Medical Licensing Exam Biased

Teacher & Employment Testing

Men scored higher than women, and whites higher than other racial groups, on the lengthy multiple-choice exam administered to all prospective medical doctors, according to a nationwide research study. Differences in academic backgrounds explained some of the overall gap between ethnic groups, but a large disparity between men and women of all races remained after controlling for preparation.


The scores and school records of more than 10,000 medical school students who took the test in 1986, 1987 and 1988 were studied. Typically the test is taken two years before expected graduation.


Approximately 8% more women than men failed Part I of the National Board of Medical Examiners (NBME) test, which consists of between 900 and 1,000 multiple-choice questions. Women did as well as men on Part II of the exam which covers clinical skills.


At the time of the study, medical schools widely used NBME Part I scores to select candidates for residency programs and to make promotion and retention decisions. Now the test is required of all those seeking medical licenses in the U.S.


The researchers expressed concern about these uses of the NBME, admitting, "It is unclear whether the differences among student groups observed in this study reflect the actual magnitude of academic difference or result from other factors." They are careful to caution that the results "do not imply that physician performance varies among racial and ethnic groups or between men and women." But they do not cite the growing body of research demonstrating that the fast-paced, multiple-choice format favors males (see Examiner, Summer 1994, Winter 1993-94). Once again, a standardized, multiple-choice test with questionable validity may be a barrier to access for a profession that ostensibly wants to better reflect the clientele it serves.


"Performance on the National Board of Medical Examiners Part I Examination by Men and Women of Different Race and Ethnicity," Journal of the American Medical Association (JAMA), September 7, 1994, Vol. 272, No. 9.