Commentary on shorter psychiatry clerkship length is associated with lower NBME psychiatry shelf exam performance

摘要

The average length of United States medical school psychiatry clerkships has been gradually declining over the past 30 years, from 6.4 weeks, in 1982 (1), to 6 weeks, in 1999 (2), to 5.5 weeks, in 2010 (3). Alexander and Bostwick report being recently put in the unenviable position of having the shortest required psychiatry clerkship in North America (4). We can all empathize with the frustration that this reduction might entail, given that their 3-week clerkship is half the length recommended by the Association of Directors of Medical Student Education in Psychiatry in its 2006 position statement (5). Alexander and Bostwick are to be commended for moving beyond their frustration to examine the impact of the reduction in clerkship length on their students' shelf scores in a thoughtful and scholarly fashion. Their challenging situation offers us an opportunity to think about the meaning and impact of clerkship length.