Does examiner bias in undergraduate oral and clinical surgery examinations occur?

Abstract

Numerous examination modalities are used to assess theoretical knowledge and competency in medical students. The oral and long case clinical examinations are particularly open to criticism, as they are inherently subjective, and may be partly assessing language skills rather than examining the students’ grasp of the curriculum1. Furthermore the examiner may have a conscious or unconscious bias, which could influence the student’s mark. This is a particular concern in South Africa, where racial classification and prejudice have been an important part of our unfortunate history and politics. The demographics of the staff and students within the Department of Surgery at the University of Cape Town are atypical in that most lecturers (and examiners) are ‘white’ males, whereas the majority of our students are female and not ‘white’. Furthermore, the medium of teaching and examining (and the home language of most examiners) is English, while many students speak another first language. We aimed to assess whether systemic bias according to language, gender or population group unfairly influenced the marks given in oral and clinical examinations in our department.