Medical Grades Research Articles

Relationships between self-efficacy beliefs and personal factors in final-year medical students

BackgroundMedical students entering postgraduate training often feel ill-prepared for clinical practice. This has implications for physician well-being and the quality of patient care. Self-efficacy represents an important contributing factor in the transition process. Identifying student characteristics associated with self-efficacy is important in order to design possible interventions to enhance self-efficacy. Therefore, we assessed the relationship between final-year medical students’ general self-efficacy with their personality traits, need for cognitive closure, and medical knowledge in order to identify factors contributing to the assessment and improvement of self-efficacy.MethodsSelf-assessed data regarding general self-efficacy was collected from 188 final-year medical students who participated in a first day of residency simulation between March and September 2023. We also assessed several personal factors including the HEXACO Personality Inventory Revised (HEXACO-PI-R), a short scale to measure Need for Cognitive Closure (16-NCCS), and students’ medical exam grades (M2). We ran multiple correlation and multiple linear regression analyses across all variables. We then added a second analysis each with general self-efficacy and HEXACO domains Emotionality and Extraversion on facet level, which both showed significant associations with self-efficacy in the respective first analysis.ResultsAcross all variables, self-efficacy correlated significantly negatively with Emotionality and positively with Extraversion. Both domains also significantly predicted self-efficacy accordingly in the regression model. On a facet analysis, Sentimentality (Emotionality) and Sociability (Extraversion) did not correlate significantly with self-efficacy. In the regression model only the facets Sociability (Extraversion) and Fearfulness (Emotionality) significantly predicted lower self-efficacy. Furthermore, self-efficacy correlated significantly and negatively with the Need for Cognitive Closure (NCC). Additionally, significant positive and negative correlations of the NCC with both Emotionality and Extraversion, respectively, as well as a significant positive correlation for exam grades (M2) and Extraversion were found.ConclusionsSelf-efficacy contributes to medial students’ preparedness for clinical practice and can be predicted by several personal factors. Students should learn and reflect about these factors and need to be supported in increasing their self-efficacy and its self-assessment towards their transition to postgraduate training. Construction of a specific instrument for self-efficacy assessment utilizing the insight provided by the findings is proposed as a next step.

Analysis of variability and trends in medical school clerkship grades

BackgroundMedical school clerkship grades are used to evaluate orthopedic surgery residency applicants, however, high interinstitutional variability in grade distribution calls into question the utility of clerkship grades when evaluating applicants from different medical schools. This study aims to evaluate the variability in grade distribution among medical schools and look for trends in grade distribution over recent years. MethodsApplications submitted to Rush University's orthopedic surgery residency program from 2015, 2019, and 2022 were collected from the Electronic Residency Application Service. Applications from the top 100 schools according to the 2023–2024 U.S. News and World Report Research Rankings were reviewed. The percentage of “honors” grades awarded by medical schools for the surgery and internal medicine clerkships were extracted from applicants' Medical Student Performance Evaluation letters. ResultsThe median percentage of honors given in 2022 was 36.0 % (range 10.0–82.0) for the surgery clerkship and 33.0 % (range 6.7–80.0) for the internal medicine clerkship. Honors were given 6.6 % more in the surgery clerkship in 2022 compared to 2015. There was a negative correlation between a higher (worse) U.S. News and World Report research ranking and the percentage of honors awarded in 2022 for the surgery and internal medicine clerkships. ConclusionThere is substantial interinstitutional variability in the rate that medical schools award an “honors” grade with evidence of grade inflation in the surgery clerkship. Residency programs using clerkship grades to compare applicants should do so cautiously provided the variability demonstrated in this study.

