USMLE Step 3 Scores Have Value in Predicting ABR Core Examination Outcome and Performance: A Multi-institutional...

Area of Science:

• Medical Education
• Radiology Residency Training
• Licensing Examinations

Background:

• The American Board of Radiology (ABR) Core examination is a critical assessment for diagnostic radiology residents.
• Identifying residents at risk of failure is essential for timely academic support and intervention.

Purpose of the Study:

• To evaluate the predictive value of United States Medical Licensing Examination (USMLE) Step 3 or Comprehensive Osteopathic Medical Licensing Examinations (COMLEX) Level 3 performance tiers for identifying radiology residents at increased risk of ABR Core examination failure.
• To assess the correlation between Step 3 performance and sub-mean performance on the ABR Core examination.

Main Methods:

• Multi-institutional data from 342 diagnostic radiology residents across 13 programs (2013-2019) were analyzed.
• Step 3 scores were converted to percentiles. Core examination outcomes (pass/fail) and scores relative to the mean were compared between residents scoring below and at/above the 50th percentile, and by quintiles.
• Statistical analysis was performed to evaluate differences in Core examination failure rates and performance.

Main Results:

• Residents scoring below the 50th percentile on Step 3 had a significantly higher Core examination failure rate (19.8%) compared to those scoring higher (2.7%).
• Residents in the lowest Step 3 quintile demonstrated an even higher failure rate (31.0%).
• Core examination performance, measured by scores below the mean, improved with higher Step 3 quintiles.

Conclusions:

• Step 3 licensing examination scores are valuable predictors of resident performance on the ABR Core examination.
• Residency programs can utilize Step 3 performance data to identify at-risk residents for early assessment and targeted intervention, potentially improving overall resident success rates.