[Logistical regression of success factors in the former internship examination for medical students]

The French competitive internship examination for medical students was replaced in 2004 by a national-ranking exam. The profile of students successful at the internship exam, although more or less stereotypical, was never methodically analyzed.

To determine the factors that influenced success in the internship exam.

Records of 242 students from four successive entering classes (1989-1992) at the Saint-Etienne Faculty of Medicine underwent logistical regression analysis. Factors studied were: gender; occupation of the head of household; details about their General Certificate of Education test (age attest, core subject, overall grade); repeating any first-cycle medical studies (PCEM1); PCEM1 grade; number of certificates resat at the end-of-year make-up session or the following year during second-cycle medical studies (DCEM), known as "debts"; and the ranking obtained in the five faculty certificate tests deemed representative of the overall competitive test and on the clinical and therapeutic summary certificate (CSCT).

The 95 students (59%) who did not take the internship exam differed from those who did. The former typically: (1) were older when they began studying medicine (p = 0.003); (2) had passed the General Certificate of Education with the lowest or next lowest pass levels (p = 0.023); (3) re-did their PCEM1 studies (p = 0.001); (4) were ranked in the lower two-thirds of their PCEM1 class (p = 0.001); (5) had more PCEM1 certificates to resit during DCEM (p = 0.007); (6) were ranked in the lower two-thirds of their class for the certificates (including the CSCT) (p < 0.001). Of the 147 students who did take the internship exam, 102 (69%) passed. Logistical regression identified three predictive factors in their success: (1) took the General Certificate of Education at an average or younger than average age (adjusted odds ratio (OR) 7.79, confidence interval (CI) 95% [1.59-38.13]); (2) had at most one "debt" (adjusted OR 16.51 [1.88-144.78); (3) ranked in the top third of their class for certificates (including the CSCT) (adjusted OR 7.84 [2.42-25.41]).

Our study objectively confirmed that consistent work and effective learning strategies, acquired early during education and applied throughout medical studies, strongly promoted success in the previous internship exam. It is likely--but should be verified--that medical students who choose this strategy of constant effort will also do best on the new national-ranking examination.