necessities. However, the research also revealed the importance of a holistic support system. Beyond tuition, the high cost of essential learning materials, including stationery, and subject-specific resources, can create a significant barrier. The study also highlighted the importance of student well-being. Health concerns, limited access to nutritious food, and even unaddressed mental health issues can all negatively impact attendance and focus. Furthermore, a gender gap emerged, with girls facing additional challenges related to social pressures to prioritize chores and the cost of menstrual hygiene products.
CONCLUSIONS: This study highlights the importance of holistic scholarship programs that extend beyond tuition coverage. To maximize impact, policymakers and funders should prioritize initiatives that address the multifaceted needs of underprivileged students.

As first-time pass rates on the North American Pharmacy Licensure Examination (NAPLEX) continue to decrease, pharmacy educators are left questioning the dynamics causing the decline and how to respond. Institutional and student factors both influence first-time NAPLEX pass rates. Pharmacy schools established before 2000, those housed within an academic medical center, and public rather than private schools have been associated with tendencies toward higher first-time NAPLEX pass rates. However, these factors alone do not sufficiently explain the issues surrounding first-time pass rates. Changes to the NAPLEX blueprint may also have influenced first-time pass rates. The number of existing pharmacy schools combined with decreasing numbers of applicants and influences from the COVID-19 pandemic should also be considered as potential causes of decreased first-time pass rates. In this commentary, factors associated with first-time NAPLEX pass rates are discussed along with some possible responses for the Academy to consider.

UNASSIGNED: Limited data are available on factors that are associated with passing rates for the Saudi Pharmacist Licensure Examination (SPLE). The aim of this study is to investigate student characteristics and academic performance characteristics that may predict their success on SPLE.
UNASSIGNED: This was a single-institution retrospective cohort study, which included pharmacy graduates from 2019 to 2021. Demographic, academic, and SPLE data were collected for each graduate. Binary logistic regression was used to explore the association between potential predictors and first-time SPLE pass status. A stepwise regression was then performed to develop multiple logistic models.
UNASSIGNED: A total of 494 graduates were included in the study. Females, PharmD graduates, and on-time graduation had higher odds of passing SPLE (P = 0.0065, P = 0.0003, and P < 0.0001, respectively). For each 0.5 increase in GPA, the odds of passing SPLE increase by 3.5 times (OR 3.53; 95 % CI, 2.83-4.42; P < 0.0001). Of the tests taken prior to university admission, the overall high school score, general aptitude test (GAT) score, and qualifying score were significantly associated with higher SPLE first-time pass rates. When multiple logistic regression analysis was performed, GPA and GAT scores were the only significant predictors for higher SPLE first-time pass rates (P < 0.0001 and P = 0.0002, respectively).
UNASSIGNED: The current research has shown that there is an association between higher SPLE first-time pass rates and several factors, most importantly the GPA and GAT score. Further research is needed, as it has the potential to inform the decision when reviewing pharmacy admission criteria.

In 2019, the Saudi Pharmacist Licensure Examination (SPLE) was first administered to all pharmacy graduates and served as one of the prerequisites for obtaining a pharmacist license. The objective of this study was to evaluate whether institution and applicant characteristics are associated with first-time SPLE success. Passing status for 2284 SPLE first-time applicants was obtained from online public data for the years 2019 and 2020. The data included applicant sex, institution type (public vs. private), and college establishment year (2006 or earlier vs. after 2006). Overall, the SPLE first-time pass rate in 2020 was significantly higher than in 2019 (98.0 vs. 95.9%; p = 0.0062). Applicants from pharmacy colleges established in or before 2006 had a higher SPLE first-time pass rate, compared to those from pharmacy colleges established after 2006 (98.2 vs. 95.2%; p < 0.0001). The pass rate for male applicants was lower compared to female applicants (95.8 vs. 97.5%; p = 0.0221). The results of logistic regression showed that exam year (2020 vs. 2019), applicant sex (female vs. male), and pharmacy college establishment year (≤2006 vs. >2006) were statistically significant predictors. Further studies are needed in the upcoming years when more cumulative data are available.

Objective. To estimate whether first-time pass rates on the North American Pharmacist Licensure Examination (NAPLEX) have been influenced by the number of pharmacy programs founded since 2000, the programs\' accreditation era, and the changes to the blueprint as well as changes to the testing conditions and passing standards implemented by the National Association of Boards of Pharmacy (NABP) beginning in 2015.Methods. This was a retrospective, observational cohort study using publicly published data. The number of programs and pass rates were collected from 2008 to 2020. Programs reporting pass rates from 2016 to 2020 were eligible. Accreditation era was defined as programs accredited before or after 2000. Pass rates were categorized into NAPLEX tests administered before or after 2015. Statistical analyses were conducted for comparisons.Results. Pass rates were initially found to decline as the number of programs rose. First-time pass rates of programs accredited before 2000 were higher than pass rates of programs accredited after 2000 every year after 2011. Only 40% of the programs accredited after 2000 exceeded the national average between 2016-2020. Blueprint changes implemented in 2015 and the changes to testing conditions plus passing standards implemented in 2016 had a greater effect on pass rates than the number of programs or applicants.Conclusion. Programs accredited after 2000 generally had lower first-time NAPLEX pass rates. Even so, blueprint changes and changes to the testing conditions plus passing standards instituted by the NABP were more important predictors of the decline of first-time NAPLEX pass rates. Stakeholders should collaborate and embrace best practices for assessing practice-ready competency for licensure.

