title: Predicting performance on the American Board of Surgery qualifying and certifying examinations: a multi-institutional study.
abstract: BACKGROUND
  We sought to determine whether US Medical Licensing Examination (USMLE) Step 1 score, American Board of Surgery (ABS) In-Training Examination (ABSITE) score, and other variables are associated with failing the ABS qualifying and certifying examinations. Identifying such factors may assist in the early implementation of an academic intervention for at-risk residents.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Seventeen general surgery training programs in the western United States.
  
  
  METHODS
  Six hundred seven residents who graduated in 2000-2007.
  
  
  METHODS
  First-time pass rates on the qualifying and certifying examinations, US vs non-US medical school graduation, USMLE Steps 1 and 2 scores, ABSITE scores, operative case volume, fellowship training, residency program type, and mandatory research.
  
  
  RESULTS
  The first-time qualifying and certifying examination pass rates for the 607 graduating residents were 78% and 74%, respectively. On multivariable analysis, scoring below the 35th percentile on the ABSITE at any time during residency was associated with an increased risk of failing both examinations (odds ratio, 0.23 [95% confidence interval, 0.08-0.68] for the qualifying examination and 0.35 [0.20-0.61] for the certifying examination), as was scoring less than 200 on the USMLE Step 1 (0.36 [0.21-0.62] for the qualifying examination and 0.62 [0.42-0.93] for the certifying examination). A mandatory research year was associated with an increased likelihood of passing the certifying examination (odds ratio, 3.3 [95% confidence interval, 1.6-6.8]).
  
  
  CONCLUSIONS
  Residents who are more likely to fail the ABS qualifying and certifying examinations can be identified by a low USMLE Step 1 score and by poor performance on the ABSITE at any time during residency. These findings support the use of the USMLE Step 1 score in the surgical residency selection process and a formal academic intervention for residents who perform poorly on the ABSITE.
authors.affiliation: Division of Vascular Surgery, Harbor-UCLA Medical Center, 1000 W Carson Street, Torrance, CA 90509, USA. cdevirgilio@labiomed.org
authors.forename: Christian
authors.initials: C
authors.lastname: de Virgilio
authors.forename: Arezou
authors.initials: A
authors.lastname: Yaghoubian
authors.forename: Amy
authors.initials: A
authors.lastname: Kaji
authors.forename: J Craig
authors.initials: JC
authors.lastname: Collins
authors.forename: Karen
authors.initials: K
authors.lastname: Deveney
authors.forename: Matthew
authors.initials: M
authors.lastname: Dolich
authors.forename: David
authors.initials: D
authors.lastname: Easter
authors.forename: O Joe
authors.initials: OJ
authors.lastname: Hines
authors.forename: Steven
authors.initials: S
authors.lastname: Katz
authors.forename: Terrence
authors.initials: T
authors.lastname: Liu
authors.forename: Ahmed
authors.initials: A
authors.lastname: Mahmoud
authors.forename: Marc L
authors.initials: ML
authors.lastname: Melcher
authors.forename: Steven
authors.initials: S
authors.lastname: Parks
authors.forename: Mark
authors.initials: M
authors.lastname: Reeves
authors.forename: Ali
authors.initials: A
authors.lastname: Salim
authors.forename: Lynette
authors.initials: L
authors.lastname: Scherer
authors.forename: Danny
authors.initials: D
authors.lastname: Takanishi
authors.forename: Kenneth
authors.initials: K
authors.lastname: Waxman
mesh_terms: D000328:Adult; D002568:Certification / Q000706:statistics & numerical data*; D004521:Educational Measurement; D013502:General Surgery / Q000193:education*; D006801:Humans; D007396:Internship and Residency / Q000458:organization & administration; D008007:Licensure, Medical / Q000592:standards; D015999:Multivariate Analysis; D012189:Retrospective Studies; D013337:Students, Medical / Q000706:statistics & numerical data; D014481:United States