The American Board of Surgery Certifying Examination: a retrospective study of the decreasing pass rates and performance for first-time examinees

Background: There has been a noticeable decrease in the pass rate for the American Board of Surgery Certifying Examination during the last 5 years. We hypothesize that this decline is statistically significant, and we wish to determine whether the pass rates had any geographic patterns of distribution.

Methods: In this retrospective cohort trial, publically available electronic data sets of pass rates on the American Board of Surgery Certifying Examination were evaluated from the American Board of Surgery website. χ(2) tests were used to determine whether there was any association between the pass rates and the academic year. A descriptive geographic evaluation of program-specific pass rates for first-time examinees was also performed.

Results: From 2006 to 2010, there has been a 7% decrease in the pass rate for the American Board of Surgery Certifying Examination. A χ(2) test shows that there is a statistically significant association with the pass percentage on the American Board of Surgery Certifying Examination and the year (p < 0.0001). Subgroup analysis demonstrated a difference in pass rate between 2006 and 2007 (p = 0.02). Geographic analysis showed the pass rates for first-time examinees were the highest in Rhode Island (100%) and the lowest in Puerto Rico (63%) from 2005 to 2010. Three of the 5 highest-performing states are on the Pacific Coast, and 4 of the 9 lowest-performing states are in the southern United States. There are differences between these 2 groups of states (p < 0.001).

Conclusions: There was a significant decrease in the pass rate for the American Board of Surgery Certifying Examination from 2006 to 2010. There also were some geographic patterns relating to first-time examinee performance from 2005 to 2010.