Factors associated with performance on the emergency medicine qualifying examination

Area of Science:

• Medical Education
• Emergency Medicine
• Physician Performance Metrics

Background:

• Board certification ensures specialists possess advanced skills beyond state licensure.
• Specialty care quality relies on demonstrated clinical expertise and professional conduct.

Purpose of the Study:

• To identify physician-specific factors associated with performance on the American Board of Emergency Medicine Qualifying Examination (QE).
• To analyze the relationship between demographic and training characteristics and QE pass rates.

Main Methods:

• Retrospective, observational, cross-sectional study of first-time test-takers of the QE (2017-2019).
• Multilevel models analyzed associations between physician characteristics and QE scores/pass rates.
• Relative risks were calculated to quantify associations.

Main Results:

• In-training Examination (ITE) scores and Medical Doctor (MD) degrees positively correlated with QE scores.
• Older age, underrepresented in medicine (URiM) status, and male gender negatively correlated with QE scores.
• The overall QE pass rate was 94%; 86% for URiM physicians compared to 95% for non-URiM.

Conclusions:

• ITE scores, older age, and URiM status were associated with decreased QE pass rates, though with small effect sizes.
• Physician characteristics significantly influence performance on the ABEM QE.
• Understanding these factors can inform strategies to support physician success in board certification.