title: Impact of extended course duration and stricter study organization on attrition and academic performance of medical students.
abstract: OBJECTIVE
  To assess whether extended medical school duration, block/modular structure of subjects, not allowing students to transfer exams into the higher course year, and curriculum implementation in line with the Bologna Accord are associated with lower attrition and better academic outcomes of medical students.
  
  
  METHODS
  We retrospectively investigated curricula at the University of Split School of Medicine and academic outcomes of 2301 medical students during a 33-year period (1979-2011). The following data were obtained: grade point average (GPA) at the end of the studies, duration of studies, graduation on time, and whether the student graduated or not.
  
  
  RESULTS
  After extension of medical curriculum from 5 to 6 years, students had significantly better grades (3.35 vs 3.68; P<0.001), shorter study duration (7.0 vs 6.0 years; P<0.001), and more students graduated on time (6.5% vs 57%; P<0.001). Changes in the 6-year curriculum, such as stricter study regulations and adoption of Bologna Accord, were associated with better indicators of students' academic success. The lowest attrition and the highest grades during the studied period were observed after the implementation of the Bologna Accord in 2005.
  
  
  CONCLUSIONS
  Introduction of a longer medical curriculum, block/modular subject structure, stricter regulations of exam transfer, and curriculum in line with the Bologna Accord may contribute to better academic outcomes and lower attrition of medical students.
authors: Department of Anatomy, Histology and Embryology, University of Split School of Medicine, Split, Croatia.
authors: Roberta Andrea
authors: RA
authors: Tešija
authors: Silvija
authors: S
authors: Maslov Kružičević
authors: Adriana
authors: A
authors: Banožić
authors: Carlos David
authors: CD
authors: Esteban
authors: Damir
authors: D
authors: Sapunar
authors: Livia
authors: L
authors: Puljak
mesh_terms: D002983:Clinical Competence; D003479:Curriculum; D004501:Education, Medical / Q000458:organization & administration*; D004521:Educational Measurement; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D012577:Schools, Medical; D013332:Student Dropouts; D013337:Students, Medical; D013663:Teaching / Q000379:methods*
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