242 - Identifying Factors That Help Predict Success on the American Board of Pediatrics Certifying Exam

Publication Number: 242.5124

Ronen Zipkin, Children's Hospital Los Angeles, Los Angeles, CA, United States

Background: As of June 2024, there are 210 categorical pediatric and 79 combined med-peds residency programs nationwide. Between 2019 and 2023, an average of 3359 residents per year were first time takers of the ABP initial certifying exam, with an average pass rate of 83.4%. Some studies have found that factors such as program size and location as well as USMLE and in-training exam scores may be able to predict success on the ABP exam. However, many of these studies did not exclusively focus on pediatrics or included a small sample size of residents.

Objective: We aimed to create a predictive model to better identify factors that will directly impact success for pediatric residents as first-time takers of the ABP exam.

Design/Methods: This was a retrospective cohort study at a quaternary care freestanding children’s hospital. All pediatric residents who were first-time ABP exam takers and graduates of our residency program between 2005 and 2022 were included. Univariate logistic regression models were used to identify independent predictors of ABP exam success, including ITE, USMLE, and OSCE scores. Multivariate logistic regression model was developed using purposeful selection of variables to predict ABP exam passage (pass/fail). All statistical analysis was performed using RStudio 4.2.3.

Results: A total of 509 pediatric residents were included in the study; 60.9% were male, 39.1% were female, and 470 (92.3%) passed the ABP certifying exam. Through univariate analysis, ITE scores in all 3 years were significant predictors of passing the ABP exam (OR 1.007, 1.013, and 1.012 respectively). After multivariate analysis, 2nd year OSCE (OR 1.061, 95% CI 1.005-1.028, p< 0.04), USMLE step 2 (OR 1.051, 95% CI 1.008-1.098, p< 0.02) and residency during 2020-2022 of COVID restrictions (OR 0.070, 95% CI 0.0008-0.392, p< 0.005) remained as significant predictors. A 10-point increase in 2nd year OSCE and USMLE step 2 was associated with an 80% and 64% increase in odds of passing the exam, respectively. Residents who trained during COVID restrictions had a 93% lower odds of passing.

Conclusion(s): ITE scores during all years of pediatric residency can help predict success on the ABP certifying exam for first time test takers. Through exclusively focusing on pediatric residents over a longer period than existing data, our study showed that, when accounting for other confounding factors, only 2nd year OSCE, USMLE step 2, and training during years of COVID restrictions were able to predict ABP exam outcome. These results can be used to help identify and support residents at risk of failing the ABP exam early on in training.

Table 1
Univariate Logistic Regression

Table 2
Multivariate Logistic Regression

Table 1
Univariate Logistic Regression

Table 2
Multivariate Logistic Regression