title: Toward a better understanding of gender-based performance in the obstetrics and gynecology clerkship: women outscore men on the NBME subject examination at one medical school.
abstract: OBJECTIVE
  To better understand why women outperform men in the obstetrics and gynecology (Ob/Gyn) clerkship.
  
  
  METHODS
  The authors conducted a retrospective cohort study of students who rotated in the Ob/Gyn clerkship from 2008 to 2011 and graduated by May 2012 from the Icahn School of Medicine at Mount Sinai in New York City. They compared female and male students' performance on preclerkship standardized tests (the Medical College Admission Test [MCAT] and United States Medical Licensing Examination [USMLE] Step 1) and on Ob/Gyn clerkship components (clinical skills achievement, oral and written case presentations, clinical evaluations, and National Board of Medical Examiners [NBME] subject examination).
  
  
  RESULTS
  The study included 163 (53.4%) women and 142 (46.6%) men. Among students who took the MCAT, women scored lower than men with a mean (standard deviation) of 33.2 (3.2) versus 34.6 (3.3) (P=.001). Similarly, among all students, women scored lower than men on the USMLE Step 1: 227 (19.1) versus 232.5 (18.8) (P=.012). There were no significant gender differences on most clerkship components. However, women scored higher than men on the Ob/Gyn NBME subject examination: 78.0 (7.5) versus 74.8 (8.4) (P=.001). Consequently, female students achieved higher overall clerkship scores than men: 88.5 (5.6) versus 87.1 (5.1) (P=.024). Analysis of covariance confirmed that gender is associated with NBME subject examination score (P<.001).
  
  
  CONCLUSIONS
  Women outscored men on the NBME subject examination in Ob/Gyn and thereby outperformed men in the Ob/Gyn clerkship.
authors.affiliation: Dr. Bibbo is clinical fellow in maternal fetal medicine, Department of Obstetrics and Gynecology, Brigham and Women's Hospital, Boston, Massachusetts. Ms. Bustamante is program coordinator of the clerkship in obstetrics and gynecology, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York. Dr. Wang is biosciences and bioinformatics subject specialist, Icahn School of Medicine at Mount Sinai, New York, New York. Dr. Friedman is associate professor and vice chair of academic affairs of obstetrics, gynecology, and reproductive science, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York. Dr. Chen is associate professor of obstetrics, gynecology, and reproductive science; associate professor of medical education; vice chair of obstetrics and gynecology education, career development, and mentorship; and director of obstetrics and gynecology medical student clerkship and electives, Department of Obstetrics, Gynecology and Reproductive Science, Icahn School of Medicine at Mount Sinai, New York, New York.
authors.forename: Carolina
authors.initials: C
authors.lastname: Bibbo
authors.forename: Alejandrina
authors.initials: A
authors.lastname: Bustamante
authors.forename: Lili
authors.initials: L
authors.lastname: Wang
authors.forename: Frederick
authors.initials: F
authors.lastname: Friedman
authors.forename: Katherine T
authors.initials: KT
authors.lastname: Chen
mesh_terms: D000328:Adult; D002982:Clinical Clerkship; D004521:Educational Measurement; D005260:Female; D006176:Gynecology / Q000193:education*; D006801:Humans; D008007:Licensure, Medical; D008297:Male; D009774:Obstetrics / Q000193:education*; D012189:Retrospective Studies; D012737:Sex Factors; D014481:United States