Abstract
The objective of the current study was to determine whether emergency medicine residents' United States Medical Licensing Examination (USMLE) scores are significantly associated with first-attempt passage of the American Board of Emergency Medicine (ABEM) qualifying (written) examination. We hypothesized that USMLE Step 2 Clinical Knowledge (CK) scores would be useful in predicting students who passed the ABEM qualifying examination on their first attempt. For this retrospective cohort study, we examined the data of residents who successfully completed training at two emergency medicine residency programs between the years 2002-2013. Because scores on the USMLE Step examinations varied greatly across years, we obtained means and standard deviations from the National Board of Medical Examiners. We subtracted the mean score for the year each resident took the examination from the resident's examination score, creating centered Step 1 and centered Step 2 CK scores. A multivariate logistic regression analysis indicated that centered Step 2 CK scores could be used to predict the odds of passing the ABEM qualifying examination (odds ratio = 1.05 [95% confidence interval 1.02 to 1.08, P < 0.001]). Using a Step 2 CK score cutoff of 7 points lower than the mean yielded 64% sensitivity and 81% specificity for predicting passage of the ABEM written examination on the first attempt. Program directors and selection committees may wish to consider whether applicants' Step 2 CK scores are near the national average when making ranking decisions, as this variable is highly predictive of passing the ABEM qualifying examination on the initial attempt.
Highlights
In the 2017 National Resident Matching Program, a total of 2,047 emergency medicine positions were offered, and the number of applicants was 2,703.1 This discrepancy in the number of applicants and available positions results in applicants applying to many residency programs to maximize their potential for matching
Evidence indicates that United States Medical Licensing Examination (USMLE) scores are associated with emergency medicine residency intraining examination (ITE) scores,[4] and ITE scores correlate with certifying examination scores
USMLE Step 1 data were missing for 16 individuals (4 Mid-Atlantic and 12 Southern), and USMLE Step 2 Clinical Knowledge (CK) data were missing for 68 individuals (29 Mid-Atlantic and 39 Southern)
Summary
In the 2017 National Resident Matching Program, a total of 2,047 emergency medicine positions were offered, and the number of applicants was 2,703.1 This discrepancy in the number of applicants and available positions results in applicants applying to many residency programs to maximize their potential for matching. In 2013, the Accreditation Council for Graduate Medical Education (ACGME) mandated that emergency medicine residency programs demonstrate an 80% first-time passage rate on the American Board of Emergency Medicine (ABEM) qualifying (written) examination.[2] selection committees want to identify applicants who will be able to pass the certifying examination on their initial attempt. The objective of the current study was to determine whether emergency medicine residents’ United States Medical Licensing Examination (USMLE) scores are significantly associated with first-attempt passage of the American Board of Emergency Medicine (ABEM) qualifying (written) examination. Conclusion: Program directors and selection committees may wish to consider whether applicants’ Step 2 CK scores are near the national average when making ranking decisions, as this variable is highly predictive of passing the ABEM qualifying examination on the initial attempt
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