Predicting Medical School and Internship Success: Does the Quality of the Research and Clinical Experience Matter?

ABSTRACT Objectives: This article explores specific aspects of self-reported clinical and research experience and their relationship to performance in medical training. Methods: This is a retrospective cohort study conducted at the Uniformed Services University. The American Medical College Application Service application was used to discern students' self-reported clinical and research experience. Two authors applied a classification scheme for clinical and research experience to the self-reported experiences. Study outcomes included medical school grade point average (GPA), U.S. Medical Licensing Examination (USMLE) scores, and intern expertise and professionalism scores. A linear regression analysis was conducted for each outcome while controlling for prematriculation GPA. Results: Data were retrieved on 1,020 matriculants. There were several statistically significant but small differences across outcomes when comparing the various categories of clinical experience with no clinical experience. The technician-level experience group had a decrease of 0.1 in cumulative GPA in comparison to students without self-reported clinical experience (p = 0.004). This group also performed 5 points lower on the USMLE Step 2 than students who did not report clinical experience (p = 0.013). The various levels of self-reported research experience were unrelated to success in medical school and graduate medical education. Discussion: These findings indicate that self-reported technician-level clinical experience is related to a small reduction in typically reported outcomes in medical school.

Download Full-text

Disciplining empathy: Differences in empathy with U.S. medical students by college major

Health An Interdisciplinary Journal for the Social Study of Health Illness and Medicine ◽

10.1177/1363459320967055 ◽

2020 ◽

pp. 136345932096705

Author(s):

Lauren D. Olsen ◽

Hana Gebremariam

Keyword(s):

Social Sciences ◽

Medical School ◽

American Medical ◽

College Major ◽

The United States ◽

American Medical College ◽

School Students ◽

Data Set ◽

Application Service ◽

Medical Educators

Citing their students’ low levels of empathy, medical educators have scrambled to implement curricula with the hopes of buffering against the corrosive effects of biomedical and clinical experiences in medical school. The assumption undergirding these studies by social scientists and medical educators alike is that immersion in biomedical education and clinical experience erodes students’ empathic capacities, and that exposure to humanities and social sciences content will amend these losses. But we do not know if this assumption is correct. In this project, we empirically assess this assumption by utilizing a unique data set constructed from student applicant and survey data from the American Medical College Application Service (AMCAS) and the Association of American Medical Colleges (AAMC). We test whether medical school students ( N = 8255) from the United States (U.S.) with different academic backgrounds represented by their college major have different levels of empathy, net of demographic control variables. We report two findings. First, we find that students who majored in humanities or interpretive social sciences disciplines have higher empathy scores than their peers who majored in the positivistic social sciences and STEM (science, technology, engineering, and mathematics) disciplines. Second, we find that the relationship between empathy and time in medical school is more nuanced than we would expect from the existing literature.

Download Full-text

Successfully Matching Into Surgical Specialties: An Analysis of National Resident Matching Program Data

Journal of Graduate Medical Education ◽

10.4300/jgme-d-09-00020.1 ◽

2010 ◽

Vol 2 (3) ◽

pp. 316-321 ◽

Cited By ~ 43

Author(s):

Jeremy R. Rinard ◽

Ben D. Garol ◽

Ashvin B. Shenoy ◽

Raman C. Mahabir

Keyword(s):

