Addressing a Gap in Medical School Training: Identifying and Caring for Human Trafficking Survivors Using Trauma-Informed Care.

Introduction: Human trafficking (HT) is a substantial public health problem, and health care workers are uniquely positioned to help identify and care for survivors. Despite this fact, few medical schools incorporate HT training using trauma-informed care (TIC) principles into their curricula. We developed a training session to educate medical students on recognizing HT red flags and providing TIC to HT survivors. Methods: One hundred twenty-seven fourth-year medical students at Rush Medical College attended a 2-hour session consisting of didactic lectures by expert speakers and participated in a group discussion guided by a clinical vignette. Students completed anonymous pre- and postsession surveys that assessed comfort levels in detecting HT red flags and providing TIC. We used a paired t test to compare pre- and postsession survey responses. Results: Ninety-five pre- and postsession surveys were matched with unique identifiers and used for analysis. The results demonstrated significant improvement in all the metrics assessed. Discussion: This training significantly improved medical students' comfort in identifying and caring for HT survivors, addressing an especially important gap in medical school education. This training can be implemented at other institutions to further improve awareness and efforts in identifying and caring for HT survivors while avoiding retraumatization.

Virtual Reality for Emergency Medicine Training in Medical School: Prospective, Large-Cohort Implementation Study.

BACKGROUND: Virtual reality (VR)-based simulation is being increasingly used to train medical students in emergency medicine. However, because the usefulness of VR may depend on various factors, the best practices for implementing this technology in the medical school curriculum are yet to be determined. OBJECTIVE: The overall objective of our study was to assess the perceptions of a large cohort of students toward VR-based training and to identify the associations between these attitudes and individual factors, such as gender and age. METHODS: The authors implemented a voluntary, VR-based teaching session in the emergency medicine course at the Medical Faculty in Tübingen, Germany. Fourth-year medical students were invited to participate on a voluntary basis. Afterward, we asked the students about their perceptions, collected data on individual factors, and assessed the test scores achieved by them in the VR-based assessment scenarios. We used ordinal regression analysis and linear mixed-effects analysis to detect the impact of individual factors on the questionnaire answers. RESULTS: A total of 129 students participated in our study (mean age 24.7, SD 2.9 years; n=51, 39.8% male; n=77, 60.2% female). No student had previously used VR for learning, and only 4.7% (n=6) of the students had prior experience with VR. Most of the students agreed that VR can convey complex issues quickly (n=117, 91%), that VR is a useful addition to mannequin-based courses (n=114, 88%) or could even replace them (n=93, 72%), and that VR simulations should also be used for examinations (n=103, 80%). However, female students showed significantly less agreement with these statements. Most students perceived the VR scenario as realistic (n=69, 53%) and intuitive (n=62, 48%), with a relatively lower agreement for the latter among female respondents. We found high agreement among all participants (n=88, 69%) for immersion but strong disagreement (n=69, 54%) for empathy with the virtual patient. Only 3% (n=4) of the students felt confident regarding the medical content. Responses for the linguistic aspects of the scenario were largely mixed; however, most of the students were confident with the English language (not native) scenarios and disagreed that the scenario should be offered in their native language (female students agreed more strongly than male students). Most of the students would not have felt confident with the scenarios in a real-world context (n=69, 53%). Although physical symptoms during VR sessions were reported by 16% (n=21) of the respondents, this did not lead to the termination of the simulation. The regression analysis revealed that the final test scores were not influenced by gender, age, or prior experience in emergency medicine or with virtual reality. CONCLUSIONS: In this study, we observed a strong positive attitude in medical students toward VR-based teaching and assessment. However, this positivity was comparatively lower among female students, potentially indicating that gender differences need to be addressed when VR is implemented in the curriculum. Interestingly, gender, age, or prior experience did not influence the final test scores. Furthermore, confidence regarding the medical content was low, which suggests that the students may need further training in emergency medicine.

Knowledge, Perceptions and Levels of Utilisation of E-Learning among Medical Students in Nigeria.

