T. Q. Ong2, J. P. Kopp1, A. T. Jones1, M. A. Malangoni1 1American Board Of Surgery,Philadelphia, PA, USA 2James Madison University,Harrisonburg, VA, USA
Introduction: Candidates pursuing certification in general surgery by the American Board of Surgery (ABS) must first pass a written qualifying exam and then an oral certifying exam (CE). Examiners evaluate candidates’ clinical ability to diagnose and manage problems encountered across the breadth of general surgery on the CE. Previous research in other contexts has found that examiners may exhibit bias toward examinees based on demographic variables such as gender. Systematic examiner bias threatens the fairness, reliability, and validity of the examination. We explored whether the gender of examinees or examiners were associated with CE scores and the likelihood of passing the CE.
Methods: Data from examinees who attempted the general surgery CE in the 2016-2017 academic year were analyzed. There were 1,341 examinees (61% male) and 216 examiners (82% male). Each examinee was rated by three pairs of examiners (one board examiner and one associate examiner). Factorial ANOVA and logistic regression analyses were conducted to examine whether examinee and examiner gender influenced CE scores and the likelihood of passing the exam. All effects were examined for both statistical and practical significance.
Results: ANOVA results indicated examiner and examinee gender did not influence average exam scores or pass rates. CE average scores were not associated with examinee gender (p = .24), board examiner gender (p = .14), or associate examiner gender (p = .10). All interaction effects between examiner and examinee gender were also nonsignificant (p’s > .05). Similarly, the likelihood of passing the CE was not associated with examinee gender (p = .88), board examiner gender (p = .77), associate examiner gender (p = .49), or any interactions between examinee and examiner gender (p’s > .05).
Conclusion: These results show there was no significant gender bias on the ABS general surgery CE. As the proportion of women entering the field of surgery increases, it will remain important to continue monitoring exam results to ensure no gender bias occurs in the future. The ABS has implemented implicit bias training for examiners to help mitigate the possibility of bias. Future research is needed to examine possible bias due to other factors.