Medical School ◽

Medical Society ◽

Research Experience ◽

Surgical Specialty ◽

Surgical Residency ◽

Application Service ◽

Usmle Step 1 ◽

Usmle Step ◽

Top 40 ◽

The Impact

Abstract Objective We explored the impact that attributes of US medical school seniors have on their success in matching to a surgical residency, in order to analyze trends for National Resident Matching Program (NRMP) match outcomes in surgical specialties between 2007 and 2009. Methods Using Electronic Residency Application Service data and NRMP outcomes, we analyzed medical students' attributes and their effect in successfully matching students into residency positions in surgery, otolaryngology, orthopedic surgery, plastic surgery, and obstetrics and gynecology. Attributes analyzed included self-reported United States Medical Licensing Examination (USMLE) Step 1 and Step 2 scores, Alpha Omega Alpha (AOA) Honor Medical Society membership, research experience, additional graduate degree status, and graduation from a top 40 National Institutes of Health (NIH)–funded medical school. Odds ratios were calculated for each criterion, and 95% confidence intervals were used to determine significance. Results Between 2007 and 2009, the number of surgical specialty residency positions increased by 86, and the number of applicants increased by 34. Membership in AOA, USMLE Step 1 and Step 2 scores, research experience, and graduation from a top 40 NIH-funded medical school frequently had a significant impact on residents successfully matching into many specialties, while additional graduate degrees had no effect on matching into surgical specialties (range 0.64 to 1.2). Conclusions Although the statistical significance varied across specialties, higher USMLE Step 1 and Step 2 scores, AOA membership, research experience, and graduation from a top 40 NIH-funded medical school generally had a positive impact on match success to surgical residency for US allopathic seniors. Test preparation and seeking research experience during undergraduate medical education may be effective approaches for increasing the likelihood of success for US seniors matching into a surgical specialty.

Download Full-text

Sexual harassment during medical training: the perceptions of medical students at a university medical school in Australia

Medical Education ◽

10.1046/j.1365-2923.2000.00684.x ◽

2000 ◽

Vol 34 (12) ◽

pp. 980-986 ◽

Cited By ~ 39

Author(s):

Gillian Eyres White

Keyword(s):

Medical Students ◽

Sexual Harassment ◽

Medical School ◽

Medical Training

Download Full-text

Effective Strategies for Global Health Training Programs A Systematic Review of Training Outcomes in Low and Middle Income Countries

Global Journal of Health Science ◽

10.5539/gjhs.v8n11p278 ◽

2016 ◽

Vol 8 (11) ◽

pp. 278 ◽

Cited By ~ 2

Author(s):

Aprill Z. Dawson ◽

Rebekah J. Walker ◽

Jennifer A. Campbell ◽

Leonard E. Egede

Keyword(s):

Medical Training ◽

Skills Training ◽

High Income ◽

Training Methods ◽

Middle Income ◽

Training Outcomes ◽

Effective Strategies ◽

Middle Income Countries ◽

Low Middle Income Countries ◽

Low And Middle Income

INTRODUCTION: Low and middle-income countries face a continued burden of chronic illness and non-communicable diseases while continuing to show very low health worker utilization. With limited numbers of medical schools and a workforce shortage the poor health outcomes seen in many low and middle income countries are compounded by a lack of within country medical training.METHODS: Using a systematic approach, this paper reviews the existing literature on training outcomes in low and middle-income countries in order to identify effective strategies for implementation in the developing world. This review examined training provided by high-income countries to low- and middle-income countries.RESULTS: Based on article eligibility, 24 articles were found to meet criteria. Training methods found include workshops, e-learning modules, hands-on skills training, group discussion, video sessions, and role-plays. Of the studies with statistically significant results training times varied from one day to three years. Studies using both face-to-face and video found statistically significant results.DISCUSSION: Based on the results of this review, health professionals from high-income countries should be encouraged to travel to low- middle-income countries to assist with providing training to health providers in those countries.

Download Full-text

On Teaching the Sum While Paying Attention to the Parts: Whole Person Care through Ethnography in Medical Education

International Journal of Whole Person Care ◽

10.26443/ijwpc.v2i2.96 ◽

2015 ◽

Vol 2 (2) ◽

Author(s):

Vasiliki Nataly Rahimzadeh ◽

David Lessard ◽

Peter Nugus

Keyword(s):