BACKGROUND: Globally, electronic learning (e-learning) is being embraced in all spheres, including the field of Medicine, where it has an engrained role in both medical education and practice. OBJECTIVES: The study aimed to assess the knowledge, perception and factors influencing the utilisation of e-learning amongst medical students in Nigeria. METHODS: It was a descriptive, cross-sectional survey. The study involved public and private medical schools across the six geopolitical zones of Nigeria. Five hundred and thirty (530) medical students responded to the online questionnaire (Google forms). Data were analyzed using SPSS version 23.0. RESULTS: The mean age of the participants was 21.5 ± 3.1 years, with 60.8% being females. About three-fifths (59.5%) of the respondents were in public universities, while the remaining were in private universities. Nearly all the respondents (98.1%) were aware of e-learning. The majority believed that e-learning would be useful for lectures and seminars, but not for laboratory demonstrations, clinical demonstrations, and bedside teaching. Class of study (p = 0.002), school ownership (p = 0.034), institutions having e-learning platform (p <0.001); having received e-learning training (p <0.001)) and institution encouraging e-learning for students (p <0.001) were significant predictors of utilization of e-learning. High cost and poor internet connectivity were the most cited disadvantages of e-learning. CONCLUSION: This study showed that e-learning is well known among Nigerian medical students, although some had never utilized it. The high financial costs, poor internet connectivity, and irregular electricity were among the major constraints to the utilization of e-learning.

CONTEXTE: Dans le monde entier, l'apprentissage électronique (elearning) est adopté dans toutes les sphères, y compris dans le domaine de la médecine, où il joue un rôle important dans l'enseignement et la pratique de la médecine. OBJECTIFS: L'étude visait à évaluer la connaissance, la perception et les facteurs influençant l'utilisation de l'apprentissage électronique chez les étudiants en médecine au Nigeria. MÉTHODES: Il s'agissait d'une enquête descriptive et transversale. L'étude a impliqué des écoles de médecine publiques et privées dans les six zones géopolitiques du Nigeria. Cinq cent trente (530) étudiants en médecine ont répondu au questionnaire en ligne (Google forms). Les données ont été analysées à l'aide de SPSS version 23.0. RÉSULTATS: L'âge moyen des participants était de 21,5 ± 3,1 ans,60,8 % étant des femmes. Environ trois cinquièmes (59,5 %) des répondants étaient dans des universités publiques, tandis que les autres étaient dans des universités privées. Presque tous les répondants (98,1 %) connaissaient l'apprentissage en ligne. La majorité d'entre eux pensaient que l'apprentissage en ligne serait utile pour les cours magistraux et les séminaires, mais pas pour les démonstrations en laboratoire, les démonstrations cliniques et l'enseignement au chevet des patients. La classe d'étude (p = 0,002), la propriété de l'école (p= 0,034), les institutions disposant d'une plateforme d'apprentissage électronique (p <0,001), ayant reçu une formation à l'apprentissage électronique (p <0,001)) et les institutions encourageant l'apprentissage électronique pour les étudiants (p <0,001) étaient des prédicteurs significatifs de l'utilisation de l'apprentissage électronique. Le coût élevé et la faible connectivité à internet étaient les inconvénients les plus cités de l'apprentissage en ligne. CONCLUSION: Cette étude a montré que l'apprentissage en ligne est bien connu parmi étudiants en médecine nigérians, même si certains ne l'ont jamais utilisé. Les coûts financiers élevés, la mauvaise connectivité à internet et l'irrégularité de l'électricité sont parmi les principales contraintes à l'utilisation de l'apprentissage en ligne. Mots Clés: Apprentissage en ligne, Connaissances, Étudiants en médecine, Nigeria, Utilisation.

[Personal drug education to learn evidence-based medicine].

A variety of new methods are being tried in education of pharmacology for medical students, to make pharmacology be directly oriented to practical medical treatment. Among them, thinking that the method of "selection of personal drug (P-drug)" is suitable for learning "evidence-based medicine (EBM)", I have been engaged in "P-drug education" in Kyushu university for many years. If doctors carefully select medicines that are indispensable for their medical treatment based on clinical evidence, are made familiar with how to use them, and in principle perform daily medical treatment using only those medicines, EBM can be really practiced. And moreover, it may also lead to the suppression of medical errors and adverse drug reactions. Such essential medicines for an individual doctor are called P-drug. Since 2003, I have adopted "P-drug selection" in the education of pharmacology for upper grade medical students. After more than 15 years of trial and error, I have been able to create an educational model using "P-drug selection" that I think could be easily adopted at any medical school. At this symposium, I talked about the relationship between "P-drug selection" and EBM and demonstrate the "P-drug education" model.

