The Double-Edged Sword of Third-Party Resources: Examining Use and Financial Burden of Extracurricular Tools in Medical Students

Abstract

Background Since before the COVID-19 pandemic, use of third-party resources (or educational tools separate from the in-house medical curriculum) has been steadily increasing. The transition to virtual learning in 2020 fostered a greater reliance on these mostly online resources during medical training, yet their contributions have rarely been evaluated. Thus, we aimed to review third-party resources and their implications for medical education, particularly their financial burden on students. Methods We examined 31 peer-reviewed articles that discuss third-party resources for medical students and relevant studies related to their equitable access. Results Studies suggest third-party resources are used in a task-dependent manner with a supplemental role to the in-house lectures during the preclinical phase and a primary role for USMLE preparation during the clinical phase. Medical students ubiquitously access these resources out of a perceived necessity to use them to perform well on board exams, prompted by studies demonstrating their efficacy in increasing USMLE Step 1 scores. Though certain resources have been more frequently cited for improving board performance (e.g.,First Aid and UWorld), students may combine multiple third-party resources to best serve their exam preparation. Findings also show the subscription-pricing model of most third-party resources and 12-month access prices range from $100 to $479, suggesting that third-party resource use contributes to an increase financial strain on students. This, coupled with overwhelming medical student debt, may exacerbate existing socioeconomic disparities in medical education. Conclusion Institutions should evaluate third-party resource use among their medical students and consider provisions to increase access to these co-curricular tools.