Which Filterable ERAS Metrics Predict Success in US Pediatric Residency? A Multisite Cohort Study.

BACKGROUND: While United States Medical Licensing Examination (USMLE) scores correlate with performance on subsequent standardized tests, it is not known whether they predict success in residency. Nonetheless, they remain the most used metric to narrow the large applicant pool. OBJECTIVE: To determine whether several filterable metrics reported by the Electronic Residency Application Service (ERAS) predict success in pediatric residency, as measured by Accreditation Council for Graduate Medical Education Pediatrics Milestone (PM) ratings. METHODS: Pediatric residency programs participating in the Association of Pediatric Program Directors (APPD) Longitudinal Educational Assessment Research Network were invited to participate in 2020; 10 of 149 programs (6.7%) provided data on 518 residents. Metrics included type of medical degree, US or non-US medical school, Alpha Omega Alpha and Gold Humanism Honor Society (GHHS) membership, USMLE Step 1 and Step 2 Clinical Knowledge (CK) numerical scores, and Step 2 Clinical Skills first attempt pass/fail status; primary outcome was mean PM ratings across all residency years. RESULTS: GHHS was positively associated with overall PM performance (B=0.15, P=.009), as was Step 2 CK (B=0.06, P=.007). By domain, Step 2 CK was positively associated with Medical Knowledge (MK), Patient Care (PC), and Practice-Based Learning and Improvement (PBLI). GHHS membership was positively associated with MK, PC, PBLI, Professionalism, and Systems-Based Practice. Effect size of GHHS was higher than Step 2 CK across all domains. CONCLUSIONS: Among filterable ERAS metrics, GHHS membership showed the strongest association with pediatric residency success, as measured by PM ratings; Step 2 CK had a weaker positive association.