Medical School Performance Research Articles

EP.TU.4Performance at Medical School predicts success in the Intercollegiate Membership of the Royal College of Surgery (MRCS) examination

Abstract Aims Identifying predictors of success in post-graduate examinations can help guide the career choices of medical students and may aid early identification of trainees requiring extra support to progress in specialty training. We assessed whether performance at medical school as quantified by the Educational Performance Measurement (EPM) and scores from the Situational Judgement Test (SJT) used for selection into Foundation Training predicted success at the Membership of the Royal College of Surgeons (MRCS) examination. Methods We analysed data from the UKMED Database for UK graduates who had attempted MRCS Part A (n = 1,975) and Part B n = 630) between 2013-2017. Univariate analysis examined the relationship between performance and the likelihood of passing MRCS at first-attempt. Logistic regression identified independent predictors of MRCS success. Results For every additional EPM decile point gained the chances of passing MRCS at first attempt increased by 52% for Part A (odds ratio 1.52 [95% confidence interval (CI) 1.46-1.60]) and 27% for Part B (1.27 [1.18-1.38]). For every point awarded for additional degrees in the EPM, candidates were 29% more likely to pass MRCS Part A first time (1.29 [1.12-1.48]). SJT score was not a statistically significant independent predictor of MRCS Part A or Part B success after adjusting for sociodemographic factors (P = 0.182 and P = 0.125 respectively). Conclusions This, the first study to investigate the relationship between medical school and success at a high stakes UK postgraduate surgical examination found that medical school performance deciles are the most significant measure of predicting later success in the MRCS.

51 The Impact of Disability on Performance in the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS)

Abstract Aim The number of clinicians with disabilities is increasing, however there is no data on the performance of doctors with registered disabilities in the postgraduate environment. If we are to ensure diversity and equality within the workforce, we must first identify whether attainment differences exist in markers of performance. To address this, we assessed the impact of disabilities on performance in the MRCS. Method All UK medical graduates who had attempted MRCS Part A (n = 9,597) and Part B (n = 4,562) between 2007-2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included. Univariate analysis identified associations with MRCS performance and logistic regression models identified independent predictors of success. Results Candidates with registered disabilities (n = 635) had lower MRCS Part A pass rates (46.3% vs 59.8% (p < 0.001)) but similar Part B pass rates (68.2% vs 70.9% (p = 0.339)). They were nearly twice as likely to fail Part A (odds ratio 0.55 [95% Confidence Interval 0.46-0.64]). When prior academic attainment (A-Levels and medical school performance) was accounted for, there was no statistically significant difference in the likelihood of MRCS success (p>0.05). Pass rates were similar for candidates with specific learning difficulties and those with other registered disabilities (p>0.05). Conclusions This is the first study to assess the impact of disability status and type on performance at a postgraduate medical examination. It appears that candidates with registered disabilities performed less well in formal, written examinations generally. Although our data indicate that current MRCS testing accommodations are fair, enabling performance unrestricted by disability.

Is Academic Attainment or Situational Judgment Test Performance in Medical School Associated With the Likelihood of Disciplinary Action? A National Retrospective Cohort Study.

Disciplinary action imposed on physicians indicates their fitness to practice medicine is impaired and patient safety is potentially at risk. This national retrospective cohort study sought to examine whether there was an association between academic attainment or performance on a situational judgment test (SJT) in medical school and the risk of receiving disciplinary action within the first 5 years of professional practice in the United Kingdom. The authors included data from the UK Medical Education Database for 34,865 physicians from 33 U.K. medical schools that started the UK Foundation Programme (similar to internship) between 2014 and 2018. They analyzed data from 2 undergraduate medical assessments used in the United Kingdom: the Educational Performance Measure (EPM), which is based on academic attainment, and SJT, which is an assessment of professional attributes. The authors calculated hazard ratios (HRs) for EPM and SJT scores. The overall rate of disciplinary action was low (65/34,865, 0.19%) and the mean time to discipline was 810 days (standard deviation [SD] = 440). None of the physicians with fitness to practice concerns identified as students went on to receive disciplinary action after they qualified as physicians. The multivariate survival analysis demonstrated that a score increase of 1 SD (approximately 7.6 percentage points) on the EPM reduced the hazard of disciplinary action by approximately 50% (HR = 0.51; 95% confidence interval [CI]: 0.38, 0.69; P < .001). There was not a statistically significant association between the SJT score and the hazard of disciplinary action (HR = 0.84; 95% CI: 0.62, 1.13; P = .24). An increase in EPM score was significantly associated with a reduced hazard of disciplinary action, whereas performance on the SJT was not. Early identification of increased risk of disciplinary action may provide an opportunity for remediation and avoidance of patient harm.

