City population size is associated with examinee outcomes on the American Board of Pediatrics Certifying Examination

The purpose of this article is to evaluate American Board of Pediatrics Certifying Examination performance based on city population, hypothesizing that larger cities are associated with higher exam performance.

Pediatric residency programs were retrospectively evaluated from 2010 to 2012. The associated city populations were found using census data. Simple linear regression was performed for continuous variables, and χ(2) tests were performed for categorical variables, using α = .05.

For 188 programs, the median pass rate was 79.5% (interquartile range = 69% to 90%). Regression showed that city size explains program size (P < .001). Examinees from larger cities had a higher pass rates than examinees from smaller cities, and examinees who are in cities that share residency programs had a higher pass rate than examinees from solo city programs (both P < .05).

City size is associated with examinee performance on the American Board of Pediatrics Certifying Examination. City size should be a consideration of future residency applicants.