Sustained Clinical Performance During Surgical Rotations Predicts NBME Shelf Exam Outcomes.

Objective To determine if longitudinal, excellent clinical performance reflected in subjective evaluations during a surgery clerkship would be associated with a greater likelihood of National Board of Medical Examiners Surgery Shelf Exam (“shelf exam”) success. Design We retrospectively reviewed medical students’ surgical clerkship performance from 2014 to 2019. Clinical evaluations for each rotation were abstracted and students were stratified by performance: excellent performers and non-excellent performers. The rotation performance grades were then combined to classify overall clerkship performance: sustained excellent performers, improved performers, worsened performers, and sustained non-excellent performers. We compared the shelf exam scores between performer class for each clinical rotation and the overall clerkship. Using logistic regression, we also sought to determine if clinical performance predicted passing the shelf exam. Setting Emory University School of Medicine in Atlanta, Georgia. Participants Third-year medical students (N = 674) who completed a surgery clerkship. Results Excellent performers scored higher than non-excellent performers on the shelf exam during both clinical rotations (all p Conclusions Clinical performance during the surgical clerkship and individual rotations correlates with shelf exam scores. Students should be encouraged to excel on the wards to maximize the educational experience and improve their odds of passing the exam.