Peer-Assisted Learning (PAL): Perceptions and Wellness of First-Year Medical Students.

Medical education is oftentimes stressful and has been documented to compromise student well-being, hinder performance, and contribute to burnout. Many medical schools aim to foster students' sense of well-being. This can be accomplished by peer-assisted learning (PAL), which has the potential to improve student wellness and performance in medical school. The PAL program at Nova Southeastern University Dr. Kiran C. Patel College of Allopathic Medicine provides first-year medical students with educational sessions related to their curriculum, led by second-year medical students. The goal of this study was to determine the efficacy of PAL in promoting wellness and enhancing knowledge. Pre- and post-program surveys were distributed to students prior to and after the completion of PAL. Data analysis included frequencies of responses, qualitative analysis, and chi-square analysis. Thirty-eight out of 51 first-year medical students responded to the pre-program survey (response rate 75%) and 23 out of 51 responded to the post-program survey (response rate 45%). A majority of respondents from the pre-survey believed that PAL would provide them with tools necessary to be successful. These findings were similar in the post-program survey with a majority of attendees sharing that PAL enhanced their knowledge, reduced test-taking anxiety, and provided useful skills. Results from the pre- and post-program surveys suggest that PAL can enhance student well-being while improving knowledge of the material taught in medical school. The online version contains supplementary material available at 10.1007/s40670-021-01381-0.

Does performance at medical school predict success at the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination? A retrospective cohort study

BackgroundIdentifying predictors of success in postgraduate examinations can help guide the career choices of medical students and may aid early identification of trainees requiring extra support to progress in specialty...

Revisiting the Core Entrustable Professional Activities for Entering Residency.

The Core EPAs for Entering Residency Pilot project aimed to test the feasibility of implementing 13 entrustable professional activities (EPAs) at 10 U.S. medical schools and to gauge whether the use of the Core EPAs could improve graduates' performance early in residency. In this manuscript, the authors (members of the pilot institutions and Association of American Medical Colleges staff supporting the project evaluation) describe the schools' capacity to collect multimodal evidence about their students' performance in each of the Core EPAs and the ability of faculty committees to use those data to make decisions regarding learners' readiness for entrustment. In reviewing data for each of the Core EPAs, the authors reflected on how each activity performed as an EPA informed by how well it could be assessed and entrusted. For EPAs that did not perform well, the authors examined whether there are underlying practical and/or theoretical issues limiting its utility as a measure of student performance in medical school.

220 Choice of UK Medical School Predicts Success in The Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination

Abstract Background UK medical schools vary in terms of factors such as mission, specific curricula and pedagogy. As relatively little is understood about the impact of these differences at a post-graduate level, we examined the relationship between medical school and MRCS success. Method Using the UKMED database we analysed data on UK medical graduates who attempted MRCS Part A (n = 9729) and MRCS Part B (n = 4644) between 2007-2017. Univariate analysis characterised the relationship between medical school and first attempt MRCS success. Logistic regression modelling identified independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P &amp;lt; 0.001). Trainees from standard-entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses ((Part A (Odds Ratio (OR) 3.72 [95% Confidence Interval (CI) 2.69-5.15]); Part B (OR 1.67 [1.02-2.76])). Non-graduates were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]). Russell Group graduates were more likely to pass MRCS Part A (OR 1.79 [1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])). Conclusions Medical programme and medical school are associated with MRCS success. Further research is needed to tease out the relationship between individual factors, medical school and MRCS performance.