Patient quality assurance (QA) is a required part of the treatment care path, and plan failure can lead to increased personnel hours or delay of treatment. The recommendation by the American Association of Physicists in Medicine is that gamma analysis be used to evaluate measured volumetric modulated arc therapy plans. Vendors have developed many different measurement geometries for patient QA devices which could yield varying pass rates when used with the recommended tolerances, normalization, and criterion. For this study, clinically treated stereotactic body radiation therapy plans were used to evaluate differences in gamma dose tolerances and sampled dose distribution complexity for centralized or peripheral measurement geometries on a cylindrical phantom. Random errors were then introduced into a subset of these plans, and the differences in pass rates between the geometries were correlated with differences in the observed mathematical differences. Finally, a single clinically relevant target coverage deviation was introduced to another subset of plans to evaluate whether a particular geometry is measurably better at identifying clinically relevant errors. It was found that centralized geometries resulted in more lenient dose tolerances and less complex sampled dose distributions compared to peripheral geometries. Pass rates were uniformly lower in the peripheral measurement geometry, and the difference in pass rates between the geometries correlated strongly with the difference in dose tolerance and weakly with the difference in the chosen complexity metrics. However, neither of the geometries were sufficiently sensitive enough to detect clinically relevant changes to target coverage when using recommended tolerances and criteria, and no statistically significant difference was found between their pass rates. Given these findings, the authors concluded that stereotactic body radiation therapy plans could fail patient QA when measured in the peripheral geometry but pass in the centralized geometry, with possibly neither having correlation to true clinical deviation.

General Surgery residency programs are evaluated on their American Board of Surgery (ABS) Qualifying examination (QE) and Certifying examination (CE) pass rates. This systematic review aims to evaluate predictive factors of ABS QE and CE first time pass rates.
Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines, the following electronic databases were searched: PubMed, Embase, JAMA Network, and Google Scholar. Studies available in the English language published between January 2000 and July 2020 were deemed eligible. Articles that did not assess either of the ABS board examinations performance and pass-rates as outcomes were excluded. The Oxford Centre for Evidence-Based Medicine was used to determine the quality and risk of bias of each study.
A total of 31 publications were included for analysis. Undergraduate medical education variables associated with first-time pass rates on the QE and CE include USMLE score, AOA membership, and class rank. Program factors affecting pass rates include program size, geographic location, and Program Director turnover. There is strong correlation between ABSITE and QE. Evidence supports the utility of mock oral examinations (MOEs) in predicting CE success.
ABSITE scores demonstrated higher correlation with QE pass rate than CE pass rate. MOEs have a positive association with first-time CE pass rates. Nonmodifiable factors such as race/ethnicity, marital status, and geographic location were also found to be predictors. Delaying board certification examination beyond 1 year after residency graduation significantly reduces first-time pass rate.

BACKGROUND: Students consider numerous variables before applying to a doctor of pharmacy program. Some key non-modifiable variables may include program length, institution type, graduating class size, and pharmacy school grading system. The purpose of this study was to determine if there exists a difference in North American Pharmacists Licensure Examination (NAPLEX) performance based upon these variables.
METHODS: This was a retrospective cohort study using observational data. NAPLEX pass rates from 2015 to 2017 were obtained from the National Association of Boards of Pharmacy (NABP) website. Data for pharmacy programs were extracted from the program, Pharmacy College Application Service, American Association of Colleges of Pharmacy, and NABP websites.
RESULTS: Based on each pharmacy program\'s performance on NAPLEX, variables with significantly higher pass rates were public institutions and those with graduating class sizes of 100 or more students.
CONCLUSIONS: The results of this study suggest that graduating class size of 100 or more students and public institutions were significant predictors of success on the NAPLEX. Lower pass rates in 2016 may be due to the examination changes implemented by NABP that year. It is possible that programs and students were not being adequately prepared for the changes made to the NAPLEX format. Although not statistically significant, there was a rise in pass rates between the years 2016 and 2017. Therefore, future studies such as this one should be performed to compare NAPLEX pass rates from 2017 forward.

Your department has had a good track record over many years for preparing trainees to successfully sit for the ACEM Fellowship exam. On average the pass rate for your trainees is over 80%. Then, to your dismay, suddenly only two of five of your trainees pass the latest Fellowship exam. Does this anomaly necessitate an urgent review of your department\'s training programme, or is it just a statistical quirk? Let us suppose you can prepare candidates so that they all have at least an 80% chance of passing. The probability that all five candidates would have passed is 32.8% (or 0.85 ) based on the multiplication rule of probability for independent events. The probability that only two of five passed is 5.1% (or 10 × 0.82 × 0.23 ) based on the binomial distribution, which is a probability distribution analogous to the normal distribution. The construction of the binomial distribution depends on two parameters: (i) number of candidates sitting (\'n\'), and (ii) probability of passing for any individual candidate (\'P\'). The distribution gives the probability that \'x\' number of individuals will pass when \'n\' number of individuals sit. Thus despite an 80% pass rate historically, the probability that only two of five candidates will pass is not negligible at 5.1%. It is an anomaly, which we may choose not to act on unless it is recurrent, noting it will be expected to occur naturally about one time out of 20. The real challenge is to maintain or increase that individual probability at 80% or higher.