Delaying the American Board of Emergency Medicine Qualifying Examination Is Associated With Poorer Performance

Abstract

Objectives: The initial step in certification by the American Board of Emergency Medicine (ABEM) requires passing a multiple-choice-question qualifying examination. The qualifying examination is typically taken in the first year after residency training. This study was undertaken to determine if a delay in taking the qualifying examination is associated with poorer performance. The authors also examined the relationship between in-training examination scores and qualifying examination scores.Methods: This was a pooled time-series cross-section study. Primary measurements were initial qualifying examination scores, the timing of the qualifying examination, and in-training examination scores. The three groups, based on qualifying examination timing, were immediate, 1-year delay, and ≥2-year delay. In-training examination scores were analyzed to determine the relationship between intrinsic ability, examination timing, and qualifying examination scores. For analysis, a generic pooled ordinary least-squares dummy variable model with robust standard errors was used. A pre hoc level of significance was determined to be a < 0.01.Results: There were 16,353 qualifying examination test administrations between 2000 and 2012. Intraining examination scores were positively correlated with qualifying examination scores (p < 0.001). The group pass rates were 98.9% immediate, 95.6% 1-year delay, and 86.6% ≥2-year delay. After controlling for in-training examination scores, delay taking the qualifying examination of 1 year was associated with a decrease in score of -0.6 (p = 0.003). A delay in taking the qualifying examination ≥2 years was associated with a decrease in score of -2.5 points (p < 0.001).

Correlation of University Comprehensive and National Certification Exam Scores for Medical Laboratory Science Students

“…Although there has been only one study specific to laboratory science, numerous studies have been published that showed correlation between medical residency in-training preparation exams and pass rates of corresponding written board qualifying exams. [6][7][8][9][10][11] One study evaluated the American Board of Emergency Medicine in-training and qualifying examinations and found a significant correlation between in-training exams taken during the final year of residency and qualifying exam scores. 7 For each point increase above the mean on the in-training exam, a 0.6 point increase was observed on the qualifying exam.…”

“…[6][7][8][9][10][11] One study evaluated the American Board of Emergency Medicine in-training and qualifying examinations and found a significant correlation between in-training exams taken during the final year of residency and qualifying exam scores. 7 For each point increase above the mean on the in-training exam, a 0.6 point increase was observed on the qualifying exam. Another study compared senior pathology residents' in-training exam scores to the American Board of Pathology certification exam and showed increased pass rates for each quartile group on the in-training exam.…”

“…16 Exams in nursing, surgery, and emergency medicine showed similar findings. 7,17,18 Grade point average (GPA) is another factor that has been identified to influence exam pass rates. Lanier and Lambert 19 showed that higher GPA for science courses taken prior to program admission correlated with higher scores on the ASCP certification exam and a comprehensive exam.…”

“…This student scored 67% on the campus exam and waited approximately three years before attempting the BOC exam. Based on the known adverse effect of time lapse prior to attempting national certification exams 7,[16][17][18] , one can infer that the 3-year wait was a confounding factor in this case.…”

The Relationship Between ACGME Duty Hour Requirements and Performance on the American Board of Emergency Medicine Qualifying Examination

“…The ABEM QE is a 305 single-best-answer, multiple-choice question examination designed to measure medical knowledge recall (approximately 33% of all items) and clinical synthesis and diagnostic reasoning (approximately 66% of all items). 19,20 Between 10% and 15% of items include pictorial stimuli. The ABEM QE is a criterion-referenced examination; it does not use a performance curve or quota for passing or failing scores.…”