Academic achievement of final-year medical students on a rural clinical platform: Can we dispel the myths?

  • S van Schalkwyk
  • N Kok
  • H Conradie
  • B van Heerden


Background: There is a growing body of literature relating to the establishment of rural clinical training platforms for medical students describing many positive outcomes, particularly in the case of extended placements. However, students’ fears about their academic achievement while at these sites remain a key concern.

Objectives: The study set out to compare the academic achievement in end-of-rotation assessments and final examinations of final-year medical students at a rural clinical school (RCS) with those of their peers at the academic hospital complex (AHC).

Methods: A cross-sectional study, comparing the marks of three successive cohorts of RCS and AHC students (2011 - 2013) using t-tests and confirmed with non-parametric rank-sum tests, was conducted. The consistency of the effect of these results across cohorts was assessed by fitting regression models with interaction terms between cohort and group, and tested for significance using F-tests. Independent t-tests were conducted to evaluate differences in the mark attained between the two groups. A p-value <0.05 was considered statistically significant.

Results: Comparison of student marks attained across six of the disciplines offered at the RCS suggested there was no difference between the RCS and AHC in each of the three cohorts at baseline. A comparison of the end-of-rotation means showed that RCS students achieved significantly better results in some disciplines. A similar trend was observed for the final examination results across all seven disciplines.

Conclusion: Despite small numbers, this study suggests that students who spend their final year at the RCS are not disadvantaged in terms of their academic achievement. Medical students’ concerns regarding academic achievement for those placed at rural clinical sites appear to be unfounded. Students who potentially could be placed at these sites should be made aware of this evidence.


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