[551] USMLE Step 1 Percentile Score Is a Predictor of the American Board of Pathology (ABP) First-Time Taker Failure Rate at the University of Pittsburgh Medical Center (UPMC)

J Picarsic, JS Raval, T Macpherson. University of Pittsburgh, Pittsburgh, PA

Background: The UPMC Pathology Residency program is an ACGME fully accredited program. The training is based on a “Center of Excellence” model in which residents rotate through sub-specialty anatomic and clinical pathology rotations. The UPMC rolling pass average for the ABP exam is above the national average, but factors predicting success or failure are unknown. The aim of this study is to investigate if the USMLE Step 1 percentile score is a predictor for ABP performance in the UPMC pathology program.
Design: Nine years of data (2001-2009) from UPMC Pathology Residents (n=72) were collected from existing files and de-identified. Five residents with incomplete data were excluded from analysis, leaving 93.1% of the resident sample, including two residents with USMLE equivalent scores. Step 1 USMLE percentile score and ABP failure rate for first time takers were compared. Results are reported as percentage of residents who failed the ABP exam, cohorted by USMLE percentile scores (≤80, 81-85, 86-89, ≥90).
Results:

ABP failure rate cohorted by USMLE Part 1 percentile score.

USMLE PERCENTILE SCORE	TRACK	TOTAL RESIDENTS n	FAILURE RATE n (%)
≥90	ALL	21	0 (0)
81-89	ALL	32	8 (25)
≤80	ALL	14	6 (42.9)
≥90	US GRAD	13	0 (0)
81-89	US GRAD	14	5 (35.7)
≤80	US GRAD	3	3 (100)
≥90	IMG GRAD	8	0 (0)
81-89	IMG GRAD	18	3 (16.7)
≤80	IMG GRAD	11	3 (27.2)

Most recent 5-year ABP rolling averages (2004-2008), provided to UPMC.

First time takers		AP n (%)			CP n (%)
	Pass	Fail	Total	Pass	Fail	Total
UPMC	38 (92.7%)	3 (7.3%)	41	30 (78.9%)	8 (21.1%)	38
National	2214 (82.8%)	460 (17.2%)	2674	1793 (73.8%)	637 (26.2%)	2430

Conclusions: At the UPMC pathology program, when residents scored ≥90 on the USMLE Step 1, there was a zero percent ABP failure rate, but there was a significant first-time taker ABP failure rate when the USMLE percentile score was ≤80. US medical graduates with USMLE percentile scores 81-89 had the highest ABP failure rate (35.7%), compared to other groups, including IMG graduates, when USMLE percentile score was <90 (Table 1). We consider this performance due to the fact that 24% of IMG graduates had at least two years of previous IMG pathology training. This data indicates that USMLE Step 1 percentile scores ≥90 and ≤80 are strong predictors of ABP first time failure rate in the UPMC program, while scores of 81-89 are less predictive.
Category: Education

Monday, March 22, 2010 9:30 AM

Poster Session I Stowell-Orbison/Surgical Pathology/Autopsy Awards Poster Session # 78, Monday Morning