191 Performance at Medical School and Foundation Programme Selection Can Predict Success in The MRCS Examination

Abstract Background Identifying factors that predict success in the Membership of the Royal College of Surgeons (MRCS) examination can aid trainees’ exam preparation and help deaneries identify candidates likely to require additional support. We assessed whether performance at Medical School and UK Foundation Programme selection (Educational Performance Measurement (EPM) and Situational Judgement Test (SJT)) predicted MRCS success. Method We analysed data from the UKMED Database for UK graduates who had attempted MRCS Part A (n = 1,975) and Part B (n = 630) between 2013-2017. Univariate analysis examined the relationship between performance and the likelihood of passing MRCS at first attempt. Logistic regression identified independent predictors of MRCS success. Results Each additional EPM decile increased the chances of passing MRCS by 52% for Part A (odds ratio 1.52 [95% confidence interval 1.46-1.60]) and 27% for Part B (1.27 [1.18-1.38]). Each EPM point awarded for degrees increased the likelihood of passing Part A by 29% (1.29 [1.12-1.48]). SJT score was not a statistically significant independent predictor of MRCS success (P&amp;gt;0.05). Conclusions This is the first study to investigate the relationship between UK medical school performance and postgraduate surgical exam success. Higher ranked students are more likely to succeed in the MRCS compared to their lower ranked peers.

Student, Faculty, and Coach Perspectives on Why Athletes Excel in Medical School: A Qualitative Analysis

Phenomenon Medical schools are tasked with selecting applicants who will excel in a rigorous curriculum and successfully perform as future physicians. While many studies have assessed quantitative prematriculation data for predicting success in medical school, fewer studies have assessed for qualitative prematriculation factors influencing medical school performance. A recent study revealed that medical students with at least one year of varsity level college athletics participation outperformed their peers on United States Medical Licensing board exams and clinical clerkships. The current study sought to explore medical student, medical school faculty, and college coach perspectives about factors explaining why medical students with collegiate athletic experience succeed in medical school. Approach: In 2019, the authors conducted semi-structured interviews with medical students with collegiate athletic experience, medical school faculty with experience educating student athletes, and college coaches with experience training student athletes who matriculated into medical school. The interview transcripts were systematically coded and analyzed for themes using a grounded theory approach. Participants were recruited and interviewed until saturation of data was reached. Findings: Fifteen medical students with collegiate athletic experience, five medical school faculty, and three collegiate coaches participated in the study. Six themes were identified as important factors explaining the academic success of these students in medical school and each of these themes appeared in student, faculty, and coach interviews: goal setting, goal pursuit, and performance appraisal; development of time management, planning, and organizational skills; development of team values and teamwork skills; development of communication and interpersonal skills; acceptance of, coping strategies for, and resilient response to stress and adversity; and prioritization of personal wellness. Participants described meaningful connections between these attributes and skills, suggesting the students’ development, transfer, and application of them is interrelated. Insights: In this study, academic success of medical students with collegiate athletic experience was attributed to specific skills and attributes developed during college. The grounded theory life skills transfer model can explain transfer of these attributes and skills from college to the medical school setting. Theoretical frameworks and empirical study findings from the sociology, educational psychology, sports psychology, and medical education literature provide helpful lenses for understanding why these skills and attributes confer success among student athletes in medical school. These findings offer important insights on skill development that may support the academic success of all medical students.

Medical School Applicants’ Online Interviews during COVID-19 Epidemic

Background: For many years, the primary criterion used to select medical school applicants worldwide has been cognitive measures of high school educational attainment. Yet academic assessment alone may not necessarily select the candidates who possess the behavioral or non-cognitive attributes thought important in medical students and doctors: honesty, integrity, flexibility, motivation, willingness to cooperate, managing emotions, self-esteem, control, leadership skills, resilience personal values, confidence, empathy, conscientiousness, and social accountability. There is evidence that significant relationship exists between both cognitive and non-cognitive variables and students’ performance in medical school. The challenge posed by the current pandemic of covid19 is that all admission interviews are now carried out via video.&#x0D; Method: In video interviews for admission to our Arabian Gulf University, the applicants were asked standardized questions under four main domains: motivation and commitment to medicine, handling stress and ethical dilemma, social skills, and responsibility as well as self-presentation. Each of these domains was given a Likert score ranging from one to five. Scores 1 and 2 indicated unsatisfactory performance, while scores 3, 4 and 5 indicated fair, good, and excellent, respectively. Each panel member scored each applicant independently. This creates the data bases for statistical analyses.&#x0D; Results and Discussion: The feedback from staff and students was so far positive, however, statistical results need a longitudinal follow-up of at least one decade: we do not have statistics showing to what extent the selection criteria for admission have a predictive validity for successfully completing the MD program and performing as a medical doctor.&#x0D; Conclusions: Transitioning medical school interviews to a virtual setting beyond the restrictions of COVID-19 would allow eliminating travel expenses and cost saving for applicants.

