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J Emerg Med. 2010 Jan;38(1):65-9. doi: 10.1016/j.jemermed.2008.04.010. Epub 2008 Oct 31.

Do United States Medical Licensing Examination (USMLE) scores predict in-training test performance for emergency medicine residents?

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  • 1Department of Emergency Medicine, Orlando Regional Medical Center, Orlando, Florida 32806, USA.



Residency selection committees commonly utilize USMLE scores as criteria to screen residency applicants.


The purpose of this study is to evaluate the relationship between United States Medical Licensing Examination (USMLE) and American Board of Emergency Medicine (ABEM) in-training examination scores (ITEs).


In an Accreditation Council for Graduate Medical Education-accredited emergency medicine residency program, data were collected for this retrospective cohort study for the classes of 2002-2006. USMLE Step 1 and 2 scores and the ABEM ITEs were recorded for each post-graduate year (PGY) within the aforementioned time frame. Step 1 and 2 scores were compared to consecutive PGY ABEM ITEs to evaluate for an association.


There were 51 USMLE Step 1 and 39 Step 2 scores available for comparison with 153 ABEM ITEs. The mean USMLE Step 1 and Step 2 scores were 228.9 (range 197-252) and 228.4 (range 168-259), respectively. The mean in-training percentiles for the PGY 1, 2, and 3 years were 40.4, 68.3, and 81.7, respectively. The R-squared values for the Step 1 scores compared to the PGY 1, 2, and 3 years' ITEs were 0.25, 0.18, and 0.16, respectively. The R-squared values for Step 2 scores as compared to the ABEM ITEs for the PGY 1, 2, and 3 years were 0.43, 0.44, and 0.38, respectively. Residents who scored below 200 on either USMLE Step 1 or Step 2 had significantly lower mean ABEM ITEs than residents who scored above 200 (p < 0.05) and were 10-fold more likely than residents who scored above 220 to score below the 70th percentile in their PGY3 ABEM ITE.


USMLE Step 1 scores are mildly correlated and Step 2 scores are moderately correlated with ABEM ITEs. Scoring below 200 on either test is associated with significantly lower ABEM ITEs.

[PubMed - indexed for MEDLINE]
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