74. LACK OF CORRELATION BETWEEN USMLE SCORES AND PERFORMANCE IN PEDIATRICS RESIDENCY TRAINING BASED ON ACGME MILESTONES RATINGS

Abstract

Introduction The United States Medical Licensing Exam (USMLE) was designed to determine whether medical trainees are competent to become licensed physicians, not necessarily as a means of providing a comparative gradient on students’ knowledge. Despite this, many residency programs use USMLE scores in the residency selection process as indicators as to whether physicians will succeed in residency. Not only is this not the intended use of the USMLE, some previous studies have suggested that USMLE scores are not effective indicators of a physician's success during residency. One method of assessing residents’ progress through residency training are the Accreditation Council for Graduate Medical Education (ACGME) Milestones in the six clinical competency domains of Patient Care, Medical Knowledge, Systems Based Practice, Practice-Based Learning and Improvement, Professionalism, and Interpersonal Communications Skills. Ratings along these milestones are completed by supervising physicians who observe and assess residents in the clinical setting. No previous literature has tried to link USMLE Step scores to resident performance using Milestone ratings. Methods USMLE Step 1 and 2 Scores and Milestones Ratings in twenty-one different competencies were collected over five years (2012 - 2017) from 187 residents enrolled in a single large pediatrics residency program. Correlations were examined using Pearson's correlation coefficients. Results Among the residents studied, the mean score of Step 1 was 236, while the mean score of Step 2 was 250. While Step 1 and 2 had correlation (r2 = -0.628), no correlation was found between Step 1 and overall Milestones average (r2 = -0.130 and Conclusion These results suggest that USMLE scores have no correlation to success in residency training as measured by progression along competency-based milestones. These confirm previous claims about the limited utility of USMLE scores in predicting success in residency training.