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Background  The primary goal of residency programs is to select and educate qualified candidates to become competent physicians. Program directors often use performance on licensure examinations to evaluate the ability of candidates during the resident application process. The American College of Osteopathic Family Physicians (ACOFP) administers an in-service examination (ISE) to residents annually. There are few prior studies of the relationship between the Comprehensive Osteopathic Medical Licensing Examination of the United States of America (COMLEX-USA) series and formative assessments of residents in training. Objective  We explored the relationship between performance on COMLEX-USA and the ACOFP in-service examination to offer support on the use of licensing examinations in resident selection. Methods  In 2016, performance data from the COMLEX-USA and the ISE were matched for 3 resident cohorts (2011–2013, inclusive; N = 1384). Correlations were calculated to examine the relationship between COMLEX-USA and ISE scores. Multiple linear regression models were used to determine if performance on COMLEX-USA significantly predicted third-year ISE (ISE-3) scores. Results  Findings indicated that correlations among performance on COMLEX-USA and ISE were statistically significant (all P &amp;lt; .001), and there was strong intercorrelation between COMLEX-USA Level 3 and ISE-1 performance (r = 0.57, P &amp;lt; .001). Performance on the COMLEX-USA Levels 1 and 2–Cognitive Examination significantly predicted performance on the ISE-3 (F(2,1381) = 228.8, P &amp;lt; .001). Conclusions  The results support using COMLEX-USA as a part of resident selection in family medicine. Additionally, program directors may use performance on COMLEX-USA to predict success on the ISE-3.

Association Between Performance on COMLEX-USA and the American College of Osteopathic Family Physicians In-Service Examination