Effect of obstetrics-gynecology clerkship duration on medical student examination performance

Objective: To compare medical student performance on the obstetrics and gyn ecology national board subject examination during two different clerkship r otation formats. Methods: We compared medical student performance on the National Board of: Medical Examiners (NBME) subject examination in obstetrics and gynecology f or 2 years before and 2 years after the length of the clerkship at the Univ ersity of Florida was decreased from 8 to 6 weeks. Medical College Admissio n Test (MCAT) and United States Medical Licensing Examination (USMLE) step I and step 2 scores were used to assess comparability between groups. Stude nt t test and chi(2) analysis were used as appropriate. Results: Medical school classes were similar with respect to MCAT and USMLE step I and step 2 scores. Collectively, 231 students who completed the 8-w eek clerkship scored significantly higher on the subject examination than 2 39 who completed the B-week clerkship (618.6 versus 593.5, P = .001). When analyzed by semester, students who completed the clerkship in the second ha lf of the academic year scored similarly regardless of clerkship length (63 0.6 versus 616.7, P = .11); however, students who completed the clerkship d uring the first half of the academic year scored significantly higher with the 8-week than the 6-week clerkship (607.3 versus 569.7, P < .001). Studen ts who took the clerkship in the last half of the academic year scored high er than students who took the clerkship in the first half for both the 8-we ek (630.6 versus 607.3; P = .02) and 6-week (616.7 versus 569.7; P < .001) formats. Those differences persisted on examination letter grade assignment . Conclusion: Decreasing the duration of the obstetrics gynecology medical st udent clerkship resulted in lower subject examination scores, especially fo r students who matriculated in the first half of the academic year. (Obstet Gynecol 2000;95:160-2. (C) 2000 by The American College of Obstetricians a nd Gynecologists.).