Clerkship order linked with outcomes on clerkship subject exams, grades, not clinical performance

Susan M. Kies, Ed.D., of the University of Illinois College of Medicine, Urbana, and colleagues conducted a study to assess whether the order in which third-year core clerkships are completed affects student performance.

Anecdotal experience has suggested that third-year medical students whose first clerkship is internal medicine may have superior performance throughout the academic year. The researchers reviewed the clerkship performance records of medical students at all four campuses of the University of Illinois College of Medicine who completed their third-year core clerkships from July 2000 through June 2008 (n = 2,236).

The authors found that "clerkship order was significantly associated with performance on clerkship subject examinations and overall grades [with the strongest associations appearing to be with internal medicine as the initial clerkship, followed by pediatrics], but not with clerkship clinical performance or United States Medical Licensing Examination Step 2 scores. The success of student clinical performance may be related to factors other than those included within the scope of this study. Additional analyses of student performance in the clinical setting and in other institutions may help provide optimal experiences for students."