To investigate whether postponing certification testing, either voluntarily or involuntarily, affects a candidate's performance on pediatric certifying examinations.

Both general pediatrics (GP) and pediatric subspecialty (PS) examination candidates were included in the study. Candidates were classified into 3 groups based on time since the completion of training: no delay (<12 months), short delay (12-24 months), and long delay (≥24 months). Examination scores and pass rates in the first GP and PS certifying examinations were compared to assess between-group differences.

Significant differences in scores and pass rates were found for GP candidates who voluntarily waited 1 year or longer to take the certifying examination. Similarly, PS candidates who opted not to take the first examination available had significantly lower scores and pass rates. However, no significant difference was found for PS candidates who had to wait to take their examination owing to the Board's offered examination schedule.

Candidates who postpone taking the certifying examination are less likely to pass the examination. The longer a candidate elects to wait to take the examination, the less likely he or she is to pass. The availability of the PS examinations once every 2 years does not affect pass rates and scores, as long as PS candidates take the first available examinations after completing fellowship.