Continuing Certification Research

Understanding Discordant Board Outcomes

A new study examines why some physicians with a top score on the American Board of Physical Medicine and Rehabilitation (ABPMR) Part I Examination subsequently struggle on the Part II Examination. Researchers reviewed ABPMR examination data from 1999 to 2025, focusing on physicians who scored in the top quartile on Part I.

Among 9,783 physicians who completed both examinations, 161 (1.6%) achieved a top-quartile Part I score but subsequently failed one or more attempts at Part II. The study identified several factors associated with this outcome. Female physicians and those participating in fellowship training at the time of Part II were less likely to experience first-attempt failure. A higher odds ratio was found for physicians over 40 years of age, who self-identified with a non-White ethnicity, and for those who graduated from a newer or smaller residency program.

The study also found that top Part I performers who passed Part II demonstrated significantly higher performance across all five Part II domains: data acquisition, problem solving, patient management, systems-based practice, and interpersonal and communication skills. These findings highlight that strong performance on the written examination does not necessarily predict success on the oral examination, which tests application of medical knowledge.

The authors conclude that even physicians with excellent Part I performance should approach Part II preparation with focused and comprehensive preparation across all examination domains.

To read the full research article click here.