Medical school policies regarding struggling medical students during the internal medicine clerkships: Results of a national survey

Sandra L. Frellsen, Elizabeth A. Baker, Klara K. Papp, Steven J. Durning

Research output: Contribution to journalArticlepeer-review

67 Scopus citations


PURPOSE: To characterize policies of medical schools regarding struggling medical students: those at risk of receiving a grade of less than pass because of problems with knowledge, clinical skills, professionalism, or a combination of these items. METHOD: The annual 2006 Clerkship Directors in Internal Medicine (CDIM) survey included a section about how clerkship directors handle struggling third- and fourth-year medical students. The section contained 14 structured questions and five items requiring free-text responses. The items explored both core and fourth-year clerkship perspectives. Data were analyzed using descriptive statistics. RESULTS: Eighty-three of the 110 (76%) institutional members responded. Respondents identified 0% to 15% of students as struggling each year during the required core internal medicine clerkship and 0% to 11% of fourth-year students. Two thirds of respondents present struggling students to a medical school promotion committee. More than half (64%) of respondents feel they should share information about struggling students with other clerkship directors, and 51% of respondents do share information. Clerkship directors are divided about whether it is in students' best interests to disclose information about them with current teachers or other clerkship directors. Only 14% of institutions have written policies about sharing information, and 57% of clerkship directors design remediation plans for struggling students. CONCLUSIONS: Internal medicine clerkship directors handle struggling students in widely varying ways. Many clerkship directors share information about struggling students; opinions are divided about whether this is appropriate. Future research is needed to determine the effectiveness of identifying and remediating struggling students and to determine effective remediation plans.

Original languageEnglish
Pages (from-to)876-881
Number of pages6
JournalAcademic Medicine
Issue number9
StatePublished - Sep 2008
Externally publishedYes


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