Graduates from vertically integrated curricula

BACKGROUND:   Vertical integration (VI) has been recommended as an undergraduate medical curriculum structure that fosters the transition to postgraduate training. Our definition of VI includes: (1) the provision of early clinical experience; (2) the integration of biomedical sciences with clinical cases; (3) long clerkships during the final year; and (4) increasing levels of clinical responsibility for students. The aim of the current study is to support the hypothesis that medical graduates from VI programmes meet the expectations of postgraduate supervisors better than those from non-VI curricula.

METHODS:   A questionnaire study was carried out among supervisors of postgraduate training programmes run at Utrecht (the Netherlands, VI; n = 128) and Hamburg (Germany, non-VI; n = 114). The supervisors were asked about their medical graduates' preparedness for work, knowledge and capabilities to manage some specific parts of the work as a doctor. They evaluated their performances on a five-point Likert scale.

RESULTS:   The two groups of supervisors did not differ in their judgment of their graduates' preparedness for work and level of knowledge. However, supervisors in Utrecht evaluated their graduates higher with respect to capability to work independently, solving medical problems, managing unfamiliar medical situations, prioritising tasks, collaborating with other people, estimating when they need to consult their supervisors and reflecting on their activities.

DISCUSSION:   Graduates from VI medical curricula appeared to be more capable in several facets of a doctor's job. Research into the actual performance of graduates from VI and non-VI curricula is needed to further support a firm recommendation for VI curricula.