Gender-Based Differences in Clinical Academic Performance Among Sixth-Year Medical Students: A Five-Year Retrospective Study at Mutah University.

IMPORTANCE: Gender-based disparities in clinical academic performance have received growing international attention, yet evidence from the Middle East, including Jordan, remains limited. OBJECTIVE: To examine gender-based differences in clinical rotation grades, General Secondary School Examination (Tawjihi) scores, and cumulative graduation grade point average (GPA) among sixth-year medical students. DESIGN SETTING AND PARTICIPANTS: This retrospective cohort study reviewed academic records of 1607 sixth-year medical students (930 females, 677 males) across 5 academic cohorts (2020-2024) at Mutah University in Al-Karak, Jordan. MAIN OUTCOMES AND MEASURES: Tawjihi scores, cumulative graduation GPA, and final grades across 4 core clinical rotations. Independent-samples t tests were performed, utilizing a manual Bonferroni correction to adjust the final alpha threshold to P <0.0125 for the clinical subject analyses. RESULTS: Male and female students did not differ significantly in baseline academic performance as measured by Tawjihi scores or cumulative graduation GPA. Subject-specific performance gaps were observed in 2 of the 4 clinical rotations. Male students achieved significantly higher scores than female students in internal medicine (mean [SD]: 74.22 [7.95] vs 72.56 [7.68]; mean difference, -1.66; 95% CI, -2.428 to -0.884; t 1 6 0 5 = -4.206; P <0.001) and in surgery (mean [SD]: 73.46 [7.95] vs 72.21 [7.98]; mean difference, -1.24; 95% CI, -2.218 to -0.272; t 1 6 0 5 = -2.510; P =0.012). Both findings remained statistically significant after Bonferroni adjustment (P <0.0125). CONCLUSIONS AND RELEVANCE: Female and male medical students demonstrated broadly comparable overall academic performance, with no significant differences in baseline aptitude or cumulative graduation GPA. However, male students exhibited small but statistically significant advantages of modest magnitude in internal medicine and surgery. These findings suggest that discipline-specific environmental or assessment factors-rather than global differences in academic ability-underlie these variations, highlighting a need for targeted evaluation of rotation-specific practices in regional medical curricula.