Current Practices and Perspectives on Clerkship Grading in Obstetrics and Gynecology.
American journal of obstetrics and gynecology
BACKGROUND: Clerkship grades in obstetrics and gynecology play an increasingly important role in the competitive application process to residency programs. An analysis of clerkship grading practices has not been queried in the past two decades in our specialty.
OBJECTIVE: To investigate obstetrics and gynecology clerkship directors' practices and perspectives in grading.
STUDY DESIGN: A 12-item electronic survey was developed and distributed to clerkship directors with active memberships in the Association of Professors of Gynecology and Obstetrics.
RESULTS: A total of 174 of 236 clerkship directors responded to the survey (response rate 73.7%). Respondents reported a variety of grading systems with the fewest (11.6%, 20/173) using a two-tiered or pass/fail systems and the most (41.6%, 72/173) using a four-tiered system. Nearly one-third (35.0%, 57/163) used a National Board of Medical Examiners subject examination score threshold to achieve the highest grade. Approximately 30% (45/151) had grading committees. Exactly half (50.0%, 87/174) reported requiring unconscious bias training for faculty who assess students. In addition, some responded that students from groups under-represented in medicine (28.9%, 50/173) and introverted students (60.7%, 105/173) received lower evaluations. Finally, 37.6% (65/173) agreed that grades should be pass/fail.
CONCLUSION: Considerable heterogeneity exists in obstetrics and gynecology clerkship directors' practices and perspectives on grading. Strategies to mitigate inequities and improve reliability of grading include elimination of a subject examination score threshold to achieve the highest grade and implementation of both unconscious bias training and grading committees.
Chen KT, Baecher-Lind L, Morosky CM, Bhargava R, Fleming A, Royce CS, et al Current practices and perspectives on clerkship grading in obstetrics and gynecology. Am J Obstet Gynecol. 2023 Sep 23:S0002-9378(23)00640-3. doi: 10.1016/j.ajog.2023.09.020. Epub ahead of print. PMID: 37748528.