A. Phares1, C. Sauder1, E. Salcedo1, D. Leshikar1, C. Irwin1, G. Middleton2, H. Phan1 1University Of California – Davis,Department Of Surgery,Sacramento, CA, USA 2University Of California – Davis,Office Of Medical Education,Sacramento, CA, USA
Introduction:
The third-year of medical school is a stressful time for students as they transition from the classroom to the clinics and wards. Students strive to perform well clinically with their patients and teams as well as academically on their assignments and exams. Many students believe that rotation sequence effects their success. At UC Davis, students interested in surgery believe that completing the internal medicine (IM) clerkship before the surgery clerkship will help improve their surgery shelf exam scores. We hypothesized, despite our students’ impressions, that students who completed the IM clerkship prior to the surgery clerkship did not receive higher surgery shelf examination scores than the students who did not.
Methods:
Deidentified academic data for all third-year UC Davis School of Medicine medical students from 2012-2017 were collected. Data included undergraduate GPA, MCAT scores, USMLE Step 1 scores, and NBME shelf exam scores for surgery. Students who did not complete all six core clerkships during the standard third-year time frame were excluded. The average shelf exam scores were analyzed using a 2-tailed t-tests both in aggregate and by individual rotation slot. Z-scores were also calculated for the average shelf exam scores by rotation slot.
Results:
Data from 424 students were included in the study. 214 students completed the IM clerkship before the surgery clerkship and 206 did not. Average undergraduate GPA, MCAT scores, and USMLE Step 1 scores were compared between the two groups, and no significant differences were found. In aggregate, average shelf exam scores of students who completed the IM clerkship prior to the surgery clerkship were significantly higher than those of students who did not (77.0% vs 73.8%, p value < 0.001). Additionally, average shelf exam scores for all students increased over the academic year. When the average shelf exam scores for the two groups were analyzed by rotation slot, no significant difference was found between the two groups (Table 1).
Conclusion:
When the shelf exam scores were analyzed in aggregate, students who completed the IM clerkship before the surgery clerkship scored higher on their surgery shelf exams. However, the surgery shelf scores were higher as the academic year progressed. Students who completed the surgery clerkship later in the academic year were more likely to have completed the IM clerkship already. When examining the two groups by rotation slot, we found no difference between the students who had already completed the IM clerkship and those who had not. These data suggest that students' scores on the surgery shelf exam are related to experience gained and are independent of the timing of the IM rotation in relation to the surgery rotation.
