Medical school policies regarding struggling medical students during the internal medicine clerkships: results of a national survey.
OBJECTIVE
To characterize policies of medical schools regarding struggling medical students: those at risk of receiving a grade of less than pass because of problems with knowledge, clinical skills, professionalism, or a combination of these items.


METHODS
The annual 2006 Clerkship Directors in Internal Medicine (CDIM) survey included a section about how clerkship directors handle struggling third- and fourth-year medical students. The section contained 14 structured questions and five items requiring free-text responses. The items explored both core and fourth-year clerkship perspectives. Data were analyzed using descriptive statistics.


RESULTS
Eighty-three of the 110 (76%) institutional members responded. Respondents identified 0% to 15% of students as struggling each year during the required core internal medicine clerkship and 0% to 11% of fourth-year students. Two thirds of respondents present struggling students to a medical school promotion committee. More than half (64%) of respondents feel they should share information about struggling students with other clerkship directors, and 51% of respondents do share information. Clerkship directors are divided about whether it is in students' best interests to disclose information about them with current teachers or other clerkship directors. Only 14% of institutions have written policies about sharing information, and 57% of clerkship directors design remediation plans for struggling students.


CONCLUSIONS
Internal medicine clerkship directors handle struggling students in widely varying ways. Many clerkship directors share information about struggling students; opinions are divided about whether this is appropriate. Future research is needed to determine the effectiveness of identifying and remediating struggling students and to determine effective remediation plans.
Frellsen
Sandra L
SL
Rush Medical College, and John H. Stroger, Jr. Hospital of Cook County, Chicago, Illinois, USA. Sandra_Frellsen@rush.edu
Baker
Elizabeth A
EA
Papp
Klara K
KK
Durning
Steven J
SJ
D002170:Canada; D002982:Clinical Clerkship; D002983:Clinical Competence; D003625:Data Collection; D004504:Education, Medical, Undergraduate; D004521:Educational Measurement / Q000379:methods*; D006801:Humans; D014481:United States