Document Detail


Prematriculation variables associated with suboptimal outcomes for the 1994-1999 cohort of US medical school matriculants.
MedLine Citation:
PMID:  20841535     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: The relationship between increasing numbers and diversity of medical school enrollees and the US physician workforce size and composition has not been described.
OBJECTIVE: To identify demographic and prematriculation factors associated with medical school matriculants' outcomes.
DESIGN, SETTING, AND PARTICIPANTS: Retrospective study using deidentified data for the 1994-1999 national cohort of 97,445 matriculants who were followed up through March 2, 2009, and had graduated, had withdrawn, or were dismissed. Data were analyzed using multivariable logistic regression to identify factors associated with suboptimal outcomes.
MAIN OUTCOME MEASURES: Academic withdrawal or dismissal, nonacademic withdrawal or dismissal, and graduation without first-attempt passing scores on the US Medical Licensing Examination Step 1 and/or Step 2 Clinical Knowledge (CK) compared with graduation with first-attempt passing scores on both of the examinations.
RESULTS: Of 84,018 matriculants (86.2%), 74,494 graduated and had first-attempt passing scores on both the Step 1 and Step 2 CK (88.7%), 6743 graduated and did not have first-attempt passing scores on the Step 1 and/or Step 2 CK (8.0%), 1049 withdrew or were dismissed for academic reasons (1.2%), and 1732 withdrew or were dismissed for nonacademic reasons (2.1%). Variables associated with greater likelihood of graduation without first-attempt passing scores on the Step 1 and/or Step 2 CK and of academic withdrawal or dismissal, respectively, were (1) Medical College Admission Test scores (scores of 18-20 [2.9% of sample] vs > 29: adjusted odds ratio [AOR], 13.06 [95% confidence interval {CI}, 11.56-14.76] and AOR, 11.08 [95% CI, 8.50-14.45]; scores of 21-23 [5.6% of sample] vs > 29: AOR, 7.52 [95% CI, 6.79-8.33] and AOR, 5.97 [95% CI, 4.68-7.62]; and scores of 24-26 [13.9% of sample] vs > 29: AOR, 4.27 [95% CI, 3.92-4.65] and AOR, 3.56 [95% CI, 2.88-4.40]), (2) race/ethnicity (Asian or Pacific Islander [18.2% of sample] vs white: AOR, 2.15 [95% CI, 2.00-2.32] and AOR, 1.69 [95% CI, 1.37-2.09]; underrepresented minority [14.9% of sample] vs white: AOR, 2.30 [95% CI, 2.13-2.48] and AOR, 2.96 [95% CI, 2.48-3.54]), and (3) premedical debt (> or = $50,000 [1.0% of sample] vs no debt: AOR, 1.68 [95% CI, 1.35-2.08] and AOR, 2.33 [95% CI, 1.57-3.46]).
CONCLUSIONS: Lower scores on the Medical College Admission Test, nonwhite race/ethnicity, and premedical debt of at least $50,000 were independently associated with a greater likelihood of academic withdrawal or dismissal and graduation without first-attempt passing scores on the US Medical Licensing Examination Step l and/or Step 2 CK.
Authors:
Dorothy A Andriole; Donna B Jeffe
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  JAMA : the journal of the American Medical Association     Volume:  304     ISSN:  1538-3598     ISO Abbreviation:  JAMA     Publication Date:  2010 Sep 
Date Detail:
Created Date:  2010-09-15     Completed Date:  2010-09-16     Revised Date:  2011-11-18    
Medline Journal Info:
Nlm Unique ID:  7501160     Medline TA:  JAMA     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1212-9     Citation Subset:  AIM; IM    
Affiliation:
Washington University School of Medicine, 660 S Euclid Ave, Campus Box 8210, St Louis, MO 63110, USA. andrioled@wustl.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Cohort Studies
Continental Population Groups
Educational Measurement / statistics & numerical data*
Educational Status
Ethnic Groups
Female
Financing, Personal
Humans
Licensure, Medical / statistics & numerical data
Male
Physicians / supply & distribution*
Retrospective Studies
Schools, Medical / statistics & numerical data*
Students, Medical / statistics & numerical data*
United States
Young Adult
Grant Support
ID/Acronym/Agency:
R01 GM085350-01/GM/NIGMS NIH HHS; R01 GM085350-01/GM/NIGMS NIH HHS; UL1 RR024992-03/RR/NCRR NIH HHS
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