Reteguiz Jo-Ann, Crosson Jesse
Department of Medicine, University of Medicine and Dentistry of New Jersey-New Jersey Medical School, Newark 07103, USA.
Fam Med. 2002 Sep;34(8):604-8.
Taking National Board of Medical Examiners (NBME) subject examinations later in the year is known to lead to higher scores. The effect of taking these exams in a particular order is not well understood.
Scores on family medicine and internal medicine examinations from 312 students in 2 academic years were analyzed to determine the effect of clerkship order on student performance. US Medical Licensing Examination (USMLE) Step 1 scores were used to control for prior academic achievement. Students were separated into groups based on the time of year they took each clerkship and prior experiences.
When controlling for USMLE scores, NBME scores varied in relation to time of year and order of clerkship experiences. Students who took internal medicine first performed better on the family medicine exam. Taking psychiatry, obstetrics-gynecology, or surgery clerkships prior to the internal medicine exam improved scores on the internal medicine examination.
The timing and order of family medicine and internal medicine clerkship experiences affects performance on the NBME family medicine and internal medicine exams. Clerkship directors should consider this effect when evaluating medical students.
众所周知，在一年中较晚时候参加美国国家医学考试委员会（NBME）的专业考试会取得更高的分数。但对于以特定顺序参加这些考试的影响，人们还了解得不够充分。
对两个学年中312名学生的家庭医学和内科学考试成绩进行分析，以确定实习顺序对学生成绩的影响。美国医师执照考试（USMLE）第一步的成绩用于控制先前的学业成绩。根据学生参加各实习的时间以及先前经历将其分组。
在控制USMLE成绩后，NBME成绩随一年中的时间和实习经历顺序而变化。先参加内科学实习的学生在家庭医学考试中表现更好。在内科学考试之前参加精神病学、妇产科或外科实习，可提高内科学考试成绩。
家庭医学和内科学实习经历的时间和顺序会影响NBME家庭医学和内科学考试的成绩。实习主任在评估医学生时应考虑这一影响。