[Practices and challenges of joint education at two medical schools utilizing online pharmacology role-playing].

The pharmacology role-play, in which students impersonate medical personnel and patients to explain illness and drug treatment, is one of the active learning of pharmacology. However, until now, it has been carried out only within one facility, and has not been carried out between different multi-facility facilities with a larger scale. However, the spread of COVID-19 infection in 2020 was a turning point that drastically changed the way of medical school education centered on traditional face-to-face lectures. Above all, remote real-time lessons using Zoom etc. have the advantage that about 300 students can be conducted at multiple facilities without having to gather them in one place at the same time. With the Korona-ka as a strange currency, the infrastructure has been set up to carry out joint education in pharmacological role-playing between different multi-institutions. We are the first in Japan to conduct a pharmacology role-play jointly by Fujita Medical University and Aichi Medical University, so we would like to introduce the contents.

Faculty bridging individual and organizational resilience: results of a qualitative analysis.

BACKGROUND: Medical student burnout and anxiety has received growing attention in the past decade. The culture of competition and assessment has resulted in increasing stress levels amongst medical students, causing a decline in their academic performance and overall mental health. The objective of this qualitative analysis was to characterize recommendations from educational experts to aid students' academic progress. METHODS: At an international meeting in 2019, worksheets were completed by medical educators during a panel discussion. Participants responded to four scenarios representing common challenges medical students face in school (eg. Postponing Step 1, failing clerkships, etc.). For each case, participants addressed what students, faculty and medical schools could do to mitigate the challenge. Inductive thematic analysis was conducted by two authors followed by deductive categorization using an individual-organizational resilience model. RESULTS: Across the four cases, common suggestions made for students, faculty and medical schools were aligned to a resilience model representing the complex interplay between individuals and organizations and the impact on student wellbeing. DISCUSSION: Using suggestions from medical educators from across the US, we were able to identify recommendations for students, faculty, and medical schools to help students succeed in medical school. By applying a model of resilience, faculty serve as a critical bridge to connect students to the medical school administration. Our findings also support a pass/fail curriculum to ease the competition and burden students place on themselves.

Increasing Inclusion, Diversity, Antiracism, and Equity With a Medical School Curriculum Quality Improvement Project.

ABSTRACT: The students at Mayo Clinic Alix School of Medicine (MCASOM) wrote a call to action to medical school leadership in June 2020. The students requested help in navigating socio-political barriers that affected one another and contributed to healthcare inequities and mistrust. Using the Association of American Medical Colleges (AAMC) tool to assess cultural competence training, our team evaluated the baseline 2017-2018 MCASOM curriculum. There were 254 learning objectives, of which 43 (17%) were related to inclusion, diversity, antiracism, and equity (I-DARE). Mirroring the concerns of the students, the findings identified minimal content about antiracism and inclusion. By applying DMAIC principles for quality and process improvement, we aimed to increase the number of taught learning objectives about I-DARE content for the first-year and second-year medical students by 100%, from 43 to 86 objectives, without adversely affecting student satisfaction and true attendance. To address the underlying causes, we launched a virtual, multisite I-DARE medical school course and doubled the number of I-DARE-taught learning objectives from 43 to 107 (149%), compared with the baseline. The program evaluation review revealed that the students were self-reflective and provided a spectrum of experiences regarding the I-DARE course.

Inventory and analysis of literature on the organisation of eight European academic medical centres-A scoping review.

Academic Medical Centres (AMCs) are important organisations for shaping healthcare. The purpose of this scoping review is to understand the scope and type of evidence related to the organisation of European AMCs. We selected the study population intending to obtain a demographic cross-section of European countries: Czech Republic, Germany, Latvia, the Netherlands, Poland, Spain, Sweden and the UK. We focused our search strategy on the relationship between medical schools and AMCs, the organisation of governing bodies, and legal ownership. We searched the bibliographic databases of PubMed and Web of Science (most recent search date 17-06-2022). To enrich the search result, we used Google search engines to conduct targeted searches for relevant websites. Our search strategy yielded 4,672 records for consideration. After screening and reviewing full-text papers, 108 sources were included. Our scoping review provided insight into the scope and type of evidence related to the organisation of European AMCs. Limited literature is available on the organisation of these AMCs. Information from national-level websites complemented the literature and provided a more complete picture of the organisation of European AMCs. We found some meta-level similarities regarding the relationship between universities and AMCs, the role of the dean and the public ownership of the medical school and the AMC. In addition, we found several reasons why a particular organisational and ownership structure was chosen. There is no uniform model for AMC organisations (apart from some meta-level similarities). Based on this study, we cannot explain the diversity in these models. Therefore, further research is needed to explain these variations. For example, by generating a set of hypotheses through in-depth case studies that also focus on the context of AMCs. These hypotheses can then be tested in a larger number of countries.

