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PurposeTo explore the relationship(s) between USMLE, In-Training Exam, and American Board of Pediatric (ABP) board-certifying exam scores within a pediatric residency-training program.MethodsData were abstracted from records of graduating residents from the Department of Pediatrics at the University of Florida/Jacksonville from 1999 to 2004. Sixty-one residents were identified and their files were reviewed for the following information: USMLE Step 1 and 2 scores (if available), in-training exam scores, and eventual board scores as reported by the ABP. Correlational and regression analyses were performed and receiver operating characteristic (ROC) curves were compared to evaluate the overall screening power of the tests by comparing their area under the curves (AUC).ResultsThe correlation coefficients between USMLE, in-training exam, and ABP scores were all statistically significant. In addition, USMLE Step 1 scores showed a strong correlation with board performance. Interestingly, none of the three in-training exam scores had any additional impact on predicting board performance given one's USMLE Step 1 score. USMLE Step 1 scores greater than 220 were associated with nearly a 100% passage rate on the board-certifying exam.ConclusionsThe data suggest that performance on Step 1 of the USMLE is an important predictor of a resident's chances of passing the pediatric boards. This information, which is available when a resident begins training, can be used to identify those at risk of not passing the boards. Individual learning plans can then be implemented early in training to maximize one's ability to pass the certifying exam.