United States Medical Licensing Examination Step 1 Two-Digit Score: A Correlation With the American Board of Pathology First-Time Test Taker Pass/Fail Rate at the University of Pittsburgh Medical Center

Context.—Factors that correlate with success or failure on the American Board of Pathology (ABP) examination are not known. Other medical residency programs have shown that standardized test scores correlate with specialty board examination scores; however, data from pathology programs are lacking. Objective.—To investigate whether the 2-digit score on step 1 of the United States Medical Licensing Examination (USMLE) was correlated with ABP examination performance at a large university pathology program. Design.—Nine years of data (2001–2009) from pathology residents (n = 72) at the University of Pittsburgh Medical Center (UPMC, Pittsburgh, Pennsylvania) was collected from existing files and deidentified. Step 1 USMLE 2-digit scores and ABP failure rates for first-time test takers were compared. Results are reported as the percentage of residents who failed either the anatomic pathology or clinical pathology part of the ABP examination in cohorts by their USMLE 2-digit score (≤80, 81–85, 86–89, ≥90). Results.—The rolling 5-year (2005–2009) ABP average failure rate for first-time test takers of the anatomic pathology examination was 3.1% (UPMC) and 14.1% (nationally); in clinical pathology, it was 13.8% (UPMC) and 23.6% (nationally). At UPMC, no resident failed the anatomic pathology or clinical pathology parts of the ABP examination if his or her 2-digit USMLE step 1 score was 90 or more across 9 years of training (2001–2009). Conclusions.—In the UPMC pathology program, 2-digit scores on USMLE step 1 of 90 or more and 80 or less were strong measures of ABP first-time pass/failure rates, whereas scores of 81 to 89 were less-accurate measures. The USMLE step 1 score is one of many criteria that can be used for screening applicants for a pathology residency program.