Effect of two preclinical curricula on NBME Part I examination performance

The Michigan State University College of Human Medicine conducts two preclinical medical education programs. In Track I (lecture-based), students attend classes 24 hours per week, and lecture time totals 908 hours over a 50-week period. In Track II (problem-based), students attend classes only 12 hours per week, and lecture time totals 112 hours over the same 50-week period. Institution of the Part I examination of the National Board of Medical Examiners (NBME) as a graduation requirement provided an opportunity to compare the performances of students in both tracks. When students from each track with similar Science Problems subtest scores on the Medical College Admission Test were compared, no significant differences were observed in the students' total scores or pass rate on the NBME examination. However, there were significant differences in scores on the microbiology subtest of the NBME examination, with the Track I students achieving higher scores. The 1984 report of the Project Panel on the General Professional Education of the Physician and College Preparation for Medicine of the Association of American Medical Colleges stressed the need to examine critically and consider reducing the scheduled instructional and lecture hours in preclinical medical education programs. In the study reported here, the authors demonstrated that reduction of scheduled instructional time, when replaced by a guided problem-solving program, is not detrimental to students' performance on the NBME Part I examination.