• Ting Dong, Annesley Copeland, Matthew Gangidine, Deanna Schreiber-Gregory, E Matthew Ritter, and Steven J Durning.
• Department of Medicine, USUHS, Bethesda, Maryland. Electronic address: ting.dong.ctr@usuhs.edu.
• J Surg Educ. 2018 Sep 1; 75 (5): 1200-1205.

PurposeWe conducted an in-depth empirical investigation to achieve a better understanding of the surgery clerkship from multiple perspectives, including the influence of clerkship sequence on performance, the relationship between self-logged work hours and performance, as well as the association between surgery clerkship performance with subsequent USMLE Step exams' scores.MethodThe study cohort consisted of medical students graduating between 2015 and 2018 (n = 687). The primary measures of interest were clerkship sequence (internal medicine clerkship before or after surgery clerkship), self-logged work hours during surgery clerkship, surgery NBME subject exam score, surgery clerkship overall grade, and Step 1, Step 2 CK, and Step 3 exam scores. We reported the descriptive statistics and conducted correlation analysis, stepwise linear regression analysis, and variable selection analysis of logistic regression to answer the research questions.ResultsStudents who completed internal medicine clerkship prior to surgery clerkship had better performance on surgery subject exam. The subject exam score explained an additional 28% of the variance of the Step 2 CK score, and the clerkship overall score accounted for an additional 24% of the variance after the MCAT scores and undergraduate GPA were controlled.ConclusionOur finding suggests that the clerkship sequence does matter when it comes to performance on the surgery NBME subject exam. Performance on the surgery subject exam is predictive of subsequent performance on future USMLE Step exams.Copyright © 2018 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

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