How to: Success factors for the implementation and establishment of the "longitudinal curriculum" on communicative competencies at the Medical Faculty Mannheim.

Communicative competencies are of great importance to the medical profession, hence the teaching of them has been continuously expanded in recent years at many German medical schools. While individual courses on communicative competencies have already been established in the curricula, there remains, in part, a lack of longitudinal anchoring over the entire course of medical study. In 2008 the Medical Faculty Mannheim began implementing a longitudinal curriculum for communicative competencies. This paper outlines the general and phase-specific success factors in this process and gives practical recommendations and tips based on the personal experiences of the authors and the existing literature.

Measuring Teaching Efforts in a Medical School Department or Division: A Scoping Review.

PURPOSE: The desire to measure faculty's teaching productivity has led many medical school departments to create academic productivity metrics and evaluation systems to track clinical and/or nonclinical teaching efforts. The authors investigated these metrics and their impact on teaching productivity and quality in the literature. METHODS: The authors performed a scoping review using keywords to query three publication databases. A total of 649 articles were identified. The search strategy resulted in the screening of a total of 496 articles after the removal of duplicate articles, of which 479 were excluded. A total of 17 papers met the criteria. RESULTS: Four of the 17 institutions exclusively measured clinical teaching productivity, and all four reported 11-20% gains in teaching or clinical productivity. Four of the six institutions that tracked only nonclinical teaching productivity shared quantitative data and experienced a variety of gains from measuring teaching productivity that centered on greater participation in teaching. The six institutions that monitored both clinical and nonclinical teaching productivity provided quantitative data. The reported effects ranged from greater learner attendance at teaching events to increases in clinical throughput and teaching hours per faculty member. Five of the 17 institutions tracked quality using qualitative measures, and none of these institutions observed a decrease in teaching quality. CONCLUSIONS: Setting metrics and measurement of teaching seems to have had a generally positive effect on amounts of teaching; however, their impacts on the quality of teaching are less clear. The diversity of metrics reported makes it difficult to generalize the impact of these teaching metrics.

Accreditation standards items of post-2nd cycle related to the decision of accreditation of medical schools by the Korean Institute of Medical Education and Evaluation.

PURPOSE: The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE). METHODS: The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions. RESULTS: After examining differences in accreditation decisions by the medical school's characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate. CONCLUSION: The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school's characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.

Evaluation of the public health clinical rotation in medical school: a qualitative case study design.

Public health clinical rotation in the Faculty of Medicine, Universitas Islam Indonesia, was conducted in Puskesmas (community health center). This study aims to evaluate the public health clinical rotation in Puskesmas, part of the clinical clerkship of the Faculty of Medicine, Universitas Islam Indonesia. Several concerns have been highlighted regarding the implementation of clinical rotations in public health in Puskesmas. A briefing session before placement in the village must be coherent with a guidebook. The placement of students in the village was based on community health issues determined by the Puskesmas supervisor. Priority in the curriculum was given to converting the alertness village (Desa Siaga) into a Program Indonesia Sehat-Pendekatan Keluarga (Healthy Indonesia Program-Family Education) program throughout implementation. Moreover, scheduling after four major clinical programs was difficult, and the writing of reports served as a guide for establishing the correct format. Therefore, the objective of the evaluation was to assess knowledge, skill, and psychomotor, and the burden of assignment in Puskesmas was difficult to accomplish a primary task in the community.

The current status of "spirituality and health" teaching in Brazilian medical schools: a nationwide survey.

