Perspective of the Graduating Medical Student: The Ideal Curriculum for the Fourth Year of Undergraduate Medical Education

Objective: To explore medical students' perspective regarding the fourth year of medical school and common educational activities thereof. Methods: The authors surveyed students graduating in 2012 with a military service obligation about the importance of common fourth-year activities, the proportion of the fourth year devoted to these activities, and important considerations for the fourth-year curriculum. The authors calculated mean importance scores for educational activities and mean proportions of the fourth year that should be devoted to certain activities. Two reviewers independently coded free-text answers to identify and calculate frequencies for common themes. Results: The response rate was 40% (376/942). Participants rated activities related to improving clinical skills and securing the residency of their choice as more than activities such as learning business skills, conducting research, and studying basic sciences. Participants indicated that electives and direct patient care should comprise the majority of the fourth year and frequently mentioned improving specialty-specific clinical skills, pursuing personal medical interests, and taking time to relax as important fourth-year themes. Conclusions: Students value activities related to securing and succeeding in their chosen residency and the opportunity to pursue electives and take vacation. Faculty should consider the student perspective when reforming curricula.