Differences in clinical knowledge levels between residents in two post-graduate rotation programmes in Japan

Area of Science:

• Medical Education
• Clinical Competence Assessment

Background:

• Japan has two post-graduate medical training curricula: comprehensive (CRP) and limited (LRP) rotation programs.
• Debate exists regarding the optimal curriculum for standardized Japanese post-graduate training.
• Previous studies indicated higher satisfaction and confidence in CRP trainees, but objective knowledge comparison was lacking.

Purpose of the Study:

• To objectively compare the clinical knowledge of post-graduate trainees in CRPs versus LRPs.
• To utilize a component of the Professional and Linguistic Assessment Board (PLAB) test for objective assessment.

Main Methods:

• A nationwide cross-sectional study conducted in February-March 2020.
• Voluntary recruitment of post-graduate medical trainees from Japanese general hospitals.
• Adaptation of the UK PLAB test to assess basic clinical knowledge, with a cut-off score of 63%.

Main Results:

• 97 trainees from 19 facilities participated; 32% in CRPs and 68% in LRPs.
• CRP trainees showed a significantly higher likelihood (OR 5.16) of being in the high-scoring group.
• Statistically significant higher scores for CRP trainees in paediatrics, mental health, and neurology.

Conclusions:

• Post-graduate trainees in CRPs exhibit better basic clinical competence knowledge as measured by the PLAB test.
• CRPs appear to foster broader knowledge across various subspecialties.
• Future research should evaluate clinical performance and longitudinal competency trends alongside exam scores.