Introduction: There are no existing data on whether performance on USMLE predicts success in ABEM certification. Aim of this study was to determine the presence of any association between USMLE scores and first-time success on the ABEM Qualifying and Oral Certification Examinations.

Methods: USMLE Step 1, Step 2 CK scores and pass/fail results from the first-attempt at ABEM qualifying and oral examinations from residents graduating between 2009 and 2011 from 9 emergency medicine programs were retrospectively collected. A composite score was defined as the sum of USMLE Step 1 and Step 2 CK scores.

Results: Sample was composed of 197 residents. Median Step 1, Step 2 CK and composite scores were 218 ([IQR] 207-232), 228 (IQR 217-239) and 444 (IQR 427-468). First-time pass rates were 95% for the qualifying examination and 93% for both parts of the examination. Step 2 CK and composite scores were better predictors of achieving ABEM initial certification compared to Step 1 score (area under the curve 0.800, 0.759 and 0.656). Step 1 score of 227, Step 2 CK score of 225 and composite score of 444 predicted a 95% chance of passing both boards.

Conclusion: Higher USMLE Step 1, Step 2 CK and composite scores are associated with better performance on ABEM examinations with Step 2 CK being the strongest predictor. Cutoff scores for USMLE Step 1, Step 2 CK and composite score were established to predict first-time success on ABEM Initial Certification.