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ABSTRACT: Background?
The fourth year of medical school has come under recent scrutiny for its lack of structure, cost- and time-effectiveness, and quality of education it provides. Some have advocated for increasing clinical burden in the fourth year, while others have suggested it be abolished.Objective?
To assess the relationship between fourth-year course load and success during internship.Methods?
We reviewed transcripts of 78 internal medicine interns from 2011-2013 and compared the number of intensive courses (defined as subinternships, intensive care, surgical clerkships, and emergency medicine rotations) with multi-source performance evaluations from the internship. We assessed relative risk (RR) and 95% confidence interval (CI) of achieving excellent scores according to the number of intensive courses taken, using generalized estimating equations, adjusting for demographics, US Medical Licensing Examination (USMLE) Step 1 board scores, and other measures of medical school performance.Results?
For each additional intensive course taken, the RR of obtaining an excellent score per intensive course was 1.05 (95% CI 1.03-1.07, P?P?=?.03). An association of intensive course work with increased risk of excellent performance was seen across multiple clinical competencies, including medical knowledge (RR 1.08, 95% CI 1.04-1.11); patient care (RR 1.07, 95% CI 1.04-1.10); and practice-based learning (RR 1.05, 95% CI 1.03-1.09).Conclusions?
For this single institution's cohort of medical interns, increased exposure to intensive course work during the fourth year of medical school was associated with better clinical evaluations during internship.
SUBMITTER: Richards CJ
PROVIDER: S-EPMC5319629 | biostudies-literature | 2017 Feb
REPOSITORIES: biostudies-literature
Richards Christopher J CJ Mukamal Kenneth J KJ DeMelo Nikki N Smith C Christopher CC
Journal of graduate medical education 20170201 1
<h4>Background</h4>The fourth year of medical school has come under recent scrutiny for its lack of structure, cost- and time-effectiveness, and quality of education it provides. Some have advocated for increasing clinical burden in the fourth year, while others have suggested it be abolished.<h4>Objective</h4>To assess the relationship between fourth-year course load and success during internship.<h4>Methods</h4>We reviewed transcripts of 78 internal medicine interns from 2011-2013 and compared ...[more]