38. PREDICTORS OF PASSING BOARD CERTIFICATION EXAMS IN A MED/PEDS RESIDENCY PROGRAM

Abstract

Introduction Combined Internal Medicine and Pediatrics (MP) residencies have primarily relied on categorical program data to predict pass rates for both the American Board of Internal Medicine Certifying Exam (ABIM-CE) and the American Board of Pediatrics Certifying Exam (ABP-CE). However, there is insufficient literature on what constitutes the best predictors of a MP resident passing each. We thus conducted a review of prior exam scores in our large MP program to determine the best predictors of passing both ABIM-CE and ABP-CE. Methods Numeric scores from USMLE Steps 1 and 2 and In-Training Exams in Internal Medicine (ITE-IM) and Pediatrics (ITE-P) for UTHSC MP residents over 10 years (2008-2017) were retrospectively reviewed. A total of 91 residents were enrolled. First time ABIM-CE and ABP-CE numeric scores (n=65, n=71 respectively) and pass/fail results (n=91, n=71 respectively) were collected. Linear and logistic regression were applied to determine if a relationship existed between scores and whether numeric ABIM-CE and ABP-CE scores or odds of passing could be predicted based on prior exams. Results Each prior USMLE, ITE-IM, and ITE-P score had a linear relationship with both ABIM-CE and ABP-CE scores. In the linear regression, adjusted r2 values showed low to moderate predictive ability ranging from 0.10 to 0.34, with the highest predictor of ABIM-CE and ABP-CE being USMLE Step 1 (0.34) and first year ITE-IM (0.32) respectively. Logistic regression showed odds ratios of passing board certifications ranging from 1.05 to 1.53 per point increase on the prior exam scores. The third year ITE-IM was the best predictor of passing both the ABIM-CE and ABP-CE using the c statistic for comparison (0.88 and 0.94 respectively). Conclusion In this large MP program, USMLE Steps 1 and 2 and all years of ITE-IM and ITE-P scores were linearly related to ABIM-CE and ABP-CE scores, with third year ITE-IM scores most predictive of passing ABIM-CE and ABP-CE. These results provide MP specific data for programs to use for individualized counseling and targeted program improvements.