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What students want in their final year
Students' Perspectives on the Fourth Year of Medical School: A Mixed-Methods Analysis.
Wolf SJ et al. Academic Medicine 2014:89:602-07.


What is the study question?
According to medical students, what is the purpose of the fourth year of medical school?

How was the study done?
The study was divided into two parts. First, two focus groups, consisting of a total of 17 students, were conducted to develop themes. The focus groups used predetermined, open ended questions and analyzed using qualitative methodology. After identifying the themes, a 10 item questionnaire was administered to all fourth year students graduating from the Colorado University School of Medicine, in a curricular session one month prior to graduation. The questionnaires were analyzed using an exploratory factor analysis to determine whether student's responses formed thematic groupings. Reliability of the factors were assessed using Cronbach's alpha.

What are the results?
The focus group discussions resulted in the identification of six themes: career development and preparation, pursing personal interests, career identification, exploratory of diverse practice settings, flexibility and individualization and influence of emotion. Five factors were then identified using the questionnaires: strengthening one's residency application, developing skills, pursuing personal interests, exploring diverse practice setting and identifying a career.

What are the implications of these findings?
The fourth year of medical school is basically unstructured compared to the first three years. No previous papers have offered the perspective of the students regarding the value of the fourth year. This study demonstrates that students value their fourth year as a time to solidify skills they will require, to explore career options, to have time for personal growth, and to prepare for their residency applications. The fourth year should be structured using personalized learning plans to best accomplish these goals for individual students.

Editor's note: There is much debate about the purpose of the final year of medical school - hearing the students' perspective adds a great deal to the conversation (SLB). Who we want to work with

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