Maitray D Patel1, Courtney M Tomblinson2, Thad Benefield3, Kamran Ali4, Carolynn M DeBenedectis5, Eric England6, Glenn C Gaviola7, Christopher P Ho8, Ann K Jay9, James M Milburn10, Seng Ong11, Jessica B Robbins12, David S Sarkany13, Darel E Heitkamp14, Sheryl G Jordan15. 1. Executive Board, Society of Radiologists in Ultrasound, Department of Radiology, Mayo Clinic Arizona, Phoenix, Arizona. Electronic address: patel.maitray@mayo.edu. 2. Associate Program Director Diagnostic Radiology Residency; Associate Director, Women in Radiology, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee. 3. Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina. 4. Program Director Diagnostic Radiology Residency; President, Radiology Group, Department of Radiology, University of Kansas School of Medicine, Wichita, Kansas. 5. Vice Chair for Education; Program Director, Radiology Residency program, Department of Radiology, University of Massachusetts Medical School, Worcester, Massachusetts. 6. Vice Chair of Education, Department of Radiology; Program Director, Diagnostic Radiology Residency; Jerome F. Wiot Endowed Chair of Radiology Residency Education, Department of Radiology, University of Cincinnati Medical Center, Cincinnati, Ohio. 7. Program Director Diagnostic Radiology Residency, Department of Radiology, Brigham and Women's Hospital, Boston, Massachusetts. 8. Program Director Diagnostic Radiology Residency, Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia. 9. Vice Chair of Education and Program Director Diagnostic Radiology Residency, Department of Radiology, MedStar Georgetown University Hospital, Washington, DC. 10. Vice Chair of Radiology, Section Head Neuroradiology, Program Director of Diagnostic Radiology Residency. ACR: Louisiana State Councilor; Department of Radiology, Ochsner Clinic Foundation, New Orleans, Louisiana. 11. Program Director Diagnostic Radiology Residency, Department of Radiology, University of Chicago Medical Center, Chicago, Illinois. 12. Vice Chair of Faculty Development and Enrichment; Associate Program Director Diagnostic Radiology and Integrated Diagnostic/Interventional Radiology Residencies, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. 13. Diagnostic Radiology Program Director, Department of Radiology, Staten Island University Hospital Northwell Health, Staten Island, New York. 14. AdventHealth Imaging, Orlando, Florida. 15. Education Director Department of Radiology, University of North Carolina School of Medicine, Chapel Hill, North Carolina.
Abstract
PURPOSE: We analyzed multi-institutional data to understand the relationship of US Medical Licensing Examination (USMLE) Step scores to ABR Core examination performance to identify Step score tiers that stratify radiology residents into different Core performance groups. METHODS: We collected USMLE Step scores and ABR Core examination outcomes and scores for anonymized residents from 13 different diagnostic radiology residency programs taking the ABR Core examination between 2013 and 2019. USMLE scores were grouped into noniles using z scores and then aggregated into three tiers based on similar Core examination pass-or-fail outcomes. Core performance was grouped using standard deviation from the mean and then measured by the percent of residents with scores below the mean. Differences between Step tiers for Core outcome and Core performance were statistically evaluated (P < .05 considered significant). RESULTS: Differences in Step 1 terciles Core failure rates (45.9%, 11.9%, and 3.0%, from lowest to highest Step tiers; n = 416) and below-mean Core performance (83.8%, 54.1%, and 21.1%, respectively; n = 402) were significant. Differences in Step 2 groups Core failure rates (30.0%, 10.6%, and 2.0%, from lowest to highest Step tiers; n = 387) and below-mean Core performance (80.0%, 43.7%, and 14.0%, respectively; n = 380) were significant. Step 2 results modified Core outcome and performance predictions for residents in Step 1 terciles of varying statistical significance. CONCLUSIONS: Tiered scoring of USMLE Step results has value in predicting radiology resident performance on the ABR Core examination; effective stratification of radiology resident applicants can be done without reporting numerical Step scores.
PURPOSE: We analyzed multi-institutional data to understand the relationship of US Medical Licensing Examination (USMLE) Step scores to ABR Core examination performance to identify Step score tiers that stratify radiology residents into different Core performance groups. METHODS: We collected USMLE Step scores and ABR Core examination outcomes and scores for anonymized residents from 13 different diagnostic radiology residency programs taking the ABR Core examination between 2013 and 2019. USMLE scores were grouped into noniles using z scores and then aggregated into three tiers based on similar Core examination pass-or-fail outcomes. Core performance was grouped using standard deviation from the mean and then measured by the percent of residents with scores below the mean. Differences between Step tiers for Core outcome and Core performance were statistically evaluated (P < .05 considered significant). RESULTS: Differences in Step 1 terciles Core failure rates (45.9%, 11.9%, and 3.0%, from lowest to highest Step tiers; n = 416) and below-mean Core performance (83.8%, 54.1%, and 21.1%, respectively; n = 402) were significant. Differences in Step 2 groups Core failure rates (30.0%, 10.6%, and 2.0%, from lowest to highest Step tiers; n = 387) and below-mean Core performance (80.0%, 43.7%, and 14.0%, respectively; n = 380) were significant. Step 2 results modified Core outcome and performance predictions for residents in Step 1 terciles of varying statistical significance. CONCLUSIONS: Tiered scoring of USMLE Step results has value in predicting radiology resident performance on the ABR Core examination; effective stratification of radiology resident applicants can be done without reporting numerical Step scores.