Prediction of 3rd & 4th year performance?

It would be fun to actually play with the numbers to actually see what things correlate and what don't (so maybe I have a sick idea of fun), but I'd say Verbal and organic grades by themselves would make for lousy predictors.

Let's assume that med students get between 8 and 13 on verbal. And assuming that current students took 2 semesters of organic, most got A's and B's (no +/-) and a few C's. I come up with only 24 combinations of the inputs, with a large portion of the group having a 10, 1 A & 1B. Maybe verbal combined with BS, but I just don't see how there's enough data behind just two organic grades to mathematically show much.

That's like saying basketball skill is correlated with height, and then only measuring the skill of players between 6' and 7'. Too narrow a focus, I'd think, for any strong correlations to come out of.

Again, for entertainment only. The above has no scientific value

My hypothesis is that people who played highschool football will do better in the clinical (3rd and 4th year) part of medical school. Many employers I have talked to claim that the commonality they observe between most of their really good employees is that most of them played highschool football. The clinical part of med school will be more like a job and less like a class. Therefore I think that med students who played football in highschool will be better at their rotations. Of course this doesn't provide a great deal of predictive power for female students because most don't have the option of playing football. Myself, I didn't play football highschool or otherwise, and I don't know how much of a disadvantage this will be in my clinical years. Guess I will have to work really hard to compensate.

With some hard work you will definitely be able to make up for not having played high school football. But the key here is really focusing and giving it your all. It won't happen unless you really dedicate yourself to it heart and soul.

I recommend that you use sled drills as a core exercise in your routine. It will help you to focus on your power drive phase, and to increase both explosiveness and speed. Good luck, and let me know how it works out.

I really have to put on some weight before the clinical years. If I can put on about 40 pounds of pure muscle I think that combative attendings/patients will think twice about giving me a hard time. Initially I am going to focus on hitting the weights I will move on to the sled drills in my summer after MS1 and during my MS2 year. However, focusing on bulk is only half the job, due to poor ancillary service I also need to keep my speed up. Any recommendations?

Originally posted by optimistique
I've heard 'talk' that MCAT verbal scores or O chem grades can predict how well you will do in med school. Wouldnt this just predict 1st & 2nd year performance in basic sciences?

Residency depends on clinical grades. What would you say is a good indication of clinical grades?* Leadership exp? Volunteering? Learning to be EMT or Nurse aide? Personality?

*Discliamer: As premeds, comments are mostly speculation. This thread is for entertainment purposes only.

Click to expand...

Mainly LOR's are the best indicator of clincial performance. BUt there ahave been rticles written about this, check"Academic Medicine" Fields et al. 2000


Early Identification of Students at Risk for Poor Academic Performance in Clinical Clerkships
SCOTT A. FIELDS, CYNTHIA MORRIS, WILLIAM L. TOFFLER and EDWARD J. KEENAN


Correspondence: Dr. Scott A. Fields, Department of Family Medicine, Oregon Health Sciences University, 3181 SW Sam Jackson Park Road, Portland, OR, 97201; e-mail: <[email protected]>.

Introduction
_
Many medical schools have revised, or are in the process of revising, their curricula.1 The impetus for this curricular change has been dependent on many factors. These factors include grant initiatives emphasizing the development of curricula to promote generalism and the Association of American Medical Colleges' Medical School Objectives Project (MSOP), as well as significant shifts in the health care system, such as the growing influence of managed care. The more innovative curricular revisions to date have included multidisciplinary, integrated courses with longitudinal curricula and early clinical experiences throughout the first two years (the preclinical curriculum).

Oregon Health Sciences University (OHSU) School of Medicine implemented its curriculum revision in 1992.2 The result of this effort was the restructuring of the first two years of the curriculum from 24 specific discipline-based courses to ten interdisciplinary units. One of the units, the Principles of Clinical Medicine (PCM), is a longitudinal two-year course composed of small-group activities half a day each week and a weekly half-day clinical preceptorship. In addition, there are nine integrated basic science courses in the first two years, and a one-week course, Transition to Clerkship, occurs at the end of the second year. The core clerkships, constituting the entire third year, include medicine, surgery, obstetrics-gynecology, family medicine, psychiatry, pediatrics, and rural primary care. Each of these clerkships is six weeks in duration with the exception of medicine, which occurs in two six-week blocks.

