title: A multilevel analysis of examinee gender and USMLE step 1 performance.
abstract: BACKGROUND
  To examine the effects of (1) examinee gender on United States Medical Licensing Examination (USMLE) Step 1 performance, (2) examinee gender on the relationships between prematriculation measures and Step 1 performance, and (3) medical school characteristics on the relationships between examinee characteristics and Step 1 performance.
  
  
  METHODS
  A series of hierarchical linear models (examinees-nested-in-schools) was conducted predicting Step 1 scores. The sample included 66,412 examinees from 133 U.S. Liaison Committee on Medical Education-accredited medical schools/campuses.
  
  
  RESULTS
  Controlling for prematriculation measures, men outperformed women slightly on Step 1. Undergraduate science grade point averages were more associated with Step 1 performance for women than men. Schools with higher mean Medical College Admission Test (MCAT) science scores had higher mean Step 1 scores, and MCAT science scores were slightly more associated with Step 1 performance for students from schools with higher percentages of female students.
  
  
  CONCLUSIONS
  Patterns of gender-related performance differences on Step 1 generally mirrored those reported in earlier research. School-level variables provided some additional insight into these relationships, but additional research is needed to fully understand why men and women perform differently on the USMLE.
authors.affiliation: National Board of Medical Examiners, 3750 Market Street, Philadelphia, PA 19104, USA. mcuddy@nbme.org
authors.forename: Monica M
authors.initials: MM
authors.lastname: Cuddy
authors.forename: David B
authors.initials: DB
authors.lastname: Swanson
authors.forename: Brian E
authors.initials: BE
authors.lastname: Clauser
mesh_terms: D000704:Analysis of Variance; D002983:Clinical Competence; D015331:Cohort Studies; D004504:Education, Medical, Undergraduate / Q000458:organization & administration*; D005260:Female; D006801:Humans; D008007:Licensure, Medical; D016014:Linear Models; D008297:Male; D012737:Sex Factors; D014481:United States