Representation and Quality of Physical Medicine and Rehabilitation Clerkships in US Medical Schools
Abstract
Purpose: Prior studies found that medical schools failed to expose undergraduate students to clinical musculoskeletal medicine. The purpose of this study was to focus on physical medicine and rehabilitation (PM and R) and add a quality assessment component. Methods: A multi-methods design was used to evaluate 154 medical schools in the U.S. Representation (availability) of required, selective, and elective clerkships was assessed using measures of central tendencies. Quality of clerkships was assessed by comparing clerkship curricula to a criterion standard developed by the authors. Results: Few medical schools required a musculoskeletal (4%) or PM and R (2%) clerkship. Few schools (7%) also required PM and R sub-specialty clerkships. Some schools offered musculoskeletal medicine (15%), and few offered PM and R sub-specialty (8%) or PM and R (2%), selective clerkships. Combined with elective clerkships, most medical schools offered at least one musculoskeletal medicine (97%) or PM and R/PM and R sub-specialty (93%) clerkship. In terms of quality, only half of the criterion standard objectives were assessed by PM and R clerkships. Bioethics and geriatric rehabilitation were disproportionately assessed in required clerkships and therapeutic and diagnostic injections objectives were disproportionately assessed in elective clerkships. Lastly, using thematic analysis, 22 objectives were added to the original criterion standard. Conclusions: Medical schools continued to exclude PM and R, and musculoskeletal medicine, from the list of required clerkships. In fact, we found a surprising downtrend in representation compared to earlier studies. Evidence suggests that these clerkships are underemphasized, not underrepresented, in undergraduate curricula. In addition, the lack of consistent and comprehensive use of objectives may be indicative of a problem with the quality of existing clerkships.
Document Details
- Document Type
- Technical Report
- Publication Date
- Jul 13, 2020
- Accession Number
- AD1186098
Entities
People
- Danny Benbassat
Organizations
- Uniformed Services University of the Health Sciences