Authors: Sun H et al.
Anesthesia & Analgesia 141(5):988–994, November 2025 DOI:10.1213/ANE.0000000000007490
Summary
This retrospective analysis from the American Board of Anesthesiology reviewed all first-attempt BASIC Examination results from 2014 through 2022, linking them to resident demographics, program characteristics, and prior in-training examination (CBY ITE) performance. The goal was to determine whether specific demographic groups had different first-time pass rates, and whether those gaps persisted after adjusting for earlier exam scores.
Data included over 17,000 examination attempts from more than 15,700 residents. Most residents were male, non-Hispanic or Latino, White, and graduates of US medical schools. First-time BASIC pass rates varied across demographic groups: males outperformed females; non-Hispanic or Latino residents outperformed Hispanic or Latino residents; Asian and White residents exceeded the first-time pass rates of Black/African American residents; and US medical graduates outperformed international graduates. Despite these early gaps, all demographic groups had eventual pass rates above 99%.
Regression modeling showed that even after adjusting for CBY ITE performance, demographic differences persisted. Female residents had reduced odds of passing on the first attempt compared to males, and Black/African American residents had significantly lower odds compared with White residents. Similar patterns were seen for Hispanic or Latino residents and those identifying as Middle Eastern or North African. Prior performance on the CBY ITE narrowed—but did not eliminate—the gender and racial performance gaps.
The study concludes that while nearly all residents ultimately pass the BASIC Examination, first-time pass rates differ meaningfully across demographic groups. The authors emphasize the need for further investigation into the causes of these disparities and strategies to support equitable educational outcomes.
What You Should Know
• Large-scale analysis covering 2014–2022 linked demographics, training program factors, and prior exam scores to BASIC Examination outcomes.
• First-attempt pass rates favored males, non-Hispanic or Latino residents, Asian and White residents, and US medical school graduates.
• Black/African American and Hispanic or Latino residents had lower first-attempt pass rates.
• Prior CBY ITE performance reduced—but did not eliminate—gender and racial gaps.
• Eventual pass rates for all demographic groups exceeded 99%.
• Findings highlight a need to explore structural or educational contributors to early exam performance differences.
KEY POINTS
Question: Are anesthesiology resident demographics, program characteristics, and/or resident prior examination performance associated with first-time pass rates on the American Board of Anesthesiology’s BASIC Examination?
Findings: Female, under-represented minority, and Hispanic/Latino residents had lower odds of passing the BASIC Examination on the first attempt than their respective counterparts; these demographic group performance differences were attenuated but not eliminated after controlling for the clinical base year in-training examination scores; however, all demographic subgroups’ eventual pass rates by their up-to-third attempts were >99%.
Meaning: The newly collected demographic information allowed the American Board of Anesthesiology to examine how equitable the acquisition of foundational knowledge as reflected in the BASIC Examination across different demographic subgroups, and future studies are needed to understand the basis of the differences in initial pass rates of the BASIC Examination among the subgroups and identify opportunities for improvement.
Thank you for allowing us to use this article from Anesthesia & Analgesia.