Poster3-05: IMPACT OF GENERAL SURGERY ROTATION EXPOSURE ON SURGERY CLERKSHIP PERFORMANCE
Patrick J Sweigert, MD1, Ariel J Hawley, BS2, William H Adams, PhD3, Adam S Kabaker, MD, FACS1; 1Loyola University Medical Center, 2Loyola University Chicago Stritch School of Medicine,3Loyola University Chicago
Introduction: Clinical knowledge of medical students is commonly assessed following their required surgery clerkship using the National Board of Medical Examiners (NBME) clinical subject examination for surgery. Due to volume constraints, surgical clerkship curricula often vary based on exposure to general surgery (GS) and subspecialty (SS) patient care. The effect of these variable exposures on assessment scores is poorly understood. We sought to evaluate if GS exposure improves NBME performance.
Methods: Student data were obtained retrospectively from a single medical school from 2015-2018. All students participated in a total of two 1-month rotations prior to testing. Supervising faculty who practice within the scope of general surgery as defined by the American Board of Surgery defined GS rotations, while those with additional training defined SS rotations. Unadjusted NBME percent correct score comparisons were performed using an independent samples t-test. A general linear model was used to test whether there was a difference in the NBME score among cohorts after controlling for their USMLE Step 1 score and MCAT score.
Results: 543 students met inclusion criteria for analysis. There were 5/15 (33%) sites defined as GS rotations, while 10/15 (67%) were consistent with the SS definition. A total of 359 (66.1%) students were exposed to a GS rotation for at least 1 month prior to their NBME exam. On unadjusted analysis, mean NBME score for those exposed to GS was 73.77 vs 73.09 for those not exposed with a mean difference 0.69 (95% CI: -0.87 to 2.25). After adjustment for USMLE Step 1 score and MCAT score, mean difference in score was 0.56 (95% CI: -0.57 to 1.69, p = 0.33).
Conclusions: After adjusting for prior standardized test performance, medical students exposed to GS rotations do not gain a performance advantage on the NBME surgery exam over those who are exposed to primarily SS care. Future studies may review how supplemental clerkship curricula and student self-study contribute to student exposure to tested topics.