Scaled Performance on the Vascular Qualifying Examination Does Not Correlate With Vascular Certifying Examination First Attempt Pass in a National Cohort of Residents and Fellows

Abstract

Specialty board certification is an important indicator of surgeon competence and necessary for residency and fellowship programs to maintain accreditation with the Accreditation Council for Graduate Medical Education. Thus, identification of trainees at risk of board certification failure is important for both vascular surgery graduates and their parent program. Passing the written Vascular Qualifying Examination (VQE) is a prerequisite for eligibility to take the Vascular Certifying Examination (VCE). However, the association between performance on the VQE and ability to pass the VCE has not been examined. We sought to examine the correlation of VQE performance on first-time pass achievement of VCE. We utilized American Board of Surgery data to examine predictive associations of a national longitudinal cohort of all vascular surgery integrated residents (VIR) and fellows (VSF) who completed the VQE and VCE from 2016 through 2021. Descriptive statistics were used to examine trends. Chi-squared tests were used to examine proportional group differences. Predictive associations between VQE scaled score performance and first-time pass achievement on subsequent VCE attempts were examined using logistic regression. VQE scaled score performance and VCE pass rates were obtained for all VIR and VSF (n = 579; 176 residents and 403 fellows) from 151 programs (47 residency and 104 fellowship) during the study period. First-attempt pass rate for the VQE was 94% in the study cohort, while first-attempt pass rate for the VCE was 93%. There were no significant differences in pass-fail rates between VIR and VSF candidates taking the VQE (P = .133) or the VCE (P = .501), respectively. Trainee scaled score performance on VQE was not predictive of subsequent first-attempt pass achievement on VCE (odds ratio, 1.00; 95% confidence interval, 1.00-1.01; P = .077) (Figure). Stratified subgroup analyses by VIR and VSF cohorts also showed no significant predictive first-attempt VCE pass achievement (P = .125 and P = .171, respectively). In this national cohort of vascular trainees taking the VQE and VCE, VQE performance was not predictive of subsequent VCE first-time pass achievement. Although this finding highlights the necessity to identify other measures of trainee competence in order to indicate preparedness of trainees for board certification examinations, it is also reflective of the ability to assess distinctive competencies between the two examinations, with VQE focused on medical knowledge, and VCE on clinical judgement and interpersonal communication skills. This ensures certification of well-rounded vascular surgeons and maintenance of high-quality standards within our specialty.