Smoking prevalence and attitudes of medical students as potential role models in tobacco control in Istanbul, Türkiye

ABSTRACT Background Medical students are potential role models for the community in tobacco control. Therefore, we aimed to determine the prevalence and dynamics of tobacco smoking among their grades. Methods A questionnaire prepared in cooperation with the “World Health Organization” was completed online by 697 medical students in 2020 as a randomized cross-sectional study covering all medical school grades. Results The prevalence of smoking among pre-grade 1 students was 3.3%, while it was 23% in grade-6. The highest prevalence was 31% in grade-2. Of the 135 current smokers, 43% smoked their first cigarette in medical school. “Having smoker best friends” was the most critical factor in starting smoking. Of current smokers, 59.3% want to quit. Only 20.7% of students who tried to quit smoking received professional help. Students took only a 1-hour lecture on tobacco control in the first two years. Conclusion While there was almost no smoking in pre-grade 1, the high prevalence seen in grade-2 indicates that psychosocial support mechanisms and tobacco control lectures should be developed to prevent students. University administrations should implement adequate programs and increase awareness that will lead to a reduction in diseases in the student population and thus in the general population.

Effects of Different Grades of Carbon Dioxide on Euthanasia of Mice (Mus musculus).

Carbon dioxide (CO2) is a conditionally acceptable method for mouse euthanasia, according to the American VeterinaryMedical Association Guidelines for the Euthanasia of Animals. In a 2012 Office of Laboratory Animal Welfare (OLAW) webinar,representatives of OLAW, the USDA and AAALACi stated that different grades of CO2, including nonpharmaceutical grades,are acceptable as long as the minimum purity is 99.0%. No systematic studies have been published on the effects of differentgrades of CO2 on animal welfare during euthanasia. In this study, mice were euthanized with one of 3 grades of CO2: USPmedical (> 99.2% CO2), bone-dry (> 99.9% CO2), or industrial (> 99.0% CO2). Times to recumbency and cessation of breathingwere measured, and escape and avoidance behaviors were noted. Our results show no difference in time to recumbency andtime to cessation of breathing in mice euthanized with these different grades of CO2. The average time to recumbency formedical, bone-dry, and industrial grades of CO2 were 39 ± 6 s, 37 ± 7 s, and 37 ± 6 s, respectively. The average time to cessation ofbreathing for medical, bone-dry, and industrial grades of CO2 were 135 ± 16 s, 131 ± 12 s, and 133 ± 10 s, respectively. Histologicassessment of the nasal cavity, pharynx, trachea, and lungs showed no difference between grades of CO2 used for euthanasia.According to survey results, responding facilities most commonly used industrial and pharmaceutical grades, with use of thepharmaceutical grade increasing with facility size. A small portion of respondents reported occasional difficulty in obtainingthe desired grades of CO2. Given our demonstration that the CO2 grade used for euthanasia is not associated with welfareissues, institutions can have the flexibility to plan for disasters or supply chain problems. In addition, cost savings may beassociated with the option of switching between medical, bone-dry, and industrial grades of CO2.

Establishment and Management of an Educational Outcome Cohort at the Keimyung University School of Medicine

An educational outcome cohort has been established at Keimyung University School of Medicine to help make educational policy decisions and improve educational programs based on data. The purpose of the educational outcome cohort is to support educational policy decisions for achieving graduation outcomes smoothly and to accomplish the intended human resources development of the university through objective analyses and regular monitoring, providing continuous feedback. The data collected for the educational outcome cohort include the student identifications of freshmen, entrance exam scores, premedical and medical school grades, titles and forms of student academic research, the results of psychological testing, scholarship recipient lists, volunteer clubs, and so forth. The data are collected using an information utilization agreement approved by the Institutional Review Board, and the collected data are encrypted and stored on a dedicated computer for enhanced personal information security. Proposals to access and utilize the educational outcome cohort data must be discussed and approved by the Educational Outcome Cohort Committee, which decides on the scope and method of utilization. The collected and managed educational outcome cohort data have been used to develop comparative programs to improve students’ competency and to support admission policy decisions through an analysis of the characteristics and performance of medical school students. The establishment and utilization of the educational outcome cohort will play an important role in determining the School of Medicine’s educational policies and suggesting new directions for educational policies in the future.

