Background: Previous work has demonstrated the impact of sex on the relationship between confidence and competence, with women having less confidence and less self-perceived competence. Recent recruitment of examiners by the American Board of Surgery (ABS) allowed exploration of confidence and perceived competence. Study design: We solicited 23,869 eligible board-certified surgeons (4,382 women) via email to serve as examiners for the ABS General Surgery Certifying Examination (GCE). Volunteers were asked about practice and comfort examining in the 14 GCE content areas. Regression models investigated the relationship between reported practice and confidence examining. Results: There were 2,157 surgeons who volunteered, of whom 420 (19.5%) were female. Men reported practicing in a greater number of content areas than women (6.59 vs 5.36, p < 0.001) and selected more content areas in which they felt comfortable examining (7.69 vs 6.64, p < 0.001). The average male volunteer was comfortable examining in 0.70 more content areas than women, controlling for self-reported practice. Conclusions: Men reported practicing more broadly and were more confident than women in their ability to examine across ABS Certifying Examination content areas. However, the confidence of male surgeons was not restricted to those areas in which they reported practicing. These data have important implications for training, leadership, and professional development.
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