A two-year experience with premedical postbaccalaureate students admitted to medical school

To determine how well premedical postbaccalaureate students performed in and adjusted to medical school, the author examined the records for all 123 matriculants to the Brown University Program in Medicine in 1987-88 and 1988-89 and sent each student a questionnaire. More than one-third of the first-year students admitted to Brown were from premedical postbaccalaureate programs (that is, they had taken the traditional premedical course requirements after graduating from college). The postbaccalaureate students were older than the rest of their classmates, on average, and were more likely to have been non-science majors in college. Academic performances over the first two years were comparable in the two groups, and there was no significant difference between the groups in their self-reports of adequacy of preparation or involvement in extracurricular activities. The author concludes that, faced with a smaller applicant pool, medical schools may wish to consider premedical postbaccalaureate students as a valuable resource.     

Retention of traditional premedical students in a medical career pathway compared with students in a combined baccalaureate-medical degree program.

This study compared the retention in medical career pathways of students enrolled in a combined baccalaureate-medical degree program to traditional premedical students at Brown University. Whereas 84% of the combined-degree students went on to medical school, only 36% of the traditional premedical students did. Among underrepresented minority students, the proportions were 74% and 39%, respectively. Scholastic Aptitude Test (SAT) scores accounted for some of the difference, yet even when SAT scores were controlled using a multiple logistic regression model, students enrolled in the combined-degree program were more than eight times as likely to continue in a medical career pathway.     

Reexamination of relationships between students' undergraduate majors, medical school performances, and career plans at Jefferson Medical College

A reexamination of the possible relationships between medical students' undergraduate academic majors and their medical school performances and career plans seems appropriate, given the continuing changes in the characteristics of the medical school applicant pool in the last several years. This study investigated these relationships by comparing cognitive and noncognitive characteristics of medical students who had had different undergraduate majors. The study sample consisted of 812 students who entered Jefferson Medical College between 1985 and 1988. They were classified into six categories based on their undergraduate majors: biological, chemical and physical, social and behavioral, other sciences, humanities and arts, and indeterminate majors. Results indicated that performances in the basic science component of medical education were about the same for students with different undergraduate majors. The groups had similar rates of delayed graduation, but the attrition rate was highest for students who had majored in humanities and arts. The students in undergraduate disciplines traditionally oriented toward medicine (biological, physical, and chemical sciences) were younger and had made the decision to become a physician at earlier ages than had their counterparts with undergraduate majors in social sciences and humanities. Also, the groups differed with regard to their estimates of their future incomes and plans for professional activities after graduation. Similarities concerning the students' preferred professional activities were also noticed among the groups.     

The missing curriculum: experience with emotional competence education and training for premedical and medical students

Medical education has long overlooked teaching the normal psychodynamics of everyday adult life (psychonormality) in favor of training in psychopathology. Proficiency in psychonormality skills (i.e., emotional competence) includes skilled management of internal emotions, external situations and relationships, and promotes patient satisfaction and healthcare outcomes as well as better mental health for practitioners. In particular, teaching psychonormality skills can be helpful to underrepresented minority (URM) students whose psychonormality experiences may differ from the culture of mainstream medical education. This paper outlines a clinically derived, pragmatic, five-step course designed to educate and train students for emotionally competent medical practice. A real-life example taken from an introductory workshop presentation of this course at a Student National Medical Association meeting is presented to illustrate the student-oriented application of the concepts. The enthusiastic reception accorded such workshops suggests an unmet need for this type of training in medical curricula. Benefits could include improved doctor-patient relationships and associated healthcare outcomes as well as higher retention of competent, professional, satisfied and healthier physicians, particularly URMs. Medical schools and residencies are encouraged to carefully evaluate the impact of incorporating psychonormality education and emotional competence training into their present curricula and faculty development.     

Comparing millennial and generation X medical students at one medical school.

PURPOSE: Two main generational cohorts comprising students enrolled in medical schools today are Generation Xers (born 1965-1980) and Millennial students (born 1981-1999). A subset is Cuspars (born 1975-1980), who share traits with both generations. Population theorists ascribe different personal characteristics, attitudes, and preferences to each group. The authors examined whether selected characteristics describing Generation X and Millennial students were quantifiable using a personality measure. Differences among Generation X, Millennial, and Cuspar medical students were investigated. METHOD: Eight hundred and nine medical students (399 females and 410 males) who matriculated between 1989-94 and 2001-04 at the Northeastern Ohio Universities College of Medicine completed the 16 Personality Factor Questionnaire (16PF). Differences in responses to the 16PF among the three generations were analyzed using multivariate analysis of variance (MANOVA). RESULTS: Analyses showed significant differences for Generation X versus Millennial students on 10 of the 16 personality factors. Millennial students scored significantly higher than Generation X students on factors including Rule-Consciousness, Emotional Stability, and Perfectionism; Generation X students scored higher than Millennials on Self-Reliance. Millennials also were significantly different from Generation Xers on several other factors. Significant differences were noted among Cuspars, Generation Xers, and Millennials. CONCLUSIONS: The 16PF is a useful tool to examine differences among these groups and to help understand the factors that constitute their personalities. Given differences among the generational groups, the authors forecast possible educational implications for medical school academic affairs and student services, and suggest areas for future research.     

