Gross Caroline, O'Halloran Conor, Winn Ariel S, Lux Samuel E, Michelson Catherine D, Sectish Theodore, Sox Colin M
Department of Pediatrics, Boston Children's Hospital & Harvard Medical School (C Gross and C O'Halloran), Boston, Mass; Department of Pediatrics, Boston Medical Center & Boston University School of Medicine (C Gross and C O'Halloran), Boston, Mass.
Division of General Pediatrics, Department of Pediatrics, Boston Children's Hospital & Harvard Medical School (AS Winn and T Sectish), Boston, Mass.
Acad Pediatr. 2020 Sep-Oct;20(7):1007-1012. doi: 10.1016/j.acap.2020.03.010. Epub 2020 Apr 5.
Our goal was to identify aspects of residency applications predictive of subsequent performance during pediatric internship.
We conducted a retrospective cohort study of graduates of US medical schools who began pediatric internship in a large pediatric residency program in the summers of 2013 to 2017. The primary outcome was the weighted average of subjects' Accreditation Council for Graduate Medical Education pediatric Milestone scores at the end of pediatric internship. To determine factors independently associated with performance, we conducted multivariate linear mixed-effects models controlling for match year and Milestone grading committee as random effects and the following application factors as fixed effects: letter of recommendation strength, clerkship grades, medical school reputation, master's or PhD degrees, gender, US Medical Licensing Examination Step 1 score, Alpha Omega Alpha membership, private medical school, and interview score.
Our study population included 195 interns. In multivariate analyses, the aspects of applications significantly associated with composite Milestone scores at the end of internship were letter of recommendation strength (estimate 0.09, 95% confidence intervals [CI]: 0.04, 0.15), numbers of clerkship honors (est. 0.05, 95% CI: 0.01-0.09), medical school ranking (est. 0.04, 95% CI: 0.08-0.01), having a master's degree (est. 0.19, 95% CI: 0.03-0.36), and not having a PhD (est. 0.14, 95% CI: 0.02-0.26). Overall, the final model explained 18% of the variance in milestone scoring.
Letter of recommendation strength, clerkship grades, medical school ranking, and having obtained a Master's degree were significantly associated with higher clinical performance during pediatric internship.
我们的目标是确定住院医师申请中能够预测儿科实习期间后续表现的方面。
我们对2013年至2017年夏季在一个大型儿科住院医师项目中开始儿科实习的美国医学院毕业生进行了一项回顾性队列研究。主要结局是儿科实习结束时受试者的毕业后医学教育认证委员会儿科里程碑分数的加权平均值。为了确定与表现独立相关的因素，我们进行了多变量线性混合效应模型，将匹配年份和里程碑评分委员会作为随机效应，以下申请因素作为固定效应：推荐信强度、临床实习成绩、医学院声誉、硕士或博士学位、性别、美国医师执照考试第一步成绩、美国医学优等生协会会员资格、私立医学院和面试成绩。
我们的研究人群包括195名实习生。在多变量分析中，与实习结束时综合里程碑分数显著相关的申请方面包括推荐信强度（估计值0.09，95%置信区间[CI]：0.04，0.15）、临床实习荣誉数量（估计值0.05，95%CI：0.01 - 0.09）、医学院排名（估计值0.04，95%CI：0.08 - 0.01）、拥有硕士学位（估计值0.19，95%CI：0.03 - 0.36）以及没有博士学位（估计值0.14，95%CI：0.02 - 0.26）。总体而言，最终模型解释了里程碑评分中18%的方差。
推荐信强度、临床实习成绩、医学院排名以及获得硕士学位与儿科实习期间较高的临床表现显著相关。
