On October 27, 2025, the American Board of Emergency Medicine (ABEM) published aggregated pass-rate data for first-time qualifying (written) and oral board exam takers.^1,2 These data were specific to each residency program, sorted by state, and included programs that had graduated at least three classes of residents who have had the opportunity to take the exams. Per ABEM, these data were aggregated to help protect the anonymity of individuals in classes with small numbers. When news of this information being published spread through the emergency medicine (EM) community, many were quick to review the information and come to conflicting conclusions about whether having this information easily accessible was a good or bad thing. Here are a few reasons why I think this transparency may be beneficial.

For one, current residency applicants will have more data to help fine tune their rank lists or even determine to which programs they consider submitting applications. While geographic preference seems to contribute a significant amount to an applicant’s desire to apply,³ that doesn’t help much when there are multiple residency programs in a single city or region. If an applicant has interviewed at all of the local programs and finds that two of them are essentially identical when it comes to training experience through offered rotations, sub-specialty exposure, and overall sense of fit during interview day, first-time qualifying exam pass rates could be a key piece of information that raises one program ahead of the other on an applicant’s rankings.

Further, hospitals and staffing groups hiring new graduates may also find these data useful. Although we cannot say group performance will always reflect the performance of an individual, this information can be used as a surrogate data point. We operate on the assumption that a residency program would never graduate someone who would not be an effective, safe, or competent emergency physician. However, we also rely on past trends to reinforce that assumption. This determination can be difficult during a time when there has been substantial growth in our specialty, and many programs do not have historical data or examples to track.

From 2010 to 2023 there were approximately 1,458 new EM residency positions, with much of that growth happening after 2016.⁴ These numbers included newly opened programs and formerly American Osteopathic Association programs that transitioned to accreditation through the Accreditation Council of Graduate Medical Education (ACGME). In 2022 and 2023 when there were unprecedented numbers of EM residency positions open after The Match, many were quick to blame the number of new residency programs despite a sudden loss of medical student interest in EM due to many different factors.⁵ With new programs came skepticism of their curriculum and training experience; some arguing that many should be closed. Although many of these new programs have not graduated enough classes of residents to meet ABEM’s publishing criteria, in future years, we will have data to see if that argument holds any weight.

Of course, we cannot conflate pass rates with a program’s overall quality or ability to produce competent and compassionate physicians. One program’s pass rate might reflect their academic rigor through didactics and board review, and the next program’s might reflect the breadth of pathology and volume of patient encounters, and yet another’s might merely reflect the ability of their residents to learn independently without much external guidance or oversight. Is a program’s consistently high pass rate a testament to its curriculum, or is it a reflection of its ability to support trainees through an unprecedented pandemic that stretched our health care system to the brink of collapse and left many physicians with emotional baggage for years to come?

Understandably, there are concerns within our community of emergency physicians regarding the ABEM pass rate data being easily accessible. Programs working to improve their resident education might feel as if their hard work, and the hard work of their residents, is not being acknowledged due to the medical field’s insistence on using standardized testing as the gold standard, even when their patient outcomes and satisfaction scores might be phenomenal. Additionally, one could argue that the timing could have been better. These data were released just two weeks before many newly minted emergency physicians will be taking written boards and, depending on which program they have graduated from, this information could either provide reassurance or increase anxiety. Although this year’s residency applicants may not have been able to use these data to help inform their application list, they can at least use it to guide their acceptance of interview invites and their rank lists.

References

1. American Board of Emergency Medicine. Now Available: ABEM Exam Pass Rates by Residency Program. October 27, 2025. https://www.abem.org/news/now-available-abem-exam-pass-rates-by-residency-program/
2. American Board of Emergency Medicine. American Board of Emergency Medicine to Begin Publishing Program Exam Pass Rates in Fall 2025. April 28, 2025. https://www.abem.org/news/american-board-of-emergency-medicine-to-begin-publishing-program-exam-pass-rates-in-fall-2025/
3. Association of American Medical Colleges. Decoding Geographic and Setting Preferences in Residency Selection. January 18, 2024. https://www.aamc.org/services/eras-institutions/geographic-preferences
4. Schnabel N, Okoli D, Calabrese J, et al. The Expansion Dilemma: A Critical Look at the 13-Year Increase in Emergency Medicine Residency Positions. AEM Educ Train. 2025;9(3):e70064. Published June 12, 2025. doi:10.1002/aet2.70064. PMCID: PMC12159687. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12159687/
5. Gettel C. Emergency medicine residencies more likely to go unfilled at for-profit and newly accredited programs. The Conversation US. January 8, 2024. Accessed November 2, 2025. https://theconversation.com/emergency-medicine-residencies-more-likely-to-go-unfilled-at-for-profit-and-newly-accredited-programs-218991