Ethnic/Racial Bias in Medical School Performance Evaluation of General Surgery Residency Applicants

Differential use of communal terms (caring/unselfish traits) versus agentic terms (goal-oriented/leadership/achievement traits) may reveal bias and has been extensively reported in letters of recommendation for residency. We evaluated bias in medical student performance evaluations (MSPE) of general surgery residency applicants. This is a retrospective study evaluating ethnic/race bias, as measured by differential use of agentic and communal terms, in MSPEs of residency applicants. 50% of MSPEs were randomly selected. An ethnic bias calculator derived from an open-source online gender bias calculator was populated with a list of validated agentic and communal terms. Relative frequency of communal and agentic terms was used to estimate bias. Multivariable regression was used to assess the association between the terms and ethnicity/race. US medical students applying for a categorical surgery residency position at a single academic institution for a single Match cycle. A total of 339 MSPEs were reviewed from 119 US medical schools. Genders were equally represented (women, 51.6%); most participants were white and Asian applicants (79.1%). Overall, MSPEs were more agency biased (65.2%) than communal biased (16.2%) or neutral (18.6%). MSPEs for Black and Hispanic/Latinx applicants were more likely to contain communal rather than agentic terms (adjusted OR: 3.02, 95% CI: 1.52-6.02) when compared to white and Asian applicants. This finding was independent of MSPE writer's gender or rank. Surgery residency applicants self-identifying as Black and Hispanic/Latinx were more likely to be described using communal traits compared to white and Asian applicants, suggesting ethnic/racial bias. Such differences in language utilized in MSPEs may impact residency opportunities for applicants who are under-represented in medicine. Educational efforts aimed at MSPE writers may help to reduce bias.

Interview Experience, Postinterview Communication, and Gender-Based Differences in the Integrated Vascular Surgery Residency Match

Integrated vascular surgery residency (IVSR) applicant perspective about the Match process has been rarely studied yet has important implications on trainee recruitment. We sought to better understand the nature of the interview process, and postinterview communication and its impact on students’ ranking choices. A voluntary and anonymous survey was sent to students who matched to IVSR in 2020, inquiring about interviews, postinterview communications and factors influencing students’ rank lists. Of the 73 matched students, 70 completed the survey (96% response rate; 23 female and 47 male). Applicants reported they were asked questions about their other programs of interest (81.4%), top choice programs (65.7%), marital status (32.9%), family planning intentions (7.1%), and religion (1.4%) during interviews. Female applicants were more frequently asked questions about family planning (17.4% vs 2.1%; P < .01) and marital status (52.5% vs 23.4%; P < .01) compared to male applicants. After interviews, 92.9% of applicants notified their top choice program of their ranking preference (Table). Of these applicants, 61.4% received postinterview communication with regards to ranking from at least one program, initiated by program directors in 81.3% of instances. Among these applicants, 58.1% reported that the postinterview communication had an impact on their rank list and 46.5% matched at a program by which they were contacted. 5.7% of applicants were asked by a program to reveal their ranking of the program and 11.4% were promised by a program to be ranked first if the applicant reciprocally ranked them first. Female and male applicants weighed program culture, operative volume, mentorship, and prestige equally in making their rank list. However, female applicants weighed the subinternship experience, personal relationships in certain cities, dedicated professional development years, and large female representation in the program more heavily (P < .02). This study provides insight into the interview experience and impactful factors for the IVSR. Both female and male applicants were asked a high number of questions about personal matters unrelated to medical school performance. Female applicants, however, experienced a higher proportion of these instances, particularly regarding family planning. These findings demonstrate the factors that are important to applicants in the match process and raises awareness of issues in the interview and recruitment process.TablePostinterview communications (n = 70)CommunicationsTotal (no.)Applicants who sent a postinterview thank you note Yes, to all programs54.3 (38) Yes, only to the programs I liked38.6 (27) None7.1 (5)Applicant perspective on thank you notes I felt obligated to write them out of fear that I would be viewed unfavorably, but prefer not to48.6 (34) I wrote thank you notes regardless they impacted the program’s impression of me because I wanted to express my gratitude.44.3 (31) I did not send any thank you cards/e-mails.7.1 (5)Applicants who wish all programs explicitly discouraged postinterviews thank you notes Yes64.3 (45) Unsure20.0 (14) No15.7 (11)Applicants who notified their first choice program that they are the first choice92.9 (65)Method of communicating intention to rank a program number one Through mentors2.9 (2) Applicant personally reached out35.8 (24) Both61.2 (41)Applicants who wish all programs explicitly discouraged postinterview communications pertaining to applicants' ranking of programs Yes40.0 (28) Unsure25.7 (18) No34.3 (24)Applicants who received postinterview communication from programs for recruitment61.4 (43)Postinterview communication was initiated by…a Program director81.3 (39) Chief/chair35.4 (17) Resident29.2 (14) Other faculty16.7 (8)Applicants who were asked by a program to reveal how they would be ranking the program5.7 (4)Applicants who were promised by a program to be ranked one if the applicant also reciprocated11.4 (8)Applicants reporting that programs’ postinterview communication to recruit them influenced their ranking lista58.1 (25)Applicants who matched at a program that contacted thema46.5 (20)Applicants who wish programs did not share with them how they were ranked before rank list submission Yes18.6 (13) Unsure40.0 (28) No41.4 (29)aIncluding only those who received postinterview communications. Open table in a new tab