Medical Students ◽

Family Medicine ◽

Medical School ◽

Professional Identity ◽

Identity Formation ◽

Medical Training ◽

Academic Discipline ◽

Professional Identity Formation ◽

Patient Centered ◽

Whole Person

Objective—This article provides a reflection on medical teaching opportunities for whole person care based on our experiences mentoring 2nd-year medical students through an Ethnography Practicum at a Canadian university. Background—The Ethnography Practicum is a new addition to the Family Medicine Transition to Clinical Practice (TCP) curriculum introduced in the second year of medical school at McGill University. It involves 30 hours of instruction (6 hours in lectures with an instructor, and 24 hours in small-group tutorials with the authors), and 9 hours of fieldwork observations in various community health settings across Montreal, QC. The primary aims of the Practicum converge with those of the TCP generally in two important ways: to inculcate in students the concepts of patient centered care, and to promote family medicine as both an academic discipline and career option. Results and Discussion— Our experiences illustrate two tensions that shape students’ expectations and experiences throughout their involvement in the Practicum and, in turn, highlight the implications for teaching whole-person care. First, ethnography as a combination of different methods has itself been the locus of tensions between positivist and critical traditions in the three last decades. Second, the Practicum is situated precisely at the crossroads of key moments on the professional identity formation continuum for our students. Such a crossroads is disruptive to the status quo of medical traineeship characteristic of the first two years in medical school, and thus reorients professional identity formation. The above tensions reveal how ethnography is not only a revered research tradition in the humanities, but can also be a conduit to whole person care-inspired clinical practice.Conclusion—As instructors and mentors involved in this Ethnography Practicum, we are continually forging a new relevance for organizational ethnography in medical training, where medical students can reflect and act on competencies beyond clinical ones. The Practicum provides a space for students to wrestle with alternative epistemologies to understanding the social world in which medicine is embedded. We lastly provide pragmatic ways to better address these tensions in an effort to support students as they proceed through the (multifaceted) development of their professional identities as future physicians.

Download Full-text

First steps in the physician-scientist pipeline: a longitudinal study to examine the effects of an undergraduate extracurricular research programme

BMJ Open ◽

10.1136/bmjopen-2020-048550 ◽

2021 ◽

Vol 11 (9) ◽

pp. e048550

Author(s):

Belinda W C Ommering ◽

Floris M van Blankenstein ◽

Friedo W Dekker

Keyword(s):

Academic Achievement ◽

Intrinsic Motivation ◽

Self Efficacy ◽

Medical Training ◽

Controlled Trial ◽

Motivational Factors ◽

Control Group ◽

Grade Point ◽

Research Engagement ◽

Physician Scientist

ObjectivesMedicine is facing a physician-scientist shortage. By offering extracurricular research programmes (ERPs), the physician-scientist training pipeline could already start in undergraduate phases of medical training. However, previous studies into the effects of ERPs are mainly retrospective and lack baseline measurements and control groups. Therefore, the current study mimics a randomised controlled trial to examine the effects of an ERP.DesignProspective cohort study with baseline measurement and comparable control group.SettingOne cohort of 315 medical undergraduates in one Dutch University Medical Center are surveyed yearly. To examine the effects of the ERP on academic achievement and motivational factors, regression analyses were used to compare ERP students to students showing ERP-interest only, adjusted for relevant baseline scores.ParticipantsOut of the 315 students of the whole cohort, 56 participated within the ERP and are thus included. These ERP students are compared with 38 students showing ERP-interest only (ie, control group).Primary outcome measureAcademic achievement after 2 years (ie, in-time bachelor completion, bachelor grade point average (GPA)) and motivational factors after 18 months (ie, intrinsic motivation for research, research self-efficacy, perceptions of research, curiosity).ResultsERP participation is related to a higher odds of obtaining a bachelor degree in the appointed amount of time (adjusted OR=2.95, 95% CI 0.83 to 10.52). Furthermore, starting the ERP resulted in higher levels of intrinsic motivation for research, also after adjusting for gender, age, first-year GPA and motivational baseline scores (β=0.33, 95% CI 0.04 to 0.63). No effect was found on research self-efficacy beliefs, perceptions of research and curiosity.ConclusionsPrevious research suggested that intrinsic motivation is related to short-term and long-term research engagement. As our findings indicate that starting the ERP is related to increased levels of intrinsic motivation for research, ERPs for undergraduates could be seen as an important first step in the physician-scientist pipeline.

