USMLE Step 1 scores and PGY-5 ABSITE performance are predictive of American Board of Surgery examination first-time pass rates

Published:October 31, 2022DOI:


      • USMLE Step 1 scores predictor of board passage rate.
      • USMLE Step 2 as predictor.
      • ABS first-time pass rate.
      • ABSITE performance correlates with first time pass rates of ABS board exams.



      Standardized exams are utilized throughout a resident's career. With USMLE Step 1 score reports changing to pass/fail only, we sought to evaluate the relationships among USMLE Step 1 and 2, PGY-5 ABSITE, and ABS performance.


      Retrospective analyses of PGY-5 USMLE Step 1 and Step 2 scores, ABSITE percentile ranks, and ABS QE and CE first-time pass rates of graduates from 2010 to 2019 were performed.


      PGY-5 residents scoring ≤ 20th percentile on ABSITE during their PGY-5 year were more likely to have lower USMLE Step 1 scores, but not Step 2 scores, and have a lower ABS first pass rate. Lower Step and ABSITE scores together were associated with lower ABS first pass rate.


      As USMLE Step 1 is now a pass/fail examination, programs may need to utilize other information to select residency candidates and structure educational activities differently within their programs.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Surgery
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


        • Panda N.
        • Bahdila D.
        • Abdullah A.
        • et al.
        Association between USMLE Step 1 Scores and In-Training Examination Performance: A Meta-Analysis.
        vol. 96. Academic Medicine, 2021: 1742-1754
        • National Resident Matching Program
        Data Release and Research Committee: Results of the 2020 NRMP Program Director Survey.
        National Resident Matching Program, Washington, DC2021
        Date accessed: May 17, 2022
        • Salehi P.
        • Azizzadeh B.
        • Lee Y.H.
        Pass/fail scoring of USMLE Step 1 and the need for residency selection reform.
        Otolaryngology-Head Neck Surg (Tokyo). 2021; 164: 9-10
        • Lund S.
        • D'Angelo J.
        • D'Angelo A.L.
        • et al.
        New heuristics to stratify applicants: predictors of general surgery residency applicant step 1 scores.
        J Surg Educ. 2021; 79: 349-354
        • Suchanek J.A.
        • Davis A.T.
        • Sbraccia J.C.
        • Lindsey H.J.
        United States Medical Licensing Examination Step 1 scores are a quantifiably better predictor of American Board of Surgery In-Training Examination success compared to Step 2 scores.
        Am J Surg. 2022; 223: 482-484
        • Lauer C.
        • Buonpane C.
        • Lane S.
        • et al.
        General surgery residency application evaluation in a USMLE Step 1 pass/fail world: a retrospective comparison.
        J of Surg Research. 2021; 265: 317-322
        • Alterman D.M.
        • Jones T.M.
        • Heidel R.E.
        • Daley B.J.
        • Goldman M.H.
        The predictive value of general surgery application data for future resident performance.
        J Surg Educ. 2011; 68: 513-518
        • Sutton E.
        • Richardson J.D.
        • Ziegler C.
        • et al.
        Is USMLE step 1 score a valid predictor of success in surgical residency?.
        Am J Surg. 2014; 208: 1029-1034
        • Dr Spurlock
        • Holden C.
        • Hartranft T.
        Using United States medical licensing examination (USMLE) examination results to predict later in-training examination performance among general surgery residents.
        J Surg Educ. 2010; 67: 452-456
        • Shellito J.L.
        • Osland J.S.
        • Helmer S.D.
        • Chang F.C.
        American board of surgery examinations: can we identify surgier residency applicants and residents who will pass the examinations on the first attempt?.
        Am J Surg. 2010; 199: 216-222
        • De Virgilio C.
        • Yaghoubian A.
        • Kaji A.
        • et al.
        Predicting performance on the American board of surgery qualifying and certifying examinations: a multi-institutional study.
        Arch Surg. 2010; 145: 852-856
        • Maker V.K.
        • Zahedi M.M.
        • Villines D.
        • Maker A.V.
        Can we predict which residents are going to pass/fail the oral boards?.
        J Surg Educ. 2012; 69: 705-713
        • American Board of Surgery
        ABS Exam Pass Rates. The American Board of Surgery.
        2022 (Philadelphia, PA)
        Date accessed: September 30, 2022
        • London D.A.
        • Awad M.M.
        The impact of an advanced certifying examination simulation program on the American Board of Surgery certifying examination passage rates.
        J Am Coll Surg. 2014; 219: 280-284
        • Lindsey H.J.
        The Turnaround: Pulling Back from the Brink. Panel Discussion on Change Management: Matching Leadership Strategy to the Challenge. Association of Program Directors in Surgery Annual Meeting.
        United States, San Antonio, TXMay 3-7, 2022