Saguil Aaron, Balog Erin K, Goldenberg Matthew N, Dong Ting, Artino Anthony R, Zahn Christopher M, Servey Jessica T, Ritter E Matthew, Welling David R, Ramsay Laura B, Ming Gerald, Durning Steven J
Department of Family Medicine, Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
Mil Med. 2012 Sep;177(9 Suppl):47-52. doi: 10.7205/milmed-d-12-00239.
The United States is experiencing an accelerating physician shortage, especially within primary care. Medical educators are actively seeking ways to predict student specialty match and workforce requirements. Previous studies investigating specialty match have focused on factors known at the time of matriculation. This study examined whether third-year clerkship performance could be used to predict specialty match later in medical school.
The authors evaluated the clerkship performance of 802 students graduating from the Uniformed Services University between 2007 and 2011. They examined the relationship of students' clerkship grades and National Board of Medical Examiners' clinical subject examination scores to specialty match. In addition, the authors combined student performance in family medicine, internal medicine, and pediatrics to create composite variables and assessed their associations with the match.
Among 802 students, 339 (42.4%) students matched to primary care specialties. There was a positive association between higher family medicine (Odds ratio [OR] 1.65, 95% confidence interval [CI] 1.05, 2.59), general surgery (OR 1.91, 95% CI 1.22, 2.99), internal medicine (OR 2.17, 95% CI 1.35, 3.49), and pediatrics (OR 2.59, 95% CI 1.52, 4.43) clerkship grades and students matching into family medicine, general surgery, internal medicine, and pediatrics, respectively. Only family medicine showed a weak correlation between higher National Board of Medical Examiners' scores and specialty match.
Higher clerkship performance in four of six Uniformed Services University third-year clerkships is associated with matching into the corresponding specialty. Clerkship performance provides a potential tool for educators in counseling students and predicting future specialty match.
美国正面临着日益严重的医生短缺问题，尤其是在初级医疗领域。医学教育工作者正在积极寻找方法来预测学生的专业匹配情况和劳动力需求。以往关于专业匹配的研究主要集中在入学时已知的因素。本研究探讨了三年级临床实习表现是否可用于预测医学院后期的专业匹配情况。
作者评估了2007年至2011年间从美国军医大学毕业的802名学生的临床实习表现。他们研究了学生的临床实习成绩与美国医学考试委员会临床科目考试成绩与专业匹配之间的关系。此外，作者将学生在家庭医学、内科和儿科的表现综合起来创建复合变量，并评估它们与匹配情况的关联。
在802名学生中，339名（42.4%）学生匹配到初级医疗专业。家庭医学（优势比[OR]1.65，95%置信区间[CI]1.05，2.59）、普通外科（OR 1.91，95%CI 1.22，2.99）、内科（OR 2.17，95%CI 1.35，3.49）和儿科（OR 2.59，95%CI 1.52，4.43）的临床实习成绩较高与分别匹配到家庭医学、普通外科、内科和儿科的学生之间存在正相关。只有家庭医学显示出美国医学考试委员会较高分数与专业匹配之间的弱相关性。
美国军医大学三年级六个临床实习科目中，有四个科目的较高临床实习表现与匹配到相应专业相关。临床实习表现为教育工作者在指导学生和预测未来专业匹配方面提供了一个潜在工具。