Learning strategies and their correlation with academic success in biology and physiology examinations during the preclinical years of medical school.

Efficient learning is essential for successful completion of the medical degree and students use a variety of strategies to cope with university requirements. However, strategies that lead to academic success have hardly been explored. We therefore evaluated the individual learning approaches used by a cohort of medical students in their first and second preclinical years and analyzed possible correlations with examination scores. 107 students participated in our longitudinal survey on cognitive, meta-cognitive and resource-oriented learning strategies using the LIST-questionnaire (Lernstrategien im Studium). The students were surveyed twice while in their first and second year of medical school, respectively and academic performances were assessed as scores obtained in two examinations written shortly after the LIST surveys. Statistical evaluations included comparisons and cluster analyses. We here identified four different patterns of learning strategy combinations, describing the relaxed, diligent, hard-working, and sociable learners. About half of the students stayed true to their initially registered pattern of learning strategy combinations while 53 students underwent a change between the first and second surveys. Changes were predominantly made between the relaxed and the sociable and between the diligent and the hard-working learners, respectively. Examination results suggested that the diligent and hard-working learners were academically more successful than the relaxed and sociable ones. Early habits of sociable learning were quickly abandoned however, not in favor of more successful patterns. It is therefore essential to develop interventions on learning skills that have a lasting impact on the pattern of the students´ learning strategy combinations.

Student Perceptions of educational handovers

Educational handovers can provide competency information about graduating medical students to residency program directors post-residency placement. Little is known about students' comfort with this novel communication. To examine graduated medical students' perceptions of educational handovers. The authors created and distributed an anonymous survey to 166 medical students at a single institution following graduation in the spring of 2018. Within this cohort, 40 students had an educational handover sent to their future program director. The survey explored comfort level with handovers (1=very uncomfortable; 5=very comfortable) and ideal content (e.g., student strengths, areas for improvement, goals, grades received after residency application). Respondents self-reported their performance in medical school and whether a handover was sent. Correlation analyses examined relationships between performance and other variables. T-tests examined differences between students who did and did not have a handover letter sent. The survey response rate was 40.4% (67/166) - 47.8% of students felt comfortable with handovers, 19.4% were neutral, and 32.8% were uncomfortable. There was no correlation between self-reported medical school performance and comfort level. Respondents felt most strongly that strengths should be included, followed by goals. Those who had a handover letter sent expressed significantly higher comfort level (3.8 ± 1.0 vs. 2.6 ±1.3, p=0.003) with this communication. Medical students reported varying levels of comfort with educational handovers; however, those who had handovers sent had more positive perceptions. In order to improve the education continuum, it is essential to engage students in the development of this handover communication.

Does the UKCAT predict performance in medical and dental school? A systematic review

ObjectivesFor the first time, this systematic review provides a summary of the literature exploring the relationship between performance in the UK Clinical Aptitude Test (UKCAT) and assessments in undergraduate medical...

Romantic Relationships, Mental Health and Academic Performance in Medical School – A Pilot Study

Romantic Relationships, Mental Health and Academic Performance in Medical School – A Pilot Study

Confirmative Evaluation: New CIPP Evaluation Model

Struggling trainees often require a substantial investment of time, effort, and resources from medical educators. An emergent challenge involves developing effective ways to accurately identify struggling students and better understand the primary causal factors underlying their poor performance. Identifying the potential reasons for poor performance in medical school is a key first step in developing suitable remediation plans. The SOM Modified Program is a remediation program that aims to ensure academic success for medical students. The purpose of this study is to determine the impact of modifying the CIPP evaluation model by adding a confirmative evaluation step to the model. This will be carried out by conducting a program evaluation of Wayne State University’s School of Medicine Modified Program to determine its effectiveness for student success. The key research questions for this study are 1) How effective is the Modified Program for student’s success in the SOM? 2) Do students benefit from a modified program in medical school? 3) Will the CIPP program evaluation model become more effective by adding confirmative evaluation component?

