The empirical association between student and resident physician performances

To further the understanding of the relationship between performances in a combined baccalaureate-MD degree program and in residency, the authors subjected their database of 298 study participants from the 1980-1983 entering classes of the University of Missouri-Kansas City School of Medicine to factor analysis and then to distribution-free statistical analyses. Distinct factors were identified among the performance measures from the combined-degree program; only one factor was identified among the measures of residency performance. Analysis of the relationship of performances in the combined-degree program and in residency indicated that almost half of the participants were in the same performance categories as students and as residents. The strongest association emerged between a clinical performance factor derived from performances in the combined-degree program and the residency clinical performance factor. However, the knowledge factor derived from performance measures in the combined-degree program was also associated with residency clinical performance. The associations were statistically significant but of limited strength; thus the present results resemble those of other investigators, despite the fact that they are based on distribution-free statistics and on purportedly cleaner and more homogeneous measures of performance. Various technical reasons may have caused this lack of strength, but it is also possible that empirical relationships between undergraduate and postgraduate performances are inherently limited because the performances expected of residents may not be mere extensions of those expected of medical students.