Performance on the National Board of Medical Examiners Part I Examination by Men and Women of Different Race and Ethnicity

OBJECTIVE: To investigate the performance of men and women from various racial and ethnic backgrounds on the National Board of Medical Examiners Part I examination, controlling for any differences in measures of educational background and academic performance before entering medical school. DESIGN: A retrospective analysis of existing records from the National Board of Medical Examiners and the Association of American Medical Colleges. SETTING: National Board of Medical Examiners. PARTICIPANTS: All students taking the June administration of Part I for the first time in 1986, 1987, or 1988 and who were 2 years from graduation from an accredited medical school. METHODS: Multiple regression methods were used to estimate Part I examination group differences in performance that would be expected if all students entered medical school with similar Medical College Admission Test scores, undergraduate grade point averages, and other prematriculation measures. MAIN OUTCOME MEASURE: Performance on the Part I examination. RESULTS: There were substantial differences in performance, with white students scoring highest, followed by Asian/Pacific Islanders, Hispanics, and blacks; within all racial and ethnic categories, women scored lower than men. Controlling for dissimilarities in academic background greatly reduced Part I differences among most racial and ethnic groups, except Asian/Pacific Islander men; unexplained differences remained between men and women. Results were consistent for the 3 years examined. CONCLUSIONS: The results of this study do not imply that physician performance varies among racial and ethnic groups or between men and women; no written examination can measure all the abilities that may be desirable to assess. Validity research investigating reasons for the reported gender and racial and ethnic differences in performance on the National Board examinations should be continued.