A Critical Disconnect: Residency Selection Factors Lack Correlation With Intern Performance.

Emergency medicine (EM) residency programs want to employ a selection process that will rank best possible applicants for admission into the specialty. We tested if application data are associated with resident performance using EM milestone assessments. We hypothesized that a weak correlation would exist between some selection factors and milestone outcomes. Utilizing data from 5 collaborating residency programs, a secondary analysis was performed on residents trained from 2013 to 2018. Factors in the model were gender, underrepresented in medicine status, United States Medical Licensing Examination Step 1 and 2 Clinical Knowledge (CK), Alpha Omega Alpha (AOA), grades (EM, medicine, surgery, pediatrics), advanced degree, Standardized Letter of Evaluation global assessment, rank list position, and controls for year assessed and program. The primary outcomes were milestone level achieved in the core competencies. Multivariate linear regression models were fitted for each of the 23 competencies with comparisons made between each model's results. For the most part, academic performance in medical school (Step 1, 2 CK, grades, AOA) was not associated with residency clinical performance on milestones. Isolated correlations were found between specific milestones (eg, higher surgical grade increased wound care score), but most had no correlation with residency performance. Our study did not find consistent, meaningful correlations between the most common selection factors and milestones at any point in training. This may indicate our current selection process cannot consistently identify the medical students who are most likely to be high performers as residents.

Red Flags, Geography, Exam Scores, and Other Factors Used by Program Directors in Determining Which Applicants Are Offered an Interview for Anesthesiology Residency.

ObjectiveThe goal of this study was to measure the most important factors in candidate applications that anesthesiology program directors (PDs) use to decide who to invite for an interview, and how that might change once the United States Medical Licensing Examination (USMLE) Step 1 is only reported as pass/fail.DesignBased on a literature review, a comprehensive list of 27 factors used by PDs to select candidates for the interview was developed. An anonymous survey link was emailed to PDs of all Accreditation Council for Graduate Medical Education (ACGME) accredited Anesthesiology residencies. The survey asked PDs to rank order the top 10 factors they currently consider for making interview invitation, and then to repeat the rank ordering as if the USMLE Step 1 score was instead reported as pass/fail as will be done beginning in 2022.ResultsForty-five of 159 (28%) PDs responded, with 82% disagreeing with changing the Step 1 score to pass/fail. 84% consider the Step 1 score (77% for Step 2) moderately or very important for selecting an applicant for an interview. The most frequently mentioned “red flags” were failure of a licensing exam, failure of a medical school course, gaps in education without explanation, and criminal history. 69% of PDs agreed that applicants coming from the medical school affiliated with their program would have an advantage over other applicants. Although, the three factors most commonly ranked in the top 10 in importance were the Step 1 score, followed by letters of recommendation, and then the Medical School Performance Evaluation, variability exists in how PDs ranked factors. For example, of the PDs that had Step 1 in the top 10, 27% had it ranked between the 6th and 10th most important. 9% of PDs did not have Step 1 score in the top 10. Core clinical clerkship grades were one of the top 5 factors by 49% of PDs, yet overall was the 6th most common top 10 factor as 36% of PDs did not have core clerkship grades at all in the top 10. Once Step 1 is reported only as pass/fail, PDs had letters of recommendation, Step 2, and the Medical School Performance Evaluation as the most frequently ranked factors in the top 10. 64% of the PDs supported restricting the number of programs a candidate can apply to, with the majority suggesting a limit of 15 to 20 programs per applicant.ConclusionVariability exists among anesthesiology PDs in the key criteria for offering an applicant an interview. Once Step 1 is reported as pass/fail, there will be an increased emphasis on Step 2 scores.

‘10% of your medical students will cause 90% of your problems’: a prospective correlational study

ObjectivesOur aim was to explore the relationship between medical student Conscientiousness Index scores and indicators of later clinical performance held in the UK Medical Education Database (UKMED). Objectives were to...