Medical school and residency performances of students admitted with and without an admission interview

In 1982 the Brown University Program in Medicine eliminated the personal interview from its process of selecting applicants for admission to medical school. This study compares the 113 M.D.-program students admitted to the first three classes (entering between 1983 and 1985) without an interview with the 67 students in the previous three classes admitted with an interview. The students' characteristics were essentially the same with respect to the preadmission variables, the proportions of women and minority students, course performances, scores on Parts I and II of the National Board of Medical Examiners examinations, and evaluation scores from residency program directors. This study offers additional evidence that the selection interview, as practiced in most U.S. medical schools, does not contribute to the predictive validity of the admission process.     

Postbaccalaureate preparation and performance in medical school

The question whether postbaccalaureate preparation before matriculation in medical school contributes to medical students' performance was addressed by this study. A total of 610 (91%) of the students who entered Jefferson Medical College between 1985 and 1987 were the study sample. Fifty-eight of these students had taken nondegree undergraduate premedical courses and 15 had taken nondegree graduate courses. Fourteen students held graduate degrees and 60 students had some combination of the aforementioned types of postbaccalaureate preparations. The other 463 students had not taken postbaccalaureate courses. Grades received in medical school courses such as anatomy, biochemistry, mechanisms of disease, physiology, microbiology, pathology, and pharmacology, as well as total scores on Part I of the National Board of Medical Examiners examination were selected as performance variables. Statistical analyses showed that the students who had taken nondegree postbaccalaureate courses had lower undergraduate grade-point averages than those without such courses and received lower grades on some measures of performance in medical school. The students with such additional academic backgrounds were also older than the average medical student. When adjustments were made for undergraduate grade-point averages by applying analysis of covariance, the observed differences that favored the group without postbaccalaureate preparation either became nonsignificant or favored those with such preparation. The differences favoring those without postbaccalaureate preparation could be accounted for mostly by these students' higher undergraduate grade-point averages and younger ages. Implications for admission decisions with regard to the changing applicant pool are discussed.     

Participation in a premedical summer program for underrepresented-minority students as a predictor of academic performance in the first three years of medical school: two studies.

PURPOSE: To determine whether the performances of underrepresented minority students in the Medical Education and Development Program (MEDP) at the University of North Carolina Chapel Hill (UNC-CH) School of Medicine (a structured, nine-week summer premedical program that simulates the medical school's first year curriculum) predicted their academic performances in the first three years of medical school. METHOD: These two studies looked separately at the predictive value of students' rankings (top quarter or top half) within their MEDP cohorts. The first study involved 165 students who had participated in the MEDP from 1981 to 1990 and who then matriculated at UNC-CH. Using backward elimination logistic regression models, the author determined whether those rankings and other, more traditional academic performance predictors predicted three types of academic difficulty during the first two years of medical school: (1) required participation in summer review; (2) deceleration; and (3) dismissal. The predictive validity of each regression model was assessed by calculating the sensitivity and the positive predictive value. The second study involved 135 students who had participated in the MEDP from 1981 to 1990 and who had finished their third-year clinical clerkships at UNC-CH. Forty-four of those students had taken the National Board of Medical Examiners (NBME) Part II examination. Using Spearman correlations, the Student t test, and the chi-square test, the author determined the simple relationships among MEDP ranking, traditional premedical academic predictors, and third-year clinical performance (as measured by clerkship grades and NBME scores). The author determined the best predictors of third-year clinical performance using stepwise backward-elimination linear regression models. RESULTS: In both studies, a student's ranking within his or her MEDP cohort was the strongest, if not the only, predictor of medical school academic performance. CONCLUSION: These studies suggest that structured summer premedical programs such as UNC-CH's MEDP are quite good at determining whether participants will be able to handle the academic rigors of medical school.     

Determinants of career aspirations of medical students in southern China

Background  

With recent changes in both the Chinese medical system and compensation of medical doctors, the career aspirations of Chinese medical students have become more diverse. Shantou University Medical College has conducted evaluations and instituted programs to enhance student preparedness to enter a variety of medical careers.     

First-year residents' performances compared with their medical school class ranks as determined by three ranking systems.

