Why the MIR exam penalizes women with the best grades in the Medicine career

• Specialized medical training Patricia Andrés, the number 1 of the MIR 2023: "I'm going to do Dermatology"

Two graduates in Medicine, a man and a woman, leave the faculty with the same average grade after 6 years of study and take the MIR exam: women usually achieve better results in the lower part of the table, but, as they rises in the

, the female applicant performs worse than the male.

Along the same lines, the more competitive the test is (that is, the more applicants there are for each MIR position), the worse the results of women tend to be compared to those of men, especially among the brightest applicants in the career.

This is the main conclusion of a documented study made public by the

Esade's Center for Economic Policies (EsadeEcPol), and which relates the existence of this gender gap to two factors inherent to the intrinsic characteristics of the MIR exam:

for access to specialized health training and

in a test that penalizes failures.

The study, signed by

, a doctoral candidate at the Carlos III University of Madrid, uses the 2022 call as a reference. In that test, which was held on January 29 of last year, the female applicants with the highest grades in their respective races obtained

than the men with the same record.

Among the lowest marks in the grade, the women obtained, however, a little more than two points above the note achieved by their male colleagues.

In the call that takes the 2022 study as a reference, the differences in the average grade of women and men are hardly significant (an average of 7.6 for women and 7.5 for men), and this trend It is an echo of that of previous calls.

Even so, if the focus is broadened, the study shows that the differences remain, at least in the last five years: during the period 2018-2022, 65% of the candidates who applied for the MIR were women, but their proportion

.

The question that arises almost automatically is: How many positions in the final lists of the test is equivalent to that difference of 3 points in the upper part of the distribution?

In light of the data in the report, this difference, which on paper seems insignificant, becomes very relevant when choosing a MIR position: in 2022, those three points were equivalent to between 500 and 600 positions in

, "depending on the econometric specification used".

To contextualize this jump, Sunyer argues that it is a difference equivalent to the distance between the third specialty that sold out its places earlier in that call (Cardiology) and the sixth (Ophthalmology), and her conclusion is that "women obtained specialties less demanded than men".

Another piece of information: in the 2022 call, only Family and Community Medicine (the last one that exhausted its teaching offer that year) put more than 500 places at stake.

The EsadeEcPol study attributes part of this gender gap to an intrinsic characteristic of multiple choice exams, the penalty that involves not answering a question, and

, "preferring not to response to risk discarding some of the options in the test, with the consequent penalty".

The analysis of the 2022 test reveals that women leave more questions blank in all grade ranges (divided into ten deciles) and, although the differences are not very significant by gender, the truth is that in seven of those ten deciles they are above 5%, in the case of them.

In any case, the report itself admits that the lower propensity of women to

is only part of the explanation, since, among the highest grades, the candidates (whether men or women) hardly leave any questions unanswered.

Sunyer then refers to a previous study, from 2022 (

:

), which analyzes data from the MIR exam from 1983 to 2019 and, with that perspective, , tries a new argument: "The higher the degree of competitiveness of a test, the lower the relative performance of women compared to men, especially among the highest grades."

In the case of the MIR exam, "competitiveness degree" is translated as the number of candidates who opt for each of the places at stake.

In the Díez-Rituerto study, four periods of time are distinguished with different levels of competitiveness: between 1983 and 1988, the level was very high, with a probability of achieving a MIR position of less than 20% (20 positions for every 100 candidates). ;

between 1989 and 2002, the level dropped and was between 20% and 40%;

between 2003 and 2011, the probability of obtaining a place was greater than 60%, and between 2012 and 2019 the offer of places was restricted and the level of competitiveness experienced an upturn (between 40 and 60%).

To establish a reference,

.

The data from the Díez Rituerto study show that there is a direct relationship between high levels of competitiveness in the MIR test and an increase in the gender gap in the test, and Sunyer launches a message that, for him, is unequivocal: "A greater competitiveness, the lower the relative average performance of women compared to that of men, and these changes in performance increase the propensity of women to leave answers blank, but also to make more errors.

How to bridge the gap

According to the EsadeEcPol study, both the design of the MIR exam and "the context in which it is presented" affect men and women differently.

In this sense, the report puts on the table some corrective measures, both intrinsic to the development of the test and related to that context.

Among the first, Sunyer proposes

and cites as an example of positive previous experience the suppression of this penalty in the university entrance exam in Chile, the equivalent of the Spanish EvAU.

This measure reduced the difference in the number of blank questions by 70% and, as a result, the gender gap in the final exam result was reduced by 13%, especially among Chilean students with the highest grades on the exam. proof.

In the case of the MIR exam, Sunyer acknowledges, however, that penalizing errors is an "effective mechanism" to improve the accuracy of the test and that eliminating it "means, therefore, harming the most qualified candidates, as it is more difficult to differentiate between degrees of knowledge".

Another alternative proposed by the Esade study to try to reduce the gender gap detected is

, since the current 90% (compared to only 10% of the academic record) supposes , according to the conclusions of the report, that we are facing

for the more than 10,000 doctors who attend it each year.

However, the author of the study admits that this alternative also has its counterpart: it is possible that

, thus resulting in another type of inequality."

According to the criteria of The Trust Project

Know more