Analysis of Preclinical Academic Performance Compared to Matched Residency

Abstract

IntroductionAs medical school enrollment has risen, the number of graduate medical education positions remains relatively unchanged. With this increased disparity, residency selection committees place heavy emphasis on USMLE Step 1 scores, clerkship grades, class rankings, and Alpha‐Omega‐Alpha membership when extending interviews and ranking applicants. The preclinical years are often overlooked in their relevance to potential residency matches but may play an important role in choosing and ultimate acceptance into a particular specialty. The purpose of this study was to assess how preclinical performance of Medical College of Georgia (MCG) graduates compared to their residency match. We hypothesized there would be academic performance differences in preclinical content areas that are typically associated with a student's residency choice.MethodsPreclinical academic performance from MCG Classes of 2017 and 2018 (n=321 students) were compared to matched residency. Residencies were categorized by relative competitiveness based on residency U.S. graduate fill rates (Highly Competitive/HC: Plastic Surgery, Orthopaedic Surgery, Otolaryngology, Ophthalmology, Radiology, Radiation Oncology, and Neurosurgery; Competitive/C: Emergency Medicine, Urology, Dermatology, General Surgery, Anesthesiology, Pediatrics, OB/Gyn.; Less Competitive/LC: Psychiatry, Pathology, Physical Medicine and Rehabilitation, Internal Medicine, Neurology, Family Medicine). ANOVA and t‐tests were used for analyses.ResultsStudents matching into highly competitive residencies performed significantly better in all preclinical courses compared to those going into competitive or less competitive residencies (p<0.05). As expected, USMLE Step 1 scores were also significantly higher for students matching in highly competitive residencies (243.7 ± 13.0) compared to other residencies (C: 231.0 ± 15.9; LC: 230.8 ± 16.3; p<0.05). Students who matched into Surgical or Radiology specialties performed significantly better in Anatomy (84.4 ± 5.6) compared to those in other specialties (82.9 ± 5.5; p<0.05). Students matching into Orthopaedic Surgery scored significantly higher than the class average for the Year 1 Tissue and Musculoskeletal System (88.9 ± 3.6 vs. 85.3 ± 5.4; p<0.01) and Year 2 Skin and Musculoskeletal System Courses (95.8 ± 1.5 vs. 92.7 ± 3.9; p<0.01). Students matching into Dermatology scored significantly higher than the class average in Pathology (92.1 ± 3.5 vs. 88.0 ± 5.4; p<0.01).ConclusionsStudents who match into highly competitive residencies need a firm foundation in the basic sciences in order to perform well on USMLE Step 1 and in the clerkships. While residencies may not look specifically at preclinical grades, more competitive programs such as Surgery specialties and Radiology place greater emphasis on class rank and overall grades, which incorporate preclinical grades. Our previous research has shown that content and performance in the preclinical curriculum do influence residency choice early in medical school. Subsequent studies will further examine how these factors are involved in residency choice.This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.