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Important Skills for Internship and the Fourth-Year Medical School Courses to Acquire Them: A National Survey of Internal Medicine Residents. Pereira AG et al. Academic Medicine 2016; 91:821-826.

Reviewed by Elizabeth Christine Lee

What was the study question?
What do internal medicine residents consider to be the most important skills and fourth-year medical school courses for internship preparation?

How was the study done? All internal medicine residents who completed the 2013-2014 Internal Medicine In-Training Examination were asked to complete 2 post-exam survey questions related to internship preparation. One question required residents to rank the importance of learning 10 skills that typically do not receive formal coverage in clinical clerkships. Another question required residents to select up to 3 courses among a list of 11 fourth-year medical school courses that were most helpful for internship preparation.

What were the results?
Among the 24,820 residents who took the exam, 20,484 (83%) completed the survey and consented to have their answers used for research. The 3 skills that were most frequently rated as very important were: 1)identifying when to seek help and expertise, 2)prioritizing clinical tasks and managing time efficiently, and 3)communicating with other providers around care transition (admission, discharge, and ICU transfer). The following courses were selected as most helpful in preparing for internship: 1)subinternship/acting internship, 2)ward rotations, and 3)subspecialty elective in internal medicine.

What are the implications of these findings?
The survey data provide feedback from internal medicine residents on: 1)skills that may be underrepresented in the medical school curriculum but are important to learn prior to internship, and 2)fourth-year medical school courses that are most helpful for internship preparation. These insights from residents can complement input from medical educators to guide discussions of the optimal fourth-year curriculum that will best prepare medical students for supervised training during internship.

Editor’s note: I’m sure pediatric residents would rate sub-internships as key preparations for internship validating their continued cultivation as key learning and acculturation experiences. For me when I was a student and for many of the students I see, the acting internship proves transformative: we feel like real doctors for the first time. (RR)

Editor’s Note (2): This excellent review was solicited of the reviewer without my being aware that the article being reviewed had just been reviewed. I apologize to the COMSEP readership for my mistake and it really makes me appreciate what a fine job Susan Bannister as editor of the COMSEP Journal Club.

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