Clinical skills acquired during third-year surgical clerkships

An instrument was developed to survey third-year medical students about their experience with 18 clinical skills that are generally recognized as required learning for the third-year surgical clerkship. The same instrument was adapted to ascertain which surgical skills 25 fourth-year medical students, 25 surgical residents, and 25 practicing surgeons thought should be acquired during the third-year surgical clerkship. None of these evaluators had completed medical school or residency at our institution. A remarkable degree of conformity was found in the rankings of the 18 clinical skills by senior students, surgical residents, and practicing surgeons; fourth-year students rated only central venous line placement and simple operative procedures as significantly more important than did more senior evaluators. The third-year medical students' actual surgical clerkship experience with 10 out of the 18 skills was significantly below the overall competency levels desired by the graduate groups. Our survey demonstrates that both students and graduates attach similar importance to the acquisition of clinical skills in the third-year surgical curriculum. The instrument utilized in this study to measure students' experience and satisfaction with this phase of their education was reliable, the measurements were consistent, and this information was useful in the evaluation and modification of the curriculum.