Shortened pre-clerkship medical school curriculum associated with reduced student performance on surgery clerkship shelf exam

Abstract

BackgroundMany U.S. medical schools are modifying their curricula with limited understanding of the impact on students’ clinical knowledge. MethodsThe surgical rotations and Surgery Shelf Exam score reports of 1514 students at a single medical school over nine academic years (2010–2018), which included a four-year transition period to a condensed pre-clerkship curriculum. Subject-specific results were compared by rotation type using Mann-Whitney tests. Regression analysis was used to assess the relationship between scores and time. ResultsData from 1514 students were included. Shelf scores decreased each year of the transition curriculum compared to the reference year (2014–2015). However, clinical exposure to specific rotations resulted in better scores in related shelf subjects. For example, students who rotated on Vascular Surgery achieved statistically better scores on the related subject than their colleagues (3.62 vs. 3.44; p = 0.0014). ConclusionsThe transition curriculum was associated with a lower performance on the surgical shelf exam when compared to the traditional curriculum, regardless of when surgery was taken during their clerkship year.