Long-term outcomes for surgeons from 3-and 4-year medical school curricula

Background: New approaches are needed to ensure that surgical trainees attain competence in a timely way. Traditional solutions have focused on the years spent in sur-gic al training. We sought to examine the outcomes of graduates from 3-year versus 4-year medical schools for differences in surgeon performance based on multisource feedback data. Methods: We used data from the College of Physicians and Surgeons of Alberta's Physician Achievement Review program to determine curricular outcomes. Data for each surgeon included assessments from 25 patients, 8 medical colleagues and 8 nonphysician coworkers (e.g., nurses), and a self-assessment. We used these data to compare 72 physicians from a 3-year school matched with graduates from 4-year schools. The instruments were assessed for evidence of validity and reliability. We compared the groups using 1-way analysis of covariance and multivariate analysis of covariance, with years since graduation as a covariate, and a Cohen d effect size calculation to assess the magnitude of the change. Results: Data for 216 surgeons indicated that there was evidence for instrument validity and reliability. No significant differences were found based on the length of the undergraduate program for any of the questionnaires or factors within the questionnaires. Conclusion: Reconsideration might be given to the time spent in medical school before surgical training if training in the specialty and career years are to be maximized. This assumes that students are able to make informed career decisions based on clerkship and other experiences in a 3-year setting.