Concordance of surgical clerkship performance and National Board of Medical Examiners Part II subtest scores. A validation model.

This study compares the National Board of Medical Examiners Part II (NBME II) subtest scores of medical students attaining honors in a clinical clerkship to those of students receiving a passing score to determine if the NBME II examinations could be considered independently as valid indicators of clinical achievement. Significant differences were found in five of the eight clinical clerkships; four of the six NBME II subtests were involved. A validation model was derived, and error estimates were obtained by using the NBME II surgery subtest scores and surgery clerkship performance as the criteria. Although the mean scores of students receiving honors in surgery were significantly higher than those not receiving honors (P less than 0.001), there was a considerable false negative error rate of 61%. These data suggest that on an individual basis, a good correlation does not exist between clinical performance in surgery and objective assessment of knowledge as determined by NBME scores.

United States citizens in foreign medical schools and the future supply of physicians.

Between 1973 and 1977, the number of United States citizens in foreign medical schools increased from 12,000 to 15,000, with Mexico and Italy responsible for training 55 per cent of these students. If all these students can successfully meet the requirements for entry into graduate training in the United States, their numbers, combined with the increasing size of entering classes in American medical schools, may exceed the number of positions presently available for first-year graduate training. Serious problems in the quality of education received in several new foreign medical schools must be addressed if these students are to enter the American medical system.

Clinical performance and specialty choice of COTRANS students.

The clinical performance and specialty choice of 33 Coordinated Transfer Application System (COTRANS) students accepted with advanced standing into the third year of an American medical school were compared with the performance and choice of students from other American medical schools. The undergraduate grade point average of the COTRANS group was considerably lower than that of the other students. The science Medical College Admission Test scores in science were comparable, and the performance on part I of the National Board of Medical Examiners was considerably higher. Clinical performance, choice of specialty, and affiliation of graduate program of the COTRANS students did not differ from those of students entering the curriculum in year 1. Carefully selected students completing the first two years of basic science in a foreign medical school can successfully compete with students already enrolled in the American medical curriculum.