Does Pass/Fail on Medical Licensing Exams Predict Future Physician Performance in Practice? A Longitudinal Cohort Study of Alberta Physicians

Abstract

ABSTRACT The purpose of this longitudinal study was to gather extrapolation evidence of validity by assessing whether performance on a national medical licensing exam, in addition to practice and socio-demographic variables, is predictive of future physician performance in practice. The study focused on a cohort of 3,404 physicians who were registered with the College of Physicians and Surgeons of Alberta (CPSA) and who completed the Medical Council of Canada Qualifying Examination (MCCQE) Parts I and II between 1992–2017. Separate multivariate quasi-Poisson regression models were run to assess the degree of relationship between first-time pass/fail status on the MCCQE I and II, and several CPSA socio-demographic variables and several CPSA socio-demographic variables, in addition to complaints/physician and various prescribing flags. Candidates who failed the MCCQE I on their first attempt had 27% more complaints lodged against them, compared to those who passed. Physicians who failed the MCCQE II on their first attempt prescribed 2+ benzodiazepines and 2+ opioids to 30% more patients than those who passed. Conclusions: Performance on the MCCQE Part I and II is an important predictor of physician performance. Combined with other critical variables, these measures provide important evidence to aid in risk modeling efforts and to guide educational interventions for physicians at an early stage of their careers.