A Comparison of the Checklist Scoring Systems, Global Rating Systems, and Borderline Regression Method for an Objective Structured Clinical Examination for a Small Cohort in a Saudi Medical School.

This study aims to compare the effectiveness of using the checklist and global rating scores to evaluate the clinical competency of medical students in Objective Structured Clinical Examinations (OSCEs). Additionally, the study assesses the appropriateness of using the borderline regression method to set standards for small-scale OSCE exams and determines if the estimated passing marks differ significantly from the university's prefixed passing score of 70%. The study also examines whether the university should utilize the borderline regression method to determine passing scores for each OSCE exam instead of a set passing score. The study analyzed medical students' grades in 11 OSCE exams in the 2022-2023 academic year at Alfaisal University, Riyadh, Saudi Arabia. Students received family medicine clerkship rotations, and after each rotation, they took an OSCE exam consisting of three stations that family medicine consultants graded. The exam included a checklist of 30 tasks and a five-level global rank scale. The study collected all the checklist marks and global rank grades and analyzed them using IBM® Statistical Package for Social Sciences (SPSS® Statistics) software. The statistical tests used were descriptive statistics, the T-test, chi-square tests, Fisher's exact test, and Pearson correlation. The study showed that students were more likely to pass when using the global rating system than the checklist scoring system. Additionally, students had a significantly lower passing rate when using the higher cut-off passing score estimated using the borderline regression method compared to the pre-set passing score of 70% established by the university (with a p-value of 0.00). Each scoring system has advantages and disadvantages, but they complement each other. Combining scoring systems can produce a more comprehensive and precise evaluation of a candidate's performance. The study also emphasizes the importance of carefully selecting and validating cut-off points in OSCE exams to ensure fairness and consistency in assessment.

744 Reducing Implicit Bias in the Neurosurgery Application and Interview Process

INTRODUCTION: Each year, Neurosurgery residency programs aim to match the best and brightest applicants aspiring to join the field. Traditionally, metrics such as USMLE Step 1 and 2 scores, publications, and medical school grades have played a key role in determining who is interviewed, the interviewers’ impression of the candidates, and subsequently who is most likely to match. However, these evaluative tools are known to reflect biases in the medical and medical education systems, potentially overlooking diverse applicants well-suited for a career in neurosurgery. METHODS: During the 2020-2021 and 2021-2022 residency application cycles, our program instituted a new process for reviewing applications, conducting interviews, and generating a final rank list. Each application was reviewed by attending and resident reviewers, who were blinded to potentially biasing information including pictures and board scores. From this review, selected applicants were interviewed using a set of standardized questions, designed to evaluate specific domains essential for success in neurosurgery. Linear regression was performed to determine correlation between traditional metrics and domain-based interview scores and final rank. RESULTS: 137 applicants were interviewed. There was no significant correlation between rank and Step 1 (p = 0.47, R2 = 0.003) or Step 2 scores (p = 0.16, R2 = 0.014).Interview scores lacked statistically significant association with Step 1 scores (p=0.10, R2=.02), but were found to correlate with Step 2 scores (p = 0.02, R2 = .05). CONCLUSIONS: In our two-cycle experience using this new system, we found no correlation between applicants’ Step 1 scores and their interview scores or final rank list position. We propose this as one alternative method to historically biased tools for evaluating neurosurgery applicants.

Dyspnea and Weight Loss following Left Internal Jugular Vein Dialysis Catheter Placement.

