C2A - 03: EFFECTS OF MEDICAL STUDENT CLINICAL EXPERIENCE ON PERFORMANCE OUTCOMES AND CAREER CHOICES
Michelle Honda, Annie Hess, Jason Crowther, PhD, Maria Ragas, Meghan Garstka, MD, MS, Christopher Ducoin, MD, MPH; Tulane University School Of Medicine

Background: The surgery clerkship serves as an introduction to a variety of surgical practices, with academic and community hospital site placements available to students at our institution.  We studied the influence of site placement on National Board of Medical Examiners Shelf (NBME) performance and the decision to enter a surgical specialty.

Methods: The NBME shelf scores and NRMP match results were collected for 910 students over a four year period. Each student rotated through two sites during their 8 week rotation. The 17 sites were divided into two categories, either academic or community. Permutations of the site combinations were then analyzed against the students’ NBME shelf scores using a one-way ANOVA. Site type was also compared to the specialties into which the students matched. Specialties were grouped into two categories, surgical and non-surgical, and compared to sites with a chi-squared test.

Results: Two-hundred thirty one students pursued a surgical specialty and 647 pursued a non-surgical specialty.  Average NBME shelf score for those pursuing a surgical specialty was 77.3 (SD = 8.67) and for those pursing a non-surgical specialty was 75.1 (SD = 8.20). Scores were significantly higher for those pursuing a surgical specialty (p < 0.001) but there were no statistical differences in NBME shelf scores as stratified by site placement (p=0.44).  There was also no statistically significant difference in clerkship sites and the decision to match into a surgical specialty (p = 0.13).  Additional data on average NBME shelf scores and percentage match into surgical specialties as stratified by sites is demonstrated in Table 1. 

Conclusions: Though students rotated through a diverse combination of surgical practices at both academic and community institutions, these differences did not result in statistical differences in the measurable outcomes of shelf exam scores or tendency to match into surgical specialties.  This finding suggests the overall quality of the surgery clerkship is not determined by site alone.