Difficulties encountered with deans' letters have prompted residency directors to rely on performance indicators, including class rank, that indicate the comparative positions of applicants. However, the validity of class rank as a predictor of performance in residency is not well established. The present investigation studied the relationship of class ranks to residents' performances, the systems of class ranking that correlated with residents' performances, and procedures that strengthened the relationship between ranking information and residents' performances. Three systems of class ranking are described. With each system, the authors used the same study group of 124 graduates (classes of 1986 and 1987) from a midwestern medical school with a baccalaureate-M.D. degree program; by 1991, each graduate had completed his or her first year of residency. All three systems were reliable for assignment of class rank. All three systems showed modest correlations with residents' performances. Multiple regression analysis revealed that a weighted combination of clinical performance measures bore the strongest relationship to performances in residency. Thus, the authors conclude that the formal computational ranking of students is not essential for the generation of reliable and valid deans' letters that can predict residents' performances. An in-depth evaluation that includes comparative information based on statistically generated formulas, as well as information based on personal qualities, may be a superior alternative.     

Course selections and career plans of black participants in a summer intervention program for minority students

From 1985 through 1987, data were gathered on 151 participants in a summer program at the Bowman Gray School of Medicine of Wake Forest University. This program was designed for academically talented minority students to promote their awareness of medicine as a potential career and to strengthen their science and mathematics backgrounds. Among the findings were that the differences in the students' selections of courses in their schools were small, regardless of the occupational or educational levels of their parents, and that the gender of the students had little relation to their choices of advanced mathematics and science courses. The significance of the findings is discussed and the importance of continued support of such intervention programs is emphasized.     

The relationship between premedical coursework in gross anatomy and histology and medical school performance in gross anatomy and histology

Many premedical students enroll in courses whose content will be encountered again during their medical education. Presumably, students believe this practice will lead to improved academic performance in corresponding medical school courses. Therefore, this study was undertaken to determine whether a premedical gross anatomy and/or histology course resulted in increased performance in corresponding medical school courses. A second aim of the study was to examine whether the type of premedical gross anatomy and/or histology course differentially affected medical school performance. A survey that assessed premedical gross anatomy and histology coursework was administered to 440 first-year medical students. The results from this survey showed that students with premedical gross anatomy (n = 236) and/or histology (n = 109) earned significantly more points in the corresponding medical school course than students without the premedical coursework (P < 0.05). Analysis of premedical course types revealed that students who took a gross anatomy course with prosected specimens (n = 35) earned significantly more points that those students without premedical gross anatomy coursework (P < 0.05). The results from this study suggest: 1) premedical gross anatomy and/or histology coursework improves academic performance in corresponding medical school courses, and 2) a premedical gross anatomy course with prosected specimens, a specific type of undergraduate course, significantly improves academic performance in medical gross anatomy.     

Effectiveness of a premedical postbaccalaureate program in improving medical college admission test scores of underrepresented minority and disadvantaged students

PURPOSE: The purpose of this article is to share the procedures used to strengthen the Medical Pathways (MEDPATH) premedical postbaccalaureate program (PBP) to increase the chances of its students successfully graduating from medical school in four years. METHODS: Subjects included students who matriculated into medical school between 1991-1999 (N = 72) following successful completion of the 12-month MEDPATH premedical PBP. Students who had passed the USMLE Step 1 on the first attempt were defined as successful and were compared to those who did not pass on their first attempt. Programmatic changes were implemented based on these findings, and outcomes were evaluated. RESULTS: There was a significant improvement in total MCAT scores between pre-2003 (PBP entry year) participants (Mn = 20.73, SD = 3.10, N = 117) and post-2003 (PBP entry year) participants (Mn = 25.27, SD = 2.96, N = 37) (t = 7.86, df = 152, p < 0.001). MEDPATH premedical PBP coursework grade-point averages improved from 3.48 to 3.67 over the same time intervals. Diversity of program participants was maintained. CONCLUSION: The enhanced MEDPATH premedical PBP appears to be producing underrepresented minority and disadvantaged medical students who are better prepared to succeed in medical school.     

Educational benefits of diversity in medical school: a survey of students.

PURPOSE: Many U.S. medical schools have abandoned affirmative action, limiting the recruitment and reducing the admission of underrepresented minority (URM) students even though research supports the premise that the public benefits from an increase in URM physicians and that URM physicians are likely to serve minority, poor, and Medicaid populations. Faculty and students commonly assume they benefit from peer cultural exchange, and the published evidence for the past two decades supports this notion. This research examined the students' perceptions of the educational merits of a diverse student body by surveying medical students at two schools. METHOD: In 2000, medical students from all four years at Harvard Medical School and the University of California, San Francisco, School of Medicine were enrolled in a telephone survey about the relevance of racial diversity (among students) in their medical education. Students responded to the interviewer's questions on a five-point Likert-type scale. RESULTS: Of the 55% of students who could be located, 97% responded to the survey. Students reported having little intercultural contact during their formative years but significantly more interactions during higher education years, especially in medical school. Students reported contacts with diverse peers greatly enhanced their educational experience. They strongly supported strengthening or maintaining current affirmative action policies in admissions. The responses and demography of the Harvard and UCSF students did not differ significantly, nor did they differ for majority students and URM students-all groups overwhelmingly thought that racial and ethnic diversity among their peers enhanced their education. CONCLUSIONS: Diversity in the student body enhanced the educational experiences of students in two U.S. medical schools.