AIMS--To evaluate the adequacy of documentation of blood culture results in patients9 medical notes. METHODS--A pro-forma was completed following review of medical notes at 24 and 48 hours after a blood culture had been reported as positive. The study was performed on blood cultures received at the Department of Microbiology, Royal Hallamshire Hospital, Sheffield, from two local hospitals. Two periods were studied: (A) May to June 1993 and (B) September to October 1993. RESULTS--There were 43 results studied in period A and 79 in period B, giving a total of 122 results studied. Overall, 72 (59%) of 122 results were recorded in the medical notes at 24 hours. Of those results deemed highly significant, 40 (63%) of 63 were recorded. There was no significant difference in the documentation of results if the result was given personally or via the telephone. Nor was there any difference in documentation between different medical grades. Throughout the study there were six inaccurate records. The cumulative documentation over 48 hours of positive results was 54 (86%) of 63 of highly significant, 27 (69%) of 39 of uncertain significance, and 11 (55%) of 20 probable contaminant results. CONCLUSIONS--Documentation of blood culture results is currently suboptimal.

Correlation of First-Year Medical Students’ Performance in Case-Based Small-Group Discussions with Overall Academic Performance in the Department of Medical Physiology

Case-based small-group discussions (SGDs) are one of the teaching strategies used in the Department of Medical Physiology of the Pamantasan ng Lungsod ng Maynila College of Medicine. The purpose of this study was to investigate the relationship between the first-year medical students’ grades in SGDs and their academic performance measured at the end of each shifting period and the end of the course. All 135 students were assessed and graded during clinical case SGDs. Correlational analyses indicate a significant relationship between the SGD grades and the students’ grades in the written examination, shifting period medical physiology grades, and final medical physiology grades. SGDs are linked to improved academic performance, but further studies are needed to investigate other predictors of students’ learning in medical physiology.

Comparing achievements of medical graduates in an alternative unique pre-medical track vs regular medical track.

To evaluate the association between the achievements of medical students and whether they were admitted via the pre-medical track or the regular direct track. We performed a comparative retrospective data study using data from a three-year experimental cohort in a six-year medical school. We analyzed the academic achievements of all students admitted at one Israeli medical school between 2013-2015, either directly to the six-year program or via a pre-medical track. We compared averages of both yearly final grades and final medical examinations grades between the two groups. Descriptive statistics were calculated and differences between groups were evaluated using multivariate analysis. Of the 324 students included in the study, 65 (20.1%) were enrolled in all three cohorts of the pre-medical track. Age and Gender distribution were nearly similar for both tracks. For the first two cohorts, the average final grades of year one of pre-medical students were significantly higher than those of regular direct track (F=(3,167) 6.10, p=0.001), but the opposite was true for the third cohort (F=(3,110)2.38, p=0.073). No further statistically significant differences were found neither between the groups in their final exams grades nor between choosing a MD/PhD optional track and admission pathway. Our results suggest promising achievements with the pre-medical admission pathway. This should encourage further discussion about the significant potential human resources lost by current admission processes and may question the effectiveness of six-year programs in medical schools.

Medical school grades may predict future clinical competence.

In real-world medical education, there is a lack of reliable predictors of future clinical competencies. Hence, we aim to identify the factors associated with clinical competencies and construct a prediction model to identify "improvement required" trainees. We analyzed data from medical students who graduated from National Yang-Ming University with clerkship training and participated in the postgraduate year (PGY) interview at Taipei Veterans General Hospital. Clinical competencies were evaluated using grades of national objective structured clinical examination (OSCEs). This study used data from medical students who graduated in July 2018 as the derivation cohort (N = 50) and those who graduated in July 2020 (n = 56) for validation. Medical school grades were associated with the performance of national OSCEs (Pearson r = 0.34, p = 0.017), but the grades of the structured PGY interviews were marginally associated with the national OSCE (Pearson r = 0.268, p = 0.06). A prediction model was constructed to identify "improvement required" trainees, defined: trainees with the lowest 25% of scores in the national OSCEs. According to this model, trainees with the lowest 25% medical school grades predicted a higher risk of the "improvement required" clinical performance (Q1-Q3 vs Q4 = 15% vs 60%, odds ratio = 8.5 [95% confidence interval = 1.8-39.4], p = 0.029). In the validation cohort, our prediction model could accurately classify 76.7% "improvement required" and "nonimprovement required" students. Our study suggests that interventions for students with unsatisfactory medical school grades are warranted to improve their clinical competencies.