BACKGROUND: Recent data on the teaching of "spirituality and health" (S/H) in medical schools are needed. In this study, we aimed to investigate the current status of S/H teaching in Brazilian medical schools, the opinions of medical directors/deans on this topic and the factors associated with its incorporation into the curriculum. METHODS: A nationwide cross-sectional survey was carried out in 2021. Information concerning the S/H content in the curricula of medical schools was obtained through medical school representatives and other sources. Medical school representatives were asked about their opinions of and barriers to S/H teaching. Regression models were used to evaluate the factors associated with the incorporation of such content into the curriculum. RESULTS: Information on the incorporation of S/H content in medical curricula was retrieved from different sources for all 342 (100%) Brazilian medical schools. Among the representatives, 150 (43.9%) completed the online form. An increase in the S/H content in Brazilian medical schools was observed (from 40% to 2011 to 65.5% in 2021). Most medical school representatives agreed that this issue is important in medical training and that more space in the curriculum is needed. However, they also observed several barriers, such as a lack of knowledge of medical teachers/faculty, a lack of time, and the topic not being included in teaching plans. The most important factors that influenced the incorporation of S/H teaching in medical schools and representatives' opinions were a lack of time and knowledge, professor preparedness and standardized national competency requirements. CONCLUSION: These results could help medical educators rethink the incorporation of S/H content into their curricula.

The ties that bind: Social network analysis describes the social element of medical workforce recruitment to rural/remote Australia.

We present the argument that medical recruitment to a previously under-recruited remote town was effected through what Social Network Analysis (SNA) measures as "brokerage" which operates amidst "structural holes". We proposed that medical graduates being generated by the national Rural Health School movement in Australia were particularly affected by the combined effect of workforce lacks (structural holes) and strong social commitments (brokerage) - all key SNA concepts. We therefore chose SNA to assess whether the characteristics of RCS-related rural recruitment had feature that SNA might be able to identify, as operantly measured using the industry-standard UCINET's suite of statistical and graphical tools. The result was clear. Graphical output from the UCINET editor showed one individual as being central to all recently recruited doctors to one rural town with recruitment issues like all the others. The statistical outputs from UCINET characterised this person as the single point of most connections. The real-world engagements of this central doctor were in accord with the description of brokerage, a core SNA construct, relationship with reported the reason for these new graduates both coming and staying in town. SNA thus proved fruitful in this first quantification of the role of social networks in drawing new medical recruits to particular rural towns. It allowed description at the level of individual actors with a potent influence on recruitment to rural Australia. We propose these measures could be helpful as key performance indicators for the national Rural Clinical School programme that is generating and distributing a large workforce in Australia, which appears from this work to have a strong social basis. This redistribution of medical workforce from urban to rural is needed internationally.

COVID-19, Racial Injustice, and Medical Student Engagement With Global Health: A Single-Institution Survey.

INTRODUCTION: United States medical schools continue to respond to student interest in global health (GH) and the evolution of the field through strengthening related curricula. The COVID-19 pandemic and superimposed racial justice movements exposed chasms in the US healthcare system. We sought to explore the possible relationship between the pandemic, US racial justice movements, and medical student interest in GH to inform future academic offerings that best meet student needs. METHODS: A novel, mixed-methods 30-question Qualtrics survey was disseminated twice (May-August 2021) through email and social media to all current students. Data underwent descriptive and thematic analysis. RESULTS: Twenty students who self-identified as interested in GH responded to the survey. Most (N = 13, 65%) were in preclinical training, and half were women (N = 10, 50%). Five (25%) selected GH definitions with paternalistic undertones, 11 (55%) defined GH as noncontingent on geography, and 12 (60%) said the pandemic and US racial justice movement altered their definitions to include themes of equity and racial justice. Eighteen (90%) became interested in GH before medical school through primarily volunteering (N = 8, 40%). Twelve (60%) students plan to incorporate GH into their careers. CONCLUSIONS: Our survey showed most respondents entered medical school with GH interest. Nearly all endorsed a changed perspective since enrollment, with a paradigm shift toward equity and racial justice. Shifts were potentially accelerated by the global pandemic, which uncovered disparities at home and abroad. These results highlight the importance of faculty and curricula that address global needs and how this might critically impact medical students.

[The first Department of physical methods of treatment in Russia is 135 years old]. / Pervoi kafedre fizicheskikh metodov lecheniya v Rossii ­ 135 let.

