Objective
To evaluate if United States Medical Licensing Examination (USMLE) Step 1, USMLE Step 2, USMLE Step 3, and residency third-year in-service training exam (ITE) results predict performance of Internal Medicine (IM) residents in American Board of Internal Medicine Certifying Exam (ABIM-CE).
Methods
A retrospective review of USMLE Step 1, USMLE Step 2, USMLE Step 3 scores, residency third year ITE and ABIM-CE of IM residents at Michigan State University from 2004 through 2017 was conducted. Pearson correlation coefficient and two sample t-tests were used to assess the relationship between various scores and pass or fail results in ABIM-CE.
Results
Among 114 MD residents included in the study; 92% (n=105) passed the ABIM-CE. There was a significant correlation of passing ABIM-CE with USMLE Step 1 (OR 1.042; 95% CI 1.004- 1.082), Step 2 (OR 1.043; 95% CI 1.004-1.085) and Step 3 (OR 1.046; 95% CI 1.004- 1.089) independently, with the combined odds of all USMLE exams being 1.044 (p=0.031). Increase in ITE percentage increased the likelihood of passing ABIM-CE (OR 1.28, 95% CI 1.160-1.419). The increase in the gap was associated with decreased chances of passing ABIM-CE (OR 0.774; 95% CI 0.670-0.893). All residents who failed ABIM-CE had Step 1 scores <220. Among 31 residents with Step 2 score <220, 20% (n=6) failed ABIM. Similarly, 9% of residents with USMLE Step 3 score less than 220 failed ABIM-CE; all residents who failed had scores less than 220. The probability curve predicted that the chance of passing ABIM- CE was around 80% with USMLE scores greater than 200 and increased to almost 100% with USMLE scores of 250 or more.
Conclusion
There is a strong correlation between ABIM-CE results with scores of USMLE Steps and third-year ITE. Thus, performance in these exams may identify the internal medicine residents who might need more help in ABIM-CE. This helps the residents as well as the program to plan and implement various measures to improve the pass rate.