Relationship between performance in medical school and postgraduate competence.

A sample of 441 graduates (between 1971 and 1981) of Jefferson Medical College in Philadelphia, Pennsylvania, who pursued their medical training in internal medicine, pediatrics, and obstetrics/gynecology was selected. It was hypothesized that the relationship between measures of academic achievement in medical school and measures of postgraduate performance would vary in different specialty programs. The hypothesis was confirmed by comparing graduates in the three specialties on grades in medical school, scores on the examinations of the National Board of Medical Examiners, and ratings in four areas of competence in the first postgraduate year (that is, medical knowledge, data-gathering skills, clinical judgement, and professional attitudes). It was also hypothesized that the strength of the relationship would vary at different levels of performance within the specialty programs. This was confirmed for some of the variables. The results indicate that inappropriate conclusions may be drawn about the relationship between performance before and after graduation from medical school if specialty differences and levels of performance are ignored.