Reviving the Sciences: a Post-clerkship Approach to Required Basic Science Education

Retention and application of basic science knowledge diminishes as students progress through medical training. Embedding advanced science learning into authentic clinical contexts may strengthen conceptual integration and better prepare students for complex patient care. As many medical schools shorten pre-clerkship curricula, innovative approaches are needed to reinforce and extend basic science learning into the post-clerkship phase. This study aimed to develop, implement, and evaluate the feasibility and student perceptions of a required post-clerkship Advanced Science Course (ASC) curriculum designed to integrate advanced basic and clinical sciences in meaningful, practice-relevant ways.

We implemented four required three-week ASCs within a 13-week semester, redistributing advanced basic and clinical science content from earlier phases and subsequently shortening the pre-clerkship phase. Each ASC combined weekly didactics with related clinical placements. Students completed medical knowledge exams, the NBME Comprehensive Basic Science Examination (CBSE), and course evaluations assessing quality, learning balance, and integration of basic, clinical, and health system science pillars. Feasibility was assessed by faculty and administrative effort (FTEs, time) and by student scheduling practicality.

The model required ~ 0.4 FTE course director and 1.4 FTE staff support, plus new 12-week clinical placements for 162-184 students annually. Students demonstrated mastery across assessments (79.4% passed all mid-terms, 85.0% finals on first attempt). CBSE equated percent correct scores improved from 50 to 62 overall, with significantly larger gains in ASC-related content areas (M = 15.7, SD = 10.4) than content areas not covered by the ASCs (M = 11.3, SD = 7.5); t(173) = 6.6, p < .01. Students reported high satisfaction in three of four courses, highlighting strong engagement and perceived integration.

A required post-clerkship ASC model is both feasible and effective for teaching advanced basic science concepts alongside authentic clinical experiences, supporting sustained integration of scientific learning in the post-clerkship phase of medical education.