Differences between medical school and PGY1 learning outcomes: An explanation for new graduates not being “work ready”?

Abstract

Background: Widespread concerns about new medical graduates’ ‘work readiness’ may reflect, in part, differences in mandatory learning outcomes for medical students and new medical graduates.

Purpose: To examine differences between required medical student and PGY1 (first year resident) training program outcomes, and the nature and magnitude of these differences.

Method: Comparison, systematic identification and thematic analysis of differences between the graduate outcomes in the Australian Medical Council Standards for the Assessment and Accreditation of Primary Medical Programs and those in the New Zealand Curriculum Framework for Prevocational Training.

Results: The relationship between these outcome statements were categorized as: essentially similar; continuity; partial discontinuity; and complete discontinuity of learning trajectory. Areas requiring substantial new learning may reflect medical schools’ focus on individual student performance, and on learning and assessments based on single episodes of often uncomplicated illness. This contrasted with a post-graduate focus on integrated health care delivery by teams and management of complex illnesses over the whole patient care journey.

Conclusions: Characterizing these marked differences between pre-graduate and postgraduate standards, within a trajectory of learning, explains some of the difficulties in students’ preparation for work readiness. These could inform learning interventions to support new graduates’ professional development to ensure patient safety. Development and revision of accreditation standards should include formal review against the expectations of the preceding and succeeding phases of learning.

Keywords:

• Accreditation
• learning outcomes
• undergraduate education
• postgraduate education

Disclosure statement

The authors acknowledge their roles in accreditation and related development of standards, as detailed above under ‘researcher positioning’. The authors alone are responsible for the content and writing of the article. Opinions expressed are their personal views and do not represent those of any committees, working parties or universities with which they have, or have had, any association.

Glossary

Work readiness: Is evidence of achievement of competencies and capabilities which are specific to and necessary for a work role, as defined by employers' and supervisors’ views. While not precisely defined, some suggest it includes concepts of organisational acumen, social intelligence, personal characteristics and work competence. It therefore extends beyond technical competence alone.

Additional information

Notes on contributors

Pete M. Ellis

Pete M. Ellis, BM BCh MA(Oxon) PhD (Otago) FRANZCP, was formerly Associate Dean, Advanced Learning in Medicine, University of Otago Medical School.

Tim J. Wilkinson

Tim J. Wilkinson, MB ChB MD PhD(Otago) M Clin Ed(UNSW) FRACP FRCP(London) FANZAHPE, is Director of the University of Otago MBChB programme.

Wendy C-Y. Hu

Wendy C-Y. Hu, MBBS (Hons) (Syd) MHA PhD FRACGP, is Associate Dean, Learning and Innovation and Professor of Medical Education, School of Medicine, Western Sydney University.