gms | German Medical Science

Importance: Only very few faculties have managed to update the allocation of lessons for each module according to their current importance in medical education.

Objective: When asked to design their medical curricula, how would students differ from current reality in German medical schools?

Design, Setting, Participants: 756 German medical students (mean age 24.35, SD±4,3) from various schools were polled during 42 days in an online survey.

Main outcome measures: Primarily, prioritisation of modules in theoretical lessons and practical training (4-point Likert scale), the subjective sense of feeling prepared for board examination and daily medical routine (4-point Likert scale), utility in daily medical routine and students‘ intrinsic motivation for studying (5-point Likert scales). Secondarily, prospective career choices in each speciality as a physician and/or researcher („yes“/„no“).

German medical schools were assigned to 6 clusters according to their type of study programme, mean performance in past 5 years and tendency in past 2 years of board examination. For comparison, 11 study locations of participants (n=585) were assessed in their actual lesson allocations.

Discussion: The main outcome measures correlated very higly, signifying a pertinent rating of implementation of curricula.

Participants favoured clinical-practical modules, especially in practical lessons. Out of these, the „big five“ modules (high patient care) were in high demand, closely followed by a few conservative and operative modules (neurology, psychiatry, emergency medicine and anesthesiology). However the latter were not represented as desired in actual lesson allocations of sampled study programmes.

In clinical-theoretical modules, theoretical lessons were clearly favoured over practical ones. Three sub-groups (pathophysiology, pathomorphology and socio-economics) were observed. Amongst these, only several pathophysiological modules (e.g. basic and clinical pharmacology) were in high demand, while pathomorphological and socio-economical modules were rated below median.

Albeit reformation in several study programmes, clusters had no significant difference in rating lesson allocation. Clusters with a higher performance in board examinations showed a significantly higher preparation for exams and daily medical routine. Especially amongst clinical-practical modules, well performing clusters rated utility significantly higher.

Age and semester proved to be significantly decisive factors for prospective career choices. In several specific cases participants favoured modules according to their vicinity towards their career prospects.

Conclusion: A five-step model is observed, according to which modules can be categorised and subsequently applied in the process of curricular reformation. This study has shown that curricula are in desperate need of rejuvenation and accentuation of already existent structures to grant an alignment with current and future health care needs.