1. Background Methods Objectives Results Conclusions USMLE Scores Predict Success in ABEM Initial Certification Ashley Pinawin 1, Nikhil Goyal 1, Elie Harmouche 1, Jumana Nagarwala 1, Rahul Bhat 2 1 Henry Ford Hospital Detroit, MI, 2 Georgetown/Washington Medical Center, Washington, DC Higher USMLE Step 1, Step 2 CK and composite scores are associated with better performance on ABEM examination. Step 2 CK score is the strongest predictor. Limitations: retrospective study. Successful ABEM certification on initial attempt is a goal for EM program directors, residents, and oversight agencies In 2014, 90% of residents passed the written examination passed on the first attempt and 96% passed the oral examination on their first attempt. USMLE scores are often utilized for selection of residency applicants. Currently, there is no existing data on whether performance on USMLE predicts success in ABEM certification. To determine the presence and strength of any association between USMLE scores and initial success on the ABEM Qualifying Examination and ABEM Oral Certification Examination. Retrospective cohort study of graduated residents from nine ACGME accredited EM residency programs between 2009-2011. USMLE Step 1, Step 2 CK, and composite score (sum of Step 1 and Step 2 CK) were identified. Pass or fail of ABEM Qualifying Examination and Oral Certification Examination on initial attempt were used as outcome variables. Wilcoxon rank sum test evaluated association. Univariable logistic regression analysis obtained ROC AUC. 286 subjects 90 excluded due to incomplete data n = 196 Results References American Board of Emergency Medicine. What are ABEM's Mission and Purposes? https://www.abem.org/public/general-information/what-are-abem's-mission-and-purposes-.www.abem.org/public/general-information/what-are-abem's-mission-and-purposes- Accreditation Council for Graduate Medical Education, American Board of Emergency Medicine. The Emergency Medicine Milestone Project. 2012; https://www.acgme.org/acgmeweb/Portals/0/PDFs/Milestones/EmergencyMedicineMilestones.pdf.www.acgme.org/acgmeweb/Portals/0/PDFs/Milestones/EmergencyMedicineMilestones.pdf Association of American Medical Colleges. Historical Specialty Specific Data, ACGME Residency, 2014-2010, By Program, Emergency Medicine. 2014; https://www.aamc.org/download/359222/data/emergencymed.pdf. https://www.aamc.org/download/359222/data/emergencymed.pdf National Resident Matching Program. Results of the 2014 NRMP Program Director Survey. 2014; http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf. http://www.nrmp.org/wp-content/uploads/2014/09/PD-Survey-Report-2014.pdf Step 1Step 2 Composite Score Mean ± SD219 ± 16228 ± 17447 ± 29 Median [IQR1- IQR3] 218 [207-232] 228 [217-239] 444 [427-468] Fail (n=14) Pass (n=182) P-value USMLE Step 1 211 ± 16219± 16 0.045 * USMLE Step 2 CK 211 ± 18230 ± 16 <0.001 * Composite USMLE Score 424± 30452 ± 280.003 * Table 2: Association of USMLE step score with boards outcome. Table 1: Testing scores and board first pass rate. 90% PPV95% PPV ROC AUC (95% CI) USMLE Step 1 208231 0.648 (0.511-0.785) USMLE Step 2 CK 217229 0.771 (0.646-0.896) Composite Score 430453 0.717 (0.568-0.865) Table 3: Prediction cut points for first-attempt success at ABEM certification.