Download Full-text

Trends in Subspecialization: A Comparative Analysis of Rural and Urban Clinical Education

Family Medicine ◽

10.22454/fammed.2020.182557 ◽

2020 ◽

Vol 52 (5) ◽

pp. 332-338

Author(s):

Andrea L. Wendling ◽

Andrew Short ◽

Fredrick Hetzel ◽

Julie P. Phillips ◽

William Short

Keyword(s):

Primary Care ◽

Rural Communities ◽

Clinical Education ◽

American Medical College ◽

Upper Peninsula ◽

Application Service ◽

Match Rate ◽

Rural And Urban ◽

Multiple Variables ◽

Urban Campus

Background and Objectives: Medical students who train in rural communities are often exposed to physicians practicing a broad scope of care, regardless of discipline. We examined how rural education is associated with practice specialization rates for students who match in primary care or general core specialties. Methods: We linked practice and specialty data (2016 AMA Masterfile dataset), demographics (American Medical College Application Service data), and internal college data for 1974-2011 Michigan State University College of Human Medicine graduates who received clinical education on either the Upper Peninsula (rural) or Grand Rapids (urban) campuses. Current practice was verified using internet searches. We compared specialty and practice data by rural or urban campus, controlling for multiple variables. Results: More rurally-trained graduates entered primary care (PC) residencies (128/208, 61.5%) than urban-trained graduates (457/891, 51.3%; P<.01), with rurally-trained graduates being twice as likely to enter family medicine (FM) residencies. Most FM residents remained PC physicians (205/219, 93.6%). Internal medicine residents were least likely to remain in primary care (91/189, 48.1%). Of the general core disciplines, general surgeons were least likely to remain in general surgical practice (45/134, 33.6%). Within each PC or general core discipline, the proportion of graduates who specialized did not differ by type of campus. Conclusions: Rurally-trained graduates are more likely to practice primary care, chiefly due to increased likelihood of choosing a FM residency. Graduates entering PC or general core residencies subspecialize at similar rates regardless of rural or urban education. FM residency match rate may be the best predictor of long-lasting impact on the primary care workforce.

Download Full-text

What Are the Characteristics of Fourth-Year Medical Students With Higher Levels of Resilience?

PRiMER ◽

10.22454/primer.2019.150381 ◽

2019 ◽

Vol 3 ◽

Author(s):

Sey Park ◽

Maribeth Porter ◽

Ki Park ◽

Lauren Bielick ◽

Benjamin J. Rooks ◽

...

Keyword(s):

Medical Students ◽

Medical School ◽

Medical Training ◽

Personal Characteristics ◽

After School ◽

Demographic Information ◽

Personal Time ◽

Resilience Scale ◽

Fourth Year Medical Students ◽

Race Ethnicity

Introduction: Burnout during medical training, including medical school, has gained attention in recent years. Resiliency may be an important characteristic for medical students to have or obtain. The aim of this study was to examine the level of resiliency in fourth-year medical students and whether certain characteristics were associated with students who have higher levels of resiliency. Methods: Subjects were fourth-year medical students who completed a survey during a required end-of-year rotation. The survey collected subjects’ demographic information including age, gender, race, ethnicity, marital status, and chosen specialty. They were also asked to complete the Brief Resilience Scale (BRS) and answer questions that assessed personal characteristics. Results: The response rate was 92.4%. Most respondents had personal time for themselves after school (92.6%), exercise or participate in physical activity for at least 30 minutes most days of the week (67.2%), were able to stop thinking about medical school after leaving for the day (58.2%), and had current financial stress (51.6%). No differences were noted in demographic information among students across specialty categories. A higher BRS score was associated with being male and having the ability to stop thinking about school. Conclusions: BRS scores in medical students are associated with specific demographic characteristics and the ability to stop thinking about school. Addressing the modifiable activities may assist students with increasing their resiliency and potentially decreasing their risk of burnout.

