Can we predict which residents are going to pass/fail the oral boards?

Previously, we identified a positive correlation between administration of regularly structured mock oral examinations and successful first time pass rates on the American Board of Surgery Certifying Examination (ABSCE)/oral boards. In this study, we investigated factors associated with test results to determine whether residents at risk of not passing the ABSCE can be identified a priori.

All general surgery chief residents who graduated from a large academic/community program between 2001 and 2010 were identified. Residents who did not pass the ABSCE on the first attempt were compared to a control group of chief residents who passed the examination on the first attempt. Evaluation metrics included "knowledge," "professional communication," and "spoken English" scores. Differences between groups were determined using one-way ANOVA and χ(2) calculations.

Over the decade, 13 residents made more than 1 attempt to pass the ABSCE. The element of the "knowledge" score associated with ABSCE first-attempt pass rates included United States medical licensing examination (USMLE) Step 2 scores (p = 0.02), and not ABSITE, American Board of Surgery Qualifying examination (ABSQE)/written examination or USMLE Step 1 scores. "Professional communication" scores associated with first-attempt pass rates included in-house mock oral examination scores (p = 0.01) and Citywide mock oral examination scores (p = 0.02). ABSCE pass rates did not differ in native vs. non-native English speakers or graduation from a United States vs. International medical school.

Compared with a control group of residents from the same program, residents who passed the ABSCE examination on the first attempt were more likely to have higher USMLE Step 2 and professional communication scores. USMLE Step 1 scores and English as a native language were not associated with certifying examination pass rates. These criteria may offer guidance for residents preparing to take the ABSCE and may aid in the selection of residents for residency programs. Larger studies to validate these findings and to investigate the role of improving communication skills and conducting interventions between the 1st and 2nd attempt are warranted.