The Association Between Performance on the Emergency Medical Services In-Training Exam and Passing the Emergency Medical Services Certifying Exam

Background: Prior studies have demonstrated a correlation between in-training exam performance and success on the certifying exam in various medical specialties. It is unknown if a relationship exists between performance on the Emergency Medical Services (EMS) In-Training Exam (EMSITE) and success on the EMS Certifying Exam (EMSCE); consequently, EMSITE score reports include percentile rankings to compare performance against other fellows, but do not offer a criterion score or prediction of success on the EMSCE. The goal of this study was to examine if an association exists between EMSITE score and success on the EMSCE. Methods: This was a retrospective data review, linking data from EMSITE records and EMSCE records. Performances on the 2020 and 2021 EMSITE were compared to the 2021 EMSCE results. Fellows who took the EMSITE but did not take the EMSCE were excluded. EMSITE performance was examined based on overall score and for each of the four content areas. EMSCE results were dichotomized as “pass” or “fail.” Odds ratios were obtained using an unadjusted univariate logistic regression and reported with 95% confidence intervals. Results: During the 2019–2020 and 2020–2021 academic years, 161 fellows took the EMSITE. This includes 132 (82.0%) who took the EMSCE in 2021. Among those who took the EMSCE, 117 (88.6%) passed. There was an association between the overall EMSITE score and passing the EMSCE (OR 1.17, 95% CI: 1.05–1.30). This association was demonstrated in the content areas of Medical Oversight of EMS (OR 1.14, 95% CI 1.05–1.23) and Quality Management and Research (OR 1.06, 95% CI 1.01–1.10). This association was not significant in the content areas of Clinical Aspects of EMS Medicine (OR 1.09, 95% CI 1.00–1.20) and Special Operations (OR 1.02, 95% CI 0.96–1.09). Conclusion: These data demonstrate an association between performance on the EMSITE and success on the EMSCE.