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Assessment of Physician

Competence and Performance

In American Samoa

David E.J. Bazzo, M.D.

William Norcross, M.D.

Peter Boal

American Samoa

• US Territory

• Population ~60,000

• 60 physicians representing multiple specialties

• LBJ Tropical Medical Center

• Department of Public Health

Facilities

Health

• Ranked #1 in BMI by WHO

• Chronic disease burden high

• 80% of population below Federal poverty level

• Salaries are low compared to mainland

• Physician recruitment is difficult

“It’s the ‘fairest’ way to fly: Samoa Air

becomes world’s first airline to charge

passengers by pound”

Physicians

• 11 are USMLE certified

• Current licensing statute

– Requires USMLE certification

– Loose guidelines

– Hospital credentials

– Many practicing not meeting requirements

PACE competency assessment

1. Intake form, practice questionnaire

2. 360 degree assessment

3. International Foundations of Medicine®

knowledge examination

4. Oral clinic examination

5. Chart review and chart stimulated recall

6. On-site direct observation of performance

7. Review of credentialing/personnel file

Assessment

• Participants will be evaluated by faculty in their

specialty or a related specialty

• Case conference will be held to consider all

material and make a final determination of

competence and performance.

• De we consider implication if significant number

do not meet competency bar?

Guidance on research questions

• Data collection will include: – Demographic information from the participant,

including training, CPD

– Results of all components of the assessment

• Other?

Potential research questions:

• Does training level of individuals predict

performance on the assessment?

• Do years in practice experience affect

performance on the assessment?

– Do number of years practicing in Samoa impact

results

• What is the predictive value of each component

of the assessment?

• Does medical school predict performance on the

assessment?

paceprogram.ucsd.edu