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Training Level

Resident PGY 1


Henry Ford Hospital


Purpose: The National Board of Medical Examiners (NBME) Surgery Shelf Exam is often criticized as not accurately reflecting surgical knowledge. As a result, medical schools implement an oral exam to better assess students’ surgical knowledge. There is no data on the correlation between performance on the shelf and oral exams. We sought to assess the utility of the oral exam as a correlate and predictor of shelf exam performance.Methods:We reviewed medical student surgery clerkship performance reports between 2012 through 2018. Students’ clinical evaluation, clinical site, clerkship dates, and exam scores were noted. Bivariate and multivariate analysis was performed to assess for the relationship between the two exams.Results:We reviewed 1,160 performance reports over four clinical sites. The average oral exam score was 20.0 [4.8]. Students with a higher clinical evaluation had a significantly higher oral exam score (21.1 [4.5] vs 19.5 [4.8], p<0.001). There was a significant difference in oral exam scores among the four different clinical sites (p<0.01). There was no difference in oral exam scores among the different clerkship dates (p = 0.23). Oral exam scores and shelf exam scores were positively correlated (r = 0.32, p < 0.001). In multivariate analysis, oral exam performance was an independent predictor for shelf exam performance (b = 0.48, 95% CI: 0.39 – 0.57, p<0.001).Conclusion:Oral exam performance correlates with and predicts shelf exam performance. Low performance on an oral exam may allow educators to intervene prior to students taking the shelf exam.

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Utility of an Oral Exam During the Third Year Surgery Clerkship