Factors affecting students performance on the National Ranking Examination in a French Medical School

Results on the National Ranking Examination (NRE) taken at the end of 6 years of medical school determine how much choice students have about the medical specialty and geographic area where they will perform their residency. Our objective was to identify academic and non-academic factors predicting performance on the NRE.

We conducted a database study of all medical students who completed the 6 years of medical studies at Creteil medical school (Paris 12 University) and who took the NRE between 2004 and 2008 (n = 473). Correlations between students' characteristics and the NRE rank were analysed using multivariate linear regression models. The students were also divided into three categories based on whether their NRE rank was in the top quartile, bottom quartile, or middle two quartiles. Those 3 groups were compared using multivariate multinomial logistic regression models.

Factors independently associated (p < or = 0.05) with rank on the NRE were repeating the first year of medical school (coefficient: 11.92 [95%IC 8.69-15.15]); rank on the first-, fifth-, and sixth-year examinations (0.14 [0.05-0.22]; 0.19 [0.12-0.26] and 0.32 [0.22-0.42] respectively); number of years with at least one failed examination (3.94 [1.08-6.80]); and failure to attend a practice NRE session (13.0 [12.39-13.61]). Factors associated with the worst NRE performance were similar to those found when the NRE rank was handled as a continuous variable. Socio-economic characteristics of students were strongly associated with medical school performance and, therefore, were not independently associated with rank on the NRE.

Performance on the NRE was strongly associated with previous performance on medical school examinations, ever since the first year of medical school. Students were informed of these results which will help us to identify high-risk students who require early remedial help.