The objective of our study was to evaluate what factors predict pediatric resident performance. A retrospective study of five classes (1991-1995) of pediatric residents graduated from a University based program were evaluated. Medical school variables evaluated included: class rank, cumulative grade point average (GPA), clinical grade point average (CGPA), pediatric clerkship grade (PCG), and National Board of Medical Examiners (NBME) Part I and II. Also gender, size of medical school attended and whether the resident was a graduate of our medical school were noted. Resident Selection (RS), final ranking and final matched rank were also considered. Resident performance was measured by the American Board of Pediatrics clinical competence average score(ABPS) and Pediatric Board Score (PBS). Chief residency selection and inservice examinations were also documented. Univariant analyses using Spearman rank correlation and t-tests were conducted. Seventy pediatric resident graduates were evaluated (42 females, 28 males, 22 from our medical school, 48 from other schools). No medical school variable correlated with ABPS. A positive correlation existed between PBS and NBMEI, INSIII, NBMEII, INSI, GPA, CGPA, PCG, RS rank, final matched rank, and class rank (rs = 0.64, 0.63, 0.55, 0.41, 0.40, 0.34, 0.33, -0.27, -0.33, -0.58 respectively). ABPS did not correlate with PBS. Chief residents' PCG, INSIII, ABPS, and PBS were higher (all p<0.05) than other residents but no difference in GPA or RS ranking was noted. The preacceptance factors and outcome measures between males and females were similar. Residents from small schools had similar PCG and GPA as those from larger ones, though NBI and PBS were higher in those from smaller schools (p = 0.01, 0.32 respectively); no difference in ABPS was seen. Our own school's residents matched with lower NBI than other residents(p = 0.028) while no difference in GPA or PCG was seen. ABPS was similar between these two groups, though our school's graduates' PBS were lower (p = 0.002). Residents' PBS correlates strongly with many factors known at the time of residency application. Our study corroborates with studies in other specialties noting that nocognitive skills are difficult to evaluate. A way to better evaluate these skills is needed if “success” is measured by the APBS and not PBS alone.