What is the PRITE?
Beyond Just Another Test (No, Seriously, Stop Rolling Your Eyes)
The PRITE is far more than just another bureaucratic hoop in your training. Research conducted by people with a lot more time on their hands than me have shown that it provides significant value in three key areas:
1. Predicting Board Certification Success
Multiple studies have demonstrated that PRITE performance correlates with subsequent performance on board certification examinations. Webb et al. found that the PRITE effectively predicts performance on the American Board of Psychiatry and Neurology Part I Examination, with correlation coefficients ranging from 0.56 to 0.71 across different years of training. This, in statistical terms means “yes, these things are related, and no, it’s not just a coincidence.”
Tankersley et al. conducted a more recent analysis showing that PRITE scores in the final year of residency had a correlation coefficient of 0.65 with initial ABPN certification exam scores. Their data also revealed that residents scoring in the top quartile of PRITE performance had a 97% pass rate on boards, compared to only 68% for those in the bottom quartile.
This predictive relationship extends to subspecialty training as well. Juul et al. analyzed data from 5,467 child and adolescent psychiatry fellows between 2000 and 2008, demonstrating that performance on Child and Adolescent Psychiatry In-Training examinations correlated strongly with certification examination outcomes (r = 0.62). Fellows scoring in the top third of the in-training exam had a 95% pass rate on the certification exam compared to 72% for those in the bottom third.
2. Identifying Knowledge Gaps
The detailed computer analysis that residents receive compares their performance to peers at similar training levels. This personalized feedback helps identify specific knowledge domains that may require additional focus. According to Lynn et al., who studied 105 psychiatry residents from eight programs, there are significant relationships between residents’ self-assessment skills and actual test performance. Their research found that residents who accurately identified their knowledge gaps and addressed them showed an average 17% improvement in PRITE scores the following year. Translation: If you know what you don’t know and then learn it, you’ll know more.
3. Improving Training Programs
Training directors receive not only individual resident results but also statistical summary data comparing their program with other groups of participants. This valuable information allows programs to adjust their curriculum to address identified gaps. Cooke et al. analyzed 10 years of PRITE data from a single institution covering 130 resident-years of data. They found that targeted curriculum changes based on previous PRITE results led to statistically significant improvements in specific content areas, with score improvements ranging from 8-15% in targeted domains.
Miller et al. also discovered that PRITE scores correlated significantly with USMLE Step 1 (r = 0.42) and Step 2 (r = 0.53) scores, suggesting that early identification of residents who might struggle with standardized testing could allow for proactive intervention and support.
Conclusion: Embrace the Pain, It's Actually Useful
The PRITE’s importance extends beyond assessment—it’s a powerful educational tool that provides valuable feedback, predicts board certification success, and helps training programs optimize their curriculum. By taking this examination seriously, residents can gain crucial insights into their progress and readiness for board certification.
Think of the PRITE as that overly honest friend who tells you there’s spinach in your teeth before an important date. Annoying? Yes. Potentially humiliating? Absolutely. But ultimately helpful? Undeniably.
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References
- Cooke BK, Garvan C, Hobbs JA. Trends in performance on the psychiatry resident-in-training examination (PRITE®): 10 years of data from a single institution. Acad Psychiatry. 2013;37:261-264.
- Juul D, Sexson SB, Brooks BA, et al. Relationship between Performance on Child and Adolescent Psychiatry In-Training and Certification Examinations. J Grad Med Educ. 2013;5(2):262-266.
- Lynn DJ, Holzer C, O’Neill P. Relationships between self-assessment skills, test performance, and demographic variables in psychiatry residents. Adv Health Sci Educ. 2006;11(1):51-60.
- Miller BJ, Sexson S, Shevitz S, et al. US Medical Licensing Exam scores and performance on the Psychiatry Resident In-Training Examination. Acad Psychiatry. 2014;38:627-631.
- Tankersley WE, Patel RS, Mekala H, et al. Does the Psychiatry Residency In-Training Examination (PRITE) Predict Performance on Initial Board Certification in Psychiatry? Acad Psychiatry. 2019;43:348-349.
- Webb LC, Juul D, Reynolds CF, et al. How well does the psychiatry residency in-training examination predict performance on the American Board of Psychiatry and Neurology. Part I. Examination? Am J Psychiatry. 1996;153:831-832.
