Are Age, Sex, or Race and Ethnicity Associated With Performance on the OBGYN NBME Exam and Clerkship?

OBJECTIVE: We sought to evaluate the association of demographic variables—sex, age, and race/ethnicity—on the OBGYN National Board of Medical Examiners (NBME) subject exam scores and clerkship final grades to identify potential disparities that could impact residency matches. DESIGN: This retrospective study included 1550 students from a single medical school, spanning graduating classes from 2015 to 2024. Statistical analyses were conducted to examine differences in the OBGYN NBME scores and grades as a function of age, sex, ethnicity, and preclerkship performance. SETTING: Uniformed Services University of Health Sciences PARTICIPANTS: All clerkship level medical students (1550) over a 10 year period. RESULTS: Results indicated that younger students performed better on the OBGYN NBME exam, with a negative correlation between age and NBME scores (r = -.15, p < 0.001). Women outperformed men on the NBME exam (d = 0.23) and had higher final OBGYN grades than men. Analysis by race and ethnicity showed that nonunderrepresented in medicine races and ethnicities (NUIM) scored significantly higher than underrepresented in medicine (UIM) on the NBME exam (d = 0.34). However, when controlling for preclerkship performance, no significant differences were observed between ethnic groups. CONCLUSIONS: These findings highlight the need for residency programs to consider demographic influences on standardized test performance. Clerkship directors may need to evaluate grading rubrics and the weight given to NBME scores to ensure fair assessment and support for all students, particularly those from UIM backgrounds. Further research is needed to explore the underlying factors contributing to these disparities and to develop strategies to mitigate them.