title: Clerkship timing and disparity in performance of racial-ethnic minorities in the medicine clerkship.
abstract: OBJECTIVE
  To determine the effect of the timing of the medicine clerkship on academic performance in different racial-ethnic student groups.
  
  
  METHODS
  Performance was measured by the average assessment of clinical preceptors, an OSCE (objective structured clinical examination), and the NBME (National Board of Medical Examiners) medicine subject examination. Outcomes were analyzed by student racial-ethnicity and clerkship sequence.
  
  
  RESULTS
  Of the 650 students who took the clerkship over four years, 6.9% were African American, 34.6% were Asian-Pacific Islander, 9.1% were Hispanic and 49.4% were white. African American and Hispanic students were in the earliest clerkship sequence 46.7% and 30.5% of the time, respectively, compared to 20% of Asian-Pacific Islanders and 27.4% of white students. Academic performance improved with time and varied among the racial-ethnic groups. All groups achieved higher scores in the NBME medicine examination later in the year but scores of African American and Hispanic students increased to a greater degree than other students.
  
  
  CONCLUSIONS
  Sometimes, a "few points" on the NBME medicine examination can affect students' final grades and alter their attractiveness to competitive residency training programs. All students, but African American and Hispanic students, in particular, can significantly improve their scores in the NBME medicine examination by taking the clerkship later in the year. Students should be counseled regarding the timing effect and methods to neutralize the disparity should be considered.
authors.affiliation: University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, USA. reteguiz@umdnj.edu
authors.forename: J
authors.initials: J
authors.lastname: Reteguiz
authors.forename: A L
authors.initials: AL
authors.lastname: Davidow
authors.forename: M
authors.initials: M
authors.lastname: Miller
authors.forename: W G
authors.initials: WG
authors.lastname: Johanson
mesh_terms: D002982:Clinical Clerkship / Q000706:statistics & numerical data*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D015510:Clinical Medicine / Q000706:statistics & numerical data*; D006801:Humans; D008913:Minority Groups / Q000706:statistics & numerical data*; D013997:Time Factors