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Special Article
May 2010

Attitudes and Performance of Third- vs Fourth-Year Neurology Clerkship Students

Author Affiliations

Author Affiliations: Department of Neurology, University of Texas Southwestern Medical School, Dallas.

Arch Neurol. 2010;67(5):548-551. doi:10.1001/archneurol.2010.64

Objective  To compare student performance, attitudes, and career plans based on whether the neurology clerkship was taken in the third or fourth year.

Design  During the 1-year transition when the neurology clerkship was officially moved from the fourth to the third year at our institution, students took the identical clinical clerkship and were mixed together at each clinical site where faculty were blinded to student's year.

Setting  University of Texas Southwestern Medical School.

Participants  Third- and fourth-year medical students.

Main Outcome Measures  Performance, enthusiasm, and match results were analyzed by year of medical school for differences.

Results  There was a statistical trend toward better performance of third-year students as measured by the clinical evaluation grade (88.4 vs 87.4; P = .051) but this represented only a 1% difference. No difference was noted on the National Board of Medical Examiners neurology shelf examination score (73.8 vs 74.9; P = .20). Students' enthusiasm for neurologic learning was significantly higher in third- as compared with fourth-year students (P = .004). The probability that students would choose a career in neurology was higher for third- than fourth-year students (P < .001), but there was no correlation between year and matching for a neurology residency (P = .17).

Conclusions  Our findings support the belief among academic neurologists that students who take the neurology clerkship in the third year have greater enthusiasm for the field and look more favorably on neurology as a possible career than those taking the neurology clerkship in their fourth year. Nevertheless, our findings do not support the notion that third-year placement results in superior achievement.

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