3D printed bioresorbable scaffolds for articular cartilage tissue engineering: a comparative study between neat polycaprolactone (PCL) and poly(lactide-b-ethylene glycol) (PLA-PEG) block copolymer

This work identifies and describes different material-scaffold geometry combinations for cartilage tissue engineering (CTE). Previously reported potentially interesting scaffold geometries were tuned and printed using bioresorbable polycaprolactone and poly(lactide-b-ethylene) block copolymer. Medical grades of both polymers were 3D printed with fused filament fabrication technology within an ISO 7 classified cleanroom. Resulting scaffolds were then optically, mechanically and biologically tested. Results indicated that a few material-scaffold geometry combinations present potential for excellent cell viability as well as for an enhance of the chondrogenic properties of the cells, hence suggesting their suitability for CTE applications.

Probing lubricated sliding wear properties of HDPE/UHMWPE hybrid bionanocomposite.

Ultra-high molecular weight polyethylene (UHMWPE) and its derivatives have been clinically used as an acetabular liner material in total hip joint replacement (THR) over last six decades. Despite significant efforts, the longevity of UHMWPE implants is still impaired due to their compromised tribological performance, leading to osteolysis and aseptic loosening. The present study aims to critically evaluate and analyze the tribological performance, of the next generation acetabular liner material, that is, a chemically modified graphene oxide (GO) reinforced HDPE/UHMWPE (HU) bionanocomposite (HUmGO), against stainless steel (SS 316L) counterface in lubricated conditions. This work also provides a performance comparative assessment of HUmGO with respect to medical grades, UHMWPE (UC) and crosslinked UHMWPE (XL-UC). Significant attempts have been made to correlate the tribological properties (frictional behavior, wear rate, wear debris shape and size, wear mechanism) with the physicomechanical conditions (contact stresses) at sliding contact and the variation in molecular architecture of different UHMWPE materials. Additionally, an emphasis is put forward to critically anlyze the nature of lubrication regime based on the bearing characterstic parameters. HUmGO exhibited a lower COF (0.07) and specific wear rate (2.86 × 10-8mm3/Nm) than UC and XL-UC under identical sliding conditions. The worn surfaces on HUmGO revealed the signatures of less abrasive wear and limited deformation. Based on the estimated lambda (λ) ratio and Sommerfield number, all the investigated sliding contacts exhibited boundary lubrication. Taken together, the modified GO reinforced HDPE/UHMWPE bionanocomposite can be considered as a new generation biomaterial for the fabrication of acetabular liner for hip-joint prosthesis.

National examination for medical residency admission: academic performance in a high-stakes test and the need for continuing education.

Performance and selection rate of non-newly graduated physicians in a medical residency admission test as an indicator for the need of continuing education. A database comprising 153 654 physicians who took a residency admission test in the period 2014-2018 was analysed. Performance and selection rates were assessed in relation to year of graduation and performance in medical school. The whole sample scored at a mean of 62.3 (SD ±8.9; range 1.11-91.11). Examinees who took the test in their year of graduation performed better (66.10) than those who took the test after their year of graduation (61.84); p<0.001.Selection rates differed accordingly; 33.9% for newly graduated physicians compared with 24.8% in those who took the test at least 1 year after graduation; p<0.001. An association between selection test performance and medical school grades was established using Pearson's correlation: r=0.40 for newly graduated physicians and r=0.30 for non-newly graduated physicians. There were statistically significant differences in selection rates for every ranking group of grades in medical school based on the χ2 test (p<0.001). The selection rates are decreased years after graduation even for candidates with high grades in medical school. There is an association between performance in a medical residency admission test and academic variables of the candidates: medical school grades and time elapsed from graduation to test taking. The evidence of decrease in retention of medical knowledge since graduation highlights the pertinence of continuing education interventions.

