Impact of duration and number of subjects on students’ performance in junior clerkship

Abstract

Abstract Background: Medical colleges need curriculum reforms in order to enhance clinical learning contingent on previous observations. Shifa College of medicine (SCM) introduced Family medicine clerkship for final year in year 2022. To accommodate this Paeds and Gynae Obs clerkships were shifted from final to fourth year. This resulted in two major curricular shifts, first: four examining (previously there were three) subjects in 4th professional MBBS exam and Second: 2 years of clinical exposure for Gynae Obs and Paeds (previously it was three years. Methods: This cross-sectional study was conducted from Jan 2021 to June 2022. Annual professional exam results of students of year 2021 and 2022 were included. We analyzed the effect of span of clinical teaching (2 years vs. three years) and the effect of number of examining subjects in professional exam (3 subjects vs. four subjects) on students’ final performance. Data was analysed by SPSS version 23. Mean scores ± SD for all theory and OSCE (Objectively structured clinical exam) were compared. Results were also compared for number of failures and high scores > 80 % between two study cohorts. Results: Two hundred and twenty students were enrolled in the study. No statistically significant difference was found in scores of Ophthalmology theory /OSCE, Gynae & Obs and ENT Theory and Paeds OSCE. Mean scores ± SD were significantly better in ENT OSCE (74.16 ± 6.38 vs. 64.25 ± 7.03, p-value = 0.000) and in Gynae & Obs OSCE (141.59 ± 15.59 vs. 146.66 ± 11.38, p-value 0.015) after 2 years of teaching/ four subjects in professional exam. Paeds theory results showed decline after 2 years of teaching as compared to three years teaching (65.01 ± 6.61 vs. 71.66 ± 7.88, p-value = 0.000). Conclusion: The curricular shift for introduction of Family medicine in senior clerkship with subsequent, reduction in teaching duration and increased number of subjects in 4th professional examination did not significantly affect students’ performance in junior clerkship.