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

Acad Emerg Med. 2014 Jun;21(6):688-93. doi: 10.1111/acem.12391.

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 α < 0.01.

Results: There were 16,353 qualifying examination test administrations between 2000 and 2012. In-training 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).

Conclusions: After accounting for innate ability using in-training examination scores, delay taking the qualifying examination was associated with poorer performance. This effect was more pronounced if the delay was ≥2 years.

MeSH terms

  • Certification*
  • Cross-Sectional Studies
  • Educational Measurement*
  • Emergency Medicine / education*
  • Humans
  • Internship and Residency
  • Specialty Boards
  • Time Factors
  • United States