Download Full-text

The Role of Admission Scores in Predicting Academic Performance in Medical Students

10.21203/rs.3.rs-885280/v1 ◽

2021 ◽

Author(s):

Fazean Idris ◽

Li Ling Chaw ◽

Joe Knights ◽

Ya Chee Lim

Keyword(s):

Academic Performance ◽

Linear Regression ◽

Patient Care ◽

Grade Point Average ◽

Linear Regression Analysis ◽

Performance Outcomes ◽

Grade Point ◽

Undergraduate Study ◽

Brunei Darussalam ◽

Unit Increase

Abstract BackgroundAdmission scores have been used to select highly capable students for an undergraduate medical programme. This study examines the relationship between three admission criteria: (i) multiple-mini-interview (MMI); (ii) pre-university final results (PUFR); (iii) entrance scores (combination of 50% MMI and 50% PUFR), with students’ academic performance in the medical programme at Universiti Brunei Darussalam (UBD).MethodsWe performed linear regression analysis on 125 students who completed the programme from 2013 to 2018 and compared their MMI, PUFR and entrance scores with their academic performance throughout their three years of undergraduate study. Academic performance outcomes were assessed from students’ Grade Point Average (GPA), cumulative Grade Point Average (cGPA) and marks in the modules ‘Health Sciences’ (HS), ‘Patient Care’ (PC), ‘Our Community and Personal Professional Development’ (OCPPD) and Special Study Modules, for overall (six-semesters average) and individual semesters.ResultsSimple linear regression results revealed that one unit increase in MMI score was associated with a significant increase in overall PC marks by 0.09. A 20-unit increase in PUFR was associated with a significant increase in students’ cGPA by 0.05; overall HS marks by 1.0; GPA in semesters 1,2,3,6; HS marks in semesters 1,2,3,6 and OCPPD marks in semesters 2,3. Meanwhile, one unit increase in entrance score was associated with a significant increase in cGPA by 0.01; overall HS by 0.2 marks and overall OCPPD by 0.11 marks. The effect of entrance score was also seen with increase in students’ GPA in semesters 1,2,3,4,6 by at least 0.01, as well as marks for HS in semesters 1,2,3,4,6 and OCPPD in semesters 2,3.ConclusionOur findings support that both PUFR and entrance scores as selection criteria for admission into a medical programme were associated with better academic performances, with PUFR showing a greater mark increase than entrance scores. Meanwhile, MMI showed better academic performance in the patient care module only, inferring that MMI grants a glimpse of candidates’ bedside attitude towards patients.

Download Full-text

Shaping the future medical workforce: take care with selection tools

Journal of Primary Health Care ◽

10.1071/hc13269 ◽

2013 ◽

Vol 5 (4) ◽

pp. 269 ◽

Cited By ~ 8

Author(s):

Phillippa Poole ◽

Boaz Shulruf

Keyword(s):

General Practice ◽

Medical School ◽

Grade Point Average ◽

Grade Point ◽

Medical School Selection ◽

Strong Interest ◽

Practice Methods ◽

The University ◽

School Selection ◽

Selection Tools

INTRODUCTION: Medical school selection is a first step in developing a general practice workforce. AIM: To determine the relationship between medical school selection scores and intention to pursue a career in general practice. METHODS: A longitudinal cohort study of students selected in 2006 and 2007 for The University of Auckland medical programme, who completed an exit survey on career intentions. Students are ranked for selection into year 2 of a six-year programme by combining grade point average from prior university achievement (60%), interview (25%) and Undergraduate Medicine and Health Sciences Admission Test (UMAT) scores (15%). The main outcome measure was level of interest in general practice at exit. Logistic regression assessed whether any demographic variables or admission scores predicted a strong interest in general practice. RESULTS: None of interview scores, grade point average, age, gender, or entry pathway predicted a strong interest in general practice. Only UMAT scores differentiated between those with a strong interest versus those with some or no interest, but in an inverse fashion. The best predictor of a strong interest in general practice was a low UMAT score of between 45 and 55 on all three UMAT sections (OR 3.37, p=0.020). Yet, the academic scores at entry of students with these UMAT scores were not lower than those of their classmates. DISCUSSION: Setting inappropriately high cut-points for medical school selection may exclude applicants with a propensity for general practice. These findings support the use of a wider lens through which to view medical school selection tools. KEYWORDS: Cognitive tests; general practice; health workforce; medical student career choice; selection; UMAT

Download Full-text