Vertical integration in medical school: effect on the transition to postgraduate training

OBJECTIVES:
Recently, many medical schools' curricula have been revised so that they represent vertically integrated (VI) curricula. Important changes include: the provision of earlier clinical experience; longer clerkships, and the fostering of increasing levels of responsibility. One of the aims of vertical integration is to facilitate the transition to postgraduate training. The purpose of the present study is to determine whether a VI curriculum at medical school affects the transition to postgraduate training in a positive way.

METHODS:
We carried out a questionnaire study among graduates of six medical schools in the Netherlands, who had followed either a VI or a non-VI curriculum. Items in the questionnaire focused on preparedness for work and postgraduate training, the time and number of applications required to be admitted to residency, and the process of making career choices.

RESULTS:
In comparison with those who have followed non-VI programmes, graduates of VI curricula appear to make definitive career choices earlier, need less time and fewer applications to obtain residency positions and feel more prepared for work and postgraduate training.

CONCLUSIONS:
The curriculum at medical school affects the transition to postgraduate training. Additional research is required to determine which components of the curriculum cause this effect and to specify under which conditions this effect occurs.