National examination for medical residency admission: academic performance in a high-stakes test and the need for continuing education

IntroductionPerformance and selection rate of non-newly graduated physicians in a medical residency admission test as an indicator for the need of continuing education.MethodsA database comprising 153 654 physicians who took...

Diagnosis of Metacarpophalangeal Synovitis with Musculoskeletal Ultrasound Images.

Rheumatoid arthritis (RA) is a chronic autoimmune disease that can result in considerable disability and pain. The metacarpophalangeal (MCP) joint is the most common diseased joint in RA. In clinical practice, MCP synovitis is commonly diagnosed on the basis of musculoskeletal ultrasound (MSUS) images. However, because of the vague criteria, the consistency in grading MCP synovitis based on MSUS images fluctuates between ultrasound imaging practitioners. Therefore, a new method for diagnosis of MCP synovitis is needed. Deep learning has developed rapidly in the medical area, which often requires a large-scale data set. However, the total number of MCP-MSUS images fell far short of the demand, and the distribution of different medical grades of images was unbalanced. With use of the traditional image augmentation methods, the diversity of the data remains insufficient. In this study, a high-resolution generative adversarial network (HRGAN) method that generates enough images for network training and enriches the diversity of the training data set is described. In comparison experiments, our proposed diagnostic system based on MSUS images provided more consistent results than those provided by clinical physicians. As the proposed method is image relevant, this study might provide a reference for other medical image classification research with insufficient data sets.

Análise fatorial do desempenho no exame de residência médica, teste de progresso e coeficiente de desempenho nos estágios do internato

Abstract: Introduction: The relationships between the students’ performance on medical residency exams and progress tests and medical clerkship rotations are not well established. Objective: The objective of this study was to measure the correlations between grades on progress tests and clerkship rotations assessments and the medical residency exam and determine which performance had the strongest correlation with the final medical residency exam. Methods: This was a retrospective and longitudinal study with correlation analyses of grades on progress tests from the 1st to 6th year of medical school, the clerkship rotations performance coefficient (5th and 6th years of school) and the final medical residency exam in a cohort of students enrolled in a federal public medical school using factor analysis. Students who performed the progress tests from the 1st to 6th year were included. Results: Of 123 students enrolled in the first year of medical school in 2009, 114 (92.7%) performed the progress tests during the six years and were included. The average grades on the progress tests from 1 to 10 were 2.67 (1st year), 3.01 (2nd year), 4.19 (3rd year), 4.01 (4th year), 5.19 (5th year), and 6.38 (6th year). The average grades in the clerkship rotations were 8.32 (5th year) and 8.26 (6th year). The average score on the theoretical medical residency exam was 7.53 and the final result of the medical residency exam was 8.05. Factor analysis detected three domains with greater correlation strength that accounted for 76.3% of the model variance. Component 1 was identified as the coefficient of academic performance (CAP) 5th, CAP 6th and final medical residency exam grades, whereas component 2 was constituted by the grades of the 5th and 6th years progress tests and the third component comprised the progress tests of the 2nd, 3rd and 4th years. Conclusions: Grades on the progress tests, the clerkship rotations assessments and the final medical residency exam were correlated. Moreover, the performance during the medical clerkship rotations showed the strongest correlations with medical residency exam grades.

