• Liselotte N Dyrbye, Matthew R Thomas, Neena Natt, and Charles H Rohren.
• Department of Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55906, USA. dyrbye.liselotte@mayo.edu
• J Gen Intern Med. 2007 Aug 1; 22 (8): 110111061101-6.

BackgroundComplementary degree programs and research training are important alternative tracks in medical school that typically interrupt the traditional MD curriculum.ObjectiveExamine effects of such a break on clinical knowledge after reentry into the MD curriculum.DesignRetrospective cohort study.ParticipantsThree hundred and two graduates of Mayo Medical School.Main MeasurementsCompared years of delay between the second and third years of medical school with third year clerkship grades, National Board of Medical Examiner's (NBME) Subject Examinations, and United States Medical License Exam (USMLE) Step 2.Main Results258, 13, and 31 students spent 0, 1, or > or = 3 years pursuing research between the second and third year. Baseline measures of knowledge before matriculation and before the third year were similar between groups. Whereas a 1-year delay had no significant effect, a > or = 3-year delay was associated with fewer clerkship honors and lower NBME Medicine, Pediatrics, and Psychiatry percentiles compared to no delay (all p < .05). Students with a > or = 3-year delay had a 77% reduction in the odds of honors in Medicine. For each year of delay beyond 3, students' third-year NBME Medicine, Neurology, Obstetrics and Gynecology, and Psychiatry scores decreased as did USMLE Step 2 scores (r = -.38 to -.50, p < .05).ConclusionsDelays of > or = 3 years between the second and third years of medical school are associated with lower grades and scores on clinical knowledge tests. Further research is needed to determine the optimal timing of research training and develop effective interventions to facilitate reentry into the medical school curriculum.

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