The prediction of academic and clinical performance in medical school

Prior studies have suggested the importance of distinguishing between performance in the earlier and later years of medical education. Factor analysis of grades by