The premise for this study was that early identification of medical students who are at academic risk provides a basis for intervention with individualized remedial programs. Previously, studies have investigated predictors of performance for years one and two of medical school.3,4 Little has been done to address early identification of students at risk for academic difficulty in the third year of medical school. The hypothesis was that performance in PCM during the predominantly pre-clinical curriculum of the first two years predicts students at risk for academic difficulty in the clinical clerkships. Accordingly, this study analyzed the relationship between parameters of student assessment, including a number of admission, curriculum, and standardized testing criteria, and an accepted standard of graded performance in the third-year core clerkships.

__ METHOD TOP
Introduction
Method
Results
Discussion
References
_
The sample studied was a cohort of students beginning with those who matriculated at OHSU from 1992 to 1995 and who graduated between 1996 and 1999. Student data were available from OHSU databases; no major change in curriculum, grading policy, or calculation of student grade-point averages occurred during these years. In the study, all individual student performance data were treated as confidential.

The primary outcome of this analysis was performance in the core clinical clerkships of the third year curriculum, which serves as a critical component of the residency application process. All courses at OHSU, including clerkships, are graded as honors, near honors, satisfactory, marginal, or fail. Grade-point average (GPA) in year three was used as the outcome, with a GPA of 3.0 representing honors; 2.0 near honors; 1.0 satisfactory, and 0 marginal/failure. After initial analysis as a continuous variable, we identified the lowest quintile of performance in year three (GPA < 2.0).

A number of potential indicators were considered to predict performance in year three. These indicators included cumulative college GPA, separate MCAT scores (Verbal Reasoning, Biological Science, Physical Science, and Writing Sample), year one and year two basic science course performance as a mean percentage examination score, performance in the PCM course, and USMLE Step 1 score. The total MCAT score combined the Verbal Reasoning, Biological Science, and Physical Science scores. For the Writing Sample, the alphabetic score was coded from 4 to 15, with M = 8. Total points for the PCM course were used. In PCM, there are 80 points available for each of six quarters: 20 points for the clinical preceptorship, 10 points for small-group discussion activities, 10 points for patient examination activities, 10 points for an essay, 10 points for written exam, and 20 points for a group objective structured clinical examination (GOSCE).3

The first series of analyses were univariate, with all continuous predictor variables correlated with the primary outcome, year three GPA. Subsequently, a parsimonious logistic regression model was fit to predict this outcome using forward selection procedures. The odds of low performance (year three GPA < 2.0) were estimated. Cutoff points for categorizing each continuous predictor variable were based on the lowest quintile of each score or percentage, with latitude for ties. The significance of each predictor variable was assessed using a likelihood-ratio test statistic obtained from a logistic regression model fit to the outcome status.

__ RESULTS TOP
Introduction
Method
Results
Discussion
References
_
In total, data for 306 students were available. All data were complete except for one student who had attended a college without grades, seven students who had taken the earlier version of the MCAT, and two students whose USMLE scores were unavailable.

Correlation coefficients were obtained for each performance indicator as compared with the year-three GPA. Of all variables, this outcome was most significantly related to the score in the PCM course (r =.61, p <.001); year two percentage performance (r =.54, p <.001); year one percentage performance (r =.52, p <.001); and USMLE 1 score (r =.47, p <.001). Year-three GPA was only modestly related to undergraduate GPA (r =.19, p <.05) and MCAT Writing Sample score (r =.16, p <.05), and was not related significantly to the total MCAT score, or to the Biological Science, Physical Science, and Verbal Science Subscores. Figure 1 shows the relationship between the year-three GPA and the PCM score.


View larger version (31K):
[in this window]
[in a new window]
_ Figure 1. Scatterplot of the relationship between Principles of Clinical Medicine (PCAA) scores and year three grade-point averages at Oregon Health Sciences University School of Medicine, 1992-1999.

