Predicting performance on the American Board of Surgery qualifying and certifying examinations: a multi-institutional study.
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.
de Virgilio
Christian
C
Division of Vascular Surgery, Harbor-UCLA Medical Center, 1000 W Carson Street, Torrance, CA 90509, USA. cdevirgilio@labiomed.org
Yaghoubian
Arezou
A
Kaji
Amy
A
Collins
J Craig
JC
Deveney
Karen
K
Dolich
Matthew
M
Easter
David
D
Hines
O Joe
OJ
Katz
Steven
S
Liu
Terrence
T
Mahmoud
Ahmed
A
Melcher
Marc L
ML
Parks
Steven
S
Reeves
Mark
M
Salim
Ali
A
Scherer
Lynette
L
Takanishi
Danny
D
Waxman
Kenneth
K
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