Students' premedical preparations and academic performances in medical school and residency

Is social sciences and humanities (SSH) premedical education marginalized in the medical school admission process? A review and contextualization of the literature

PURPOSE

To investigate the performance outcomes of medical students with social sciences and humanities (SSH) premedical education during and beyond medical school by reviewing the literature, and to contextualize this review within today's admission milieu.

METHOD

From May to July 2012, the lead author searched the PubMed, MEDLINE, and PsycINFO databases, and reference lists of relevant articles, for research that compared premedical SSH education with premedical sciences education and its influence on performance during and/or after medical school. The authors extracted representative themes and relevant empirical findings. They contextualized their findings within today's admission milieu.

RESULTS

A total of 1,548 citations were identified with 20 papers included in the review. SSH premedical education is predominately an American experience. For medical students with SSH background, equivalent academic, clinical, and research performance compared with medical students with a premedical science background is reported, yet different patterns of competencies exist. Post-medical-school equivalent or improved clinical performance is associated with an SSH background. Medical students with SSH backgrounds were more likely to select primary care or psychiatry careers. SSH major/course concentration, not SSH course counts, is important for admission decision making. The impact of today's admission milieu decreases the value of an SSH premedical education.

CONCLUSIONS

Medical students with SSH premedical education perform on par with peers yet may possess different patterns of competencies, research, and career interests. However, SSH premedical education likely will not attain a significant role in medical school admission processes.

Premed survival: understanding the culling process in premedical undergraduate education

PURPOSE

Why undergraduate students pursue or drop a premedical curriculum has received only scant attention. In this study the authors attempted to uncover reasons why students either persevere in their premedical studies or seek alternative careers.

METHOD

Using convenience sampling, the authors surveyed 97 undergraduates at a small liberal arts college from November 2000 to March 2001. Of those surveyed, 44 were former premed students who completed a three-page questionnaire about why they had decided not to become physicians; 53 premed students completed a two-page questionnaire about their career aspirations.

RESULTS

The response rate was 100%. Premed students were attracted to the field by the intellectual stimulation and the power to help others, yet most were also very concerned about being in debt, dealing with patients who might die, and the compatibility of medicine with having a family. Women students were more concerned than the men about having only limited time to become acquainted with patients on a social level (71% of women versus 45% of men: p =.05). The decision of students to forgo a career as a physician was shaped by apprehensions regarding the years of work required in residency, the need to be on call, unacceptably low grades, and the realization that other attractive career options are available. Of those who said low grades were a deciding factor, most (78%) named organic chemistry as the single course that had affected their plans. Students who acknowledged the role of their poor performance in organic chemistry were more likely to be dissatisfied with their change in plans than were those who did not identify this course as influential (44% versus 29%).

CONCLUSIONS

Although the sampling technique and sample size severely limit the authors' ability to generalize their findings, the data offer a starting point for those interested in the reasons for the drop in medical school applicants. The authors state the fact that most former premed students admitted organic chemistry had played a significant role in the change in their career plans deserves attention, and it may be time to consider whether a single course should contribute to eliminating persons who might otherwise excel as physicians.