PGY-1 surgery preparatory course design: identification of key curricular components

The importance of preparing senior medical students (SMS) for surgical internship is clear, and initiatives to standardize such curricula are of national interest. Less clear, however, are the specific subject areas most important for inclusion in such courses. In this study, we aimed to identify key curricular components in the development of a PGY-1 Surgery Preparatory Course.

A month-long PGY-1 preparatory course was offered to SMS entering surgical residencies, consisting of 55 sessions providing instruction in 3 main areas: 19 Ward Management Tasks (WMT), 12 Operative and Technical Skills (OTS), and 4 Professionalism Skillsets (PS). To determine curricular topics most valued and needed by students, data were reviewed from precourse and postcourse surveys, knowledge tests, and performance examinations. Pretest/posttest scores were compared using t-tests, α = 0.05.

In all, 22 SMS enrolled in the course. Prior to course participation, students placed greatest importance on WMT (4.35 ± 0.05) over OTS (4.09 ± 0.06) and PS (3.90 ± 0.15), p < 0.05. Precourse confidence levels were lowest in WMT (2.28 ± 0.12), versus OTS (2.41 ± 0.20) and PS (3.50 ± 0.30). Mean pretest scores were 54.8 ± 2.1% in WMT and 82.7 ± 2.5% in OTS, with significant improvement to 82.2 ± 1.9% and 93.2 ± 1.3%, respectively (p < 0.05 for both), further showing greater need for instruction in WMT.

SMS participating in a PGY-1 Surgery Preparatory Course identified WMT as more important than OTS and PS. Further, they demonstrated the lowest precourse confidence in this area and found that course participation most dramatically improved their perceived ability to execute these types of tasks. As efforts continue to formalize the transition from medical school to surgical residency, these findings will be instrumental in developing standardized curricula.