The article presents the main stages of formation and development of the Department of Physical and Rehabilitation Medicine of the I.I. Mechnikov NWSMU of the Ministry of Health of Russia, describes in detail the contribution department staff in a specific historical period, the formation and development of scientific medical schools, among the research areas of which were physical methods of treatment. The important role of the staff of the department during the Great Patriotic War and their significant contribution not only to the treatment of the wounded and sick in besieged Leningrad, but also in the training of highly qualified medical personnel for military hospitals and hospitals are shown. The post-war period of the department's development is described in detail, as well as the important role of its staff in the study of patterns and trends in the development of restorative medicine and medical rehabilitation, the formation of a new organization of specialized medical care, in which, based on the most significant achievements of fundamental sciences, the interrelation of therapeutic and rehabilitation processes was reflected, which served as the basis for their unification into a new section of medical science - physical and rehabilitation medicine.

Multiple mini-interviews is a predictor of students' academic achievements in early undergraduate medical years: a retrospective study.

BACKGROUND: Our study determined Multiple Mini-Interview (MMI) effectiveness in evaluating specific skill sets based on medical students' performances during the undergraduate years and compared the academic performances of medical students who appeared for onsite/online MMI. METHODS: A retrospective study of 140 undergraduate medical students between 2016 and 2020 included data on age, gender, pre-university results, MMI scores, and examination results. Appropriate non-parametric tests were applied to compare the students' MMI and academic performances. RESULTS: Ninety-eight students from cohorts 12 to 15 had an overall MMI score of 69.0(IQR: 65.0-73.2)/100 and an overall Cumulative Grade Point Average(GPA) of 3.64 (3.42-3.78)/5.0. Spearman's correlation revealed a significantly positive relationship between MMI and cGPA (rho = 0.23) and GPA from the first 2 semesters (GPA1 rho = 0.25, GPA2 rho = 0.27). This observation was similar to that for station A in the first year (cGPA rho = 0.28, GPA1 rho = 0.34, GPA2 rho = 0.24), and in station B (GPA4 rho = 0.25) and D (GPA3 rho = 0.28, GPA4 rho = 0.24) in the second year. Of twenty-nine cohort16 students, 17(58.6%) underwent online and 12(41.4%) offline modes of MMI assessment, respectively. The overall median MMI score was 66.6(IQR: 58.6-71.6)/100, and the overall median cGPA was 3.45 (3.23-3.58)/5.0. When comparing the median marks of cohort16 groups, the online group scored significantly higher marks for station D than the offline group (p = 0.040). CONCLUSION: Correspondence between MMI scores and cGPA predicted MMI scoring during student selection and entry process might ensure the success of their academic performance in medical school.

The added value of free preparatory activities for widening access to medical education: a multi-cohort study.

BACKGROUND: Medical schools are reported to be less accessible to students with non-traditional backgrounds. These students face barriers when applying for and transitioning to medical school, which may be reduced by offering free preparatory activities. By equalizing access to resources, these activities are expected to reduce disparities in selection outcomes and early academic performance. In the present study, four free institutionally-provided preparatory activities were evaluated by comparing the demographic composition of participating and non-participating applicants. Additionally, the association between participation and selection outcomes and early academic performance was investigated for subgroups (based on sex, migration background and parental education). METHODS: Participants were applicants to a Dutch medical school in 2016-2019 (N = 3592). Free preparatory activities included Summer School (N = 595), Coaching Day (N = 1794), Pre-Academic Program (N = 217), and Junior Med School (N = 81), supplemented with data on participation in commercial coaching (N = 65). Demographic compositions of participants and non-participants were compared using chi-squared tests. Regression analyses were performed to compare selection outcomes (curriculum vitae [CV], selection test score, probability of enrolment) and early academic performance (first-course grade) between participants and non-participants of demographic subgroups, controlling for pre-university grades and participation in other activities. RESULTS: Generally, no differences in sociodemographic compositions of participants and non-participants were found, but males participated less often in Summer School and Coaching Day. Applicants with a non-Western background participated less often in commercial coaching, but the overall participation rate was low and participation had negligible effects on selection outcomes. Participation in Summer School and Coaching Day were stronger related with selection outcomes. In some cases, this association was even stronger for males and candidates with a migration background. After controlling for pre-university grades, none of the preparatory activities were positively associated with early academic performance. CONCLUSIONS: Free institutionally-provided preparatory activities may contribute to student diversity in medical education, because usage was similar across sociodemographic subgroups, and participation was positively associated with selection outcomes of underrepresented and non-traditional students. However, since participation was not associated with early academic performance, adjustments to activities and/or curricula are needed to ensure inclusion and retention after selection.