Persistence and Academic Performance of Medical Students in Online Learning Environment During the COVID-19 Pandemic Lockdown

Government response to the COVID 19 pandemic in the spring of 2020 came as a wave of physical closures requiring sudden change in the method of instruction from face-to-face to a completely online. Assessment of students adaptation to this change during emergency lockdown is the focus of this study. We used a One-way ANOVA to compare pandemic and pre-pandemic Performance of First Year medical students at the University of Arkansas for Medical Sciences in the brain and behavior module. Students’ test scores related to perception of persistence levels was studied using correlation analysis. In addition, a regression analysis was performed to examine prediction factors of medical student course grades during COVID-19. Students’ grades in the module during the COVID-19 were significantly higher compared to the grades in recent prior years at the p&lt;.001 level [F (3, 692) = 9.08]. Pearson product-moment correlation results showed a strong and positive correlation between students’ persistence level (M = 3.46, SD = .997, n = 79), and their module grade during COVID-19 (M = 258.777, SD = 14.6878, n = 79), r = .33, p = &lt; .01. The multiple linear regression analysis accounts for 14% of the variance in students’ module grades and the variance was statistically significant at p &lt; .05. As such, we conclude that students’ persistence to adjust to a new learning environment coupled with module directors and faculty successfully employing remote education methods, met the learning challenges during the pandemic and students maintained a high level of academic success.

National Resident Matching Program Rank Order and Performance in an Internal Medicine Residency.

Prospective first-year house staff and residency program leaders spend substantial time, effort, and expense preparing a rank order list for the National Resident Matching Program (NRMP). Previous studies have mostly shown minimal or no relation between rank order and subsequent resident performance, raising questions about the value of this process. Furthermore, no previous studies have been done with Internal Medicine residencies. As such, the purpose of this study was to compare NRMP rank order to multiple objective outcomes of an Internal Medicine residency. A retrospective cohort of Internal Medicine residents from five consecutive graduating classes, trained between July 1, 2013 and July 31, 2020, were evaluated for five objective outcomes: Accreditation Council for Graduate Medical Education (ACGME) milestones, faculty rankings of quality, National In-Training Examination scores, chief resident attainment, and fellowship attainment. Outcomes were analyzed in relation to eight potential predictors: NRMP rank, medical school type and grades, immigration status, added qualifications, sex, age and US Medical Licensing Examination (USMLE) scores, using univariate and multivariate analyses. From a cohort of 61 residents, 56 were eligible. All eligible residents' data were included, for a participation rate of 100% (56 of 56). There were no statistically significant univariate or multivariate predictors for the endpoint of fellowship attainment. Higher USMLE scores were predictive of chief resident status in univariate analysis only. NRMP rank was significantly correlated with ACGME milestones in the univariate analysis. The multivariate analysis revealed that higher USMLE score was statistically significantly predictive of more favorable milestones, faculty ranking, and National In-Training Examination score. Higher USMLE score was statistically significantly associated with multiple favorable objective residency outcomes in an Internal Medicine residency. A better NRMP rank was correlated with favorable ACGME milestones in univariate analysis, but USMLE score emerged as the strongest predictor in multivariate analysis.

The Effects of Pre-medical Anatomy and Clinical Experiences on Medical School Anatomy-Related Academic Performance.

The objective of this study was to examine the effects that pre-medical patient care clinical experiences and anatomical education had on undergraduate medical course grades and anatomy practical exam scores. This study provides a unique perspective to this line of inquiry in that it included data from 9 class year cohorts between academic years 2010-2011 and 2018-2019, all from a single institution. A survey to assess pre-medical clinical and anatomical experiences was completed by each new matriculate. Results were compared to each student's course grades and anatomy practical exam scores. The effects of pre-medical experiences on practical scores and final grades were evaluated using generalized linear mixed models. Several positive and negative associations were identified. The most obvious effect revealed by data analysis was the class year cohort effect, seen as variation in the academic performance of each cohort from year-to-year. Other significant results included a positive association between pre-medical comparative anatomy coursework and anatomy assessment performance over the entire year's anatomy curriculum. Counterintuitively, some pre-medical clinical experiences, such as nursing experience, had a negative effect on course grades and practical exam performance. Pre-medical students can use this information to decide whether to enroll in undergraduate anatomy courses or engage in extra pre-medical clinical work. It may also be valuable to medical school admissions departments in regard to determining the anatomy coursework and clinical experience requirements for their applicants.