_

Prior to logistic regression analysis, the relationship of each variable to performance in the lowest quintile of year-three GPA was analyzed in order to determine the accuracy of prediction. Each was dichotomized by the lowest quintile and compared in a 2 x 2 table with low year-three GPA. A score in the lowest quintile of PCM ( 380) correctly predicted low year three performances of 38 of 68 students (positive predictive value = 56%). Of 238 students who had score above the lowest quintile, 212 (negative predictive value = 89%) had year-three GPAs above the lowest quintile. These values were similar considering performance in the lowest quintile in year two (positive predictive value = 53%, predicting 36 of 68; negative predictive value = 89%, 211 of 238). A USMLE Step 1 score in the lowest quintile ( 190) correctly predicted 28 of 68 students who scored in the lowest quintile of year-three GPA (positive predictive value = 41%), whereas a score above the lowest quintile predicted 206 of 238 (negative predictive value = 87%). No other variable performed similarly in univariate analysis.

A multivariate logistic regression model significantly predicted low year-three GPA (p <.001). (See Table 1.) Overall, performance in the lowest quintile in PCM was associated with a 9.45 times increased risk of performance in the lowest quintile of year-three GPA (95% CI, 4.71-18.98). Similarly, performance in the lowest quintile of year two conferred a 6.39 times risk of low year-three GPA (95% CI, 2.96-13.80). This model also included performance in the lowest quintile of the USMLE Step 1, although this was not significant (relative risk 1.83; 95% CI, 0.84-3.99). Last, performance by quintile of PCM score, after adjustment for USMLE Step 1 score and year-two percentage score, was linearly rela

i posted it tongue-in-cheek, but the journal is for reals. Lemme know if you want any other premed/med school related research...ie a correlation of kissing-up-icity vs. popularity with attending physicians.

Attractiveness to the opposite sex is the key factor in determining the success in these years. If you are however, unattractive - the length of your toes added together and multiplied by your shoe size yields a number that correlates highly with success. The hugher your number, the more your physical unattractivenesss is offset.

woo-hoo. i played powder puff!

Enthusiasm will get you far on the wards. Seriously.

Knowledge helps, but aside from shelf exams, your clinical evaluation will reflect how interested you are, how well you click with the team, and how willing you are to pitch in and help out. If you can get your work done, help your teammates, and come out smiling, you'll be a star. Really.

doepug (MS III)

Originally posted by wack
My hypothesis is that people who played highschool football will do better in the clinical (3rd and 4th year) part of medical school. Many employers I have talked to claim that the commonality they observe between most of their really good employees is that most of them played highschool football. The clinical part of med school will be more like a job and less like a class. Therefore I think that med students who played football in highschool will be better at their rotations. Of course this doesn't provide a great deal of predictive power for female students because most don't have the option of playing football. Myself, I didn't play football highschool or otherwise, and I don't know how much of a disadvantage this will be in my clinical years. Guess I will have to work really hard to compensate.

Click to expand...

Nice theory about how playing football predicts your success during the clinical rotations. I wish we could tell this to all the football couches out there about how thier dump players can succeed in academic life.

I think the football theory is as good as any. In my experience I have determined that clinical grades are assigned randomly. You can act exactly the same in different situations even within the same rotation and some people will love you and some people will hate you. Nothing you can really do about it. And then the people who seemed to like you will give you a bad evaluation and someone who you thought didn't even know you existed will give you a great one.

Originally posted by doepug

Knowledge helps, but aside from shelf exams, your clinical evaluation will reflect how interested you are, how well you click with the team, and how willing you are to pitch in and help out. If you can get your work done, help your teammates, and come out smiling, you'll be a star. Really.

Click to expand...

Someone told me that it's a good idea to ask for a mid-term evaluation from your supervising resident too. I understand that it will help you locate areas for improvement, and help you get an idea of how you are performing before the rotation is finished. I've heard it also helps show your enthusiasm to do better, and take initiative. And I've heard that it will get better 4th year, you are almost through the tough ones, so no worries. Anyway, good luck with rotations, and choosing your field of interest.

It's nice to see that someone who hasn't even started medical school (carrigallen) feels entitled to provide feedback to a 3rd year who's nearly a 4th-year.

What doepug said is accurate. Don't try predicting your grades. Put in 110%. Everyday. End of story.

Originally posted by md_student10021
It's nice to see that someone who hasn't even started medical school (carrigallen) feels entitled to provide feedback to a 3rd year who's nearly a 4th-year.

Click to expand...

I simply don't know where that is coming from. I posted helpful, encouraging information. please refrain from comments which may be interpreted as intimidating or derisive.