Does high achievement in preclinical years predicts similar achievement in clinical year in medical students? A correlational study

Introduction: There is speculation that early medical school basic science instruction is ultimate of limited utility when students enter clinical rotations. It is worthwhile to establish whether early performance in pre-clinical years correlates with performance in later clinical years so that curricula can be adapted accordingly, and actionable predictors of student performance can be identified.Objective: The objective of the study is to investigate the predictive role of student academic performance in early (i.e. “pre-clinical”) medical school years for performance in later (i.e. “clinical”) medical school years.Methods: We employed a retrospective correlation approach by compiling data from medical students in a major academic center in Lahore, Pakistan. The sample cohort consisted of 413 students taken from three consecutive graduating classes (2018, 2019, 2020). Two separate (but thematically related) statistical analyses were undertaken: 1)we created a multivariate linear regression model to predict performance in later (clinical) years (year 5) based on a student’s known demographic factors and academic performance in early (pre-clinical) exams (years 1 and 2) we performed multivariate logistic regression to model the likelihood of attaining “super high achiever” status at the time of graduation (outcome variable) and used demographic data as well as “high achiever” status in early exams (i.e. first three ‘prof ’ exams) as covariates.Results: The most important predictor of performance in the final summative examination was the performance in early ‘prof ’ exams (Year 2 Prof Score F ratio 91.3, p<0.0001). Early attainment of high-achiever status in medical school correlated with the attainment of ‘super high achiever’ status at the time of graduation (p<0.0001).Conclusion: Performance in early medical school years (i.e., “pre-clinical”) correlated with performance in the later medical school years (i.e. “clinical”). KEYWORDS:Early performance, pre-clinical, high-achiever