Council on Medical Student Education in Pediatrics


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COMSEP Meeting in Ottawa, ON

Platform Presentation:

Clinical Track in Pediatrics: Milestone Based Curriculum and Assessment for the 4th Year in Medical School

Nancy Liao,Ohio State University,Columbus,OH,Ansley Splinter,Ohio State University,Columbus,OH,Meena . Khan,MD,Columbus,OH,Jennifer McCallister,Ohio State University,Columbus,OH,John Mahan,,Columbus,OH


Most medical schools offer pediatric clerkships ranging from 4-8 weeks in duration. This is insufficient time to adequately prepare students for pediatric internship. The 4th year is underutilized and can be optimized to strike a balance between avoiding “pre-residency syndrome” and building a foundation for successful transition into residency(1-8).

  • To describe a pediatric milestone-based curriculum for the 4th year of medical school.
  • To graduate medical students with milestone competency similar to that of an intermediate intern.


14 Ohio State University students enrolled in the clinical track in academic year 2015-2016. Student competency exceeded level 2 (level 4 is ACGME’s graduation requirement) in all milestones evaluated. When compared to that of Nationwide Children's interns, 4th year students had lower scores, especially among the patient care related milestones. The two groups had similar achievement in problem-based learning and improvement and systems based practice milestones.


This is a generalizable program especially for schools interested in individualized instruction and can be translated to other specialties. Program initiation requires strong support from college of medicine administration and faculty and the designation of a track director. Other important elements are administrative support and simulation center involvement.

We are exploring ways to increase pediatric clinical exposure to improve competency within the patient care related milestones. We are also tracking the students into residency to assess their internship readiness and plan to evaluate differential achievement between track graduates and peer interns who did not complete the track.  Lastly, we are forming a clinical competency committee to further evaluate the validity of milestone assignments. (This data as well as 2016-2017 MS4 milestone competency may be available for 2017 COMSEP conference).