Association Between Licensure Examination Scores and Practice in Primary Care

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Abstract
The medical profession ensures the basic competence of physicians by requiring them to pass licensing and certifying examinations.1 Although it is generally assumed that these examinations predict how physicians will practice in the future,2 the data in support of this assumption are mostly indirect. Physicians who have more training in a discipline are more knowledgeable3,4 and achieve higher scores in their respective discipline on recertification examinations.5 More knowledgeable physicians are more likely to adhere to evidence-based guidelines in the delivery of care6,7 and achieve better patient outcomes.6 Certification status, which represents pass/fail status on certification examinations, is an important predictor of quality of care.8,9