Does the National Board of Medical Examiners’ Surgery Subtest level the playing field?

Background We sought to determine if scores on the National Board of Medical Examinersʹ Surgery Subject Examination (NBME-SS) correlated with ward assessment of Fund of Knowledge and how the NBME-SS scores impacted surgery clerkship grade. Methods Student evaluations from 4 academic years (1999–2003) were analyzed. Scores from the Fund of Knowledge subsection were compared with scores on the NBME-SS. Student final grades were calculated with (at a weight of 10%) and without NBME-SS score. Results Data were available for all 399 students who rotated on surgery during the study period. Fund of Knowledge score and NBME-SS scores correlated minimally (Pearsonʹs r = 0.108, P = 0.031). Performance on the NBME-SS helped 11% of studentsʹ grades, but 64% of studentsʹ grades were hurt. Fifteen percent of the students missed receiving honors because of their performance on the NBME-SS. Conclusions The NBME-SS negatively influenced the grades of a large proportion of students and correlated only minimally with Fund of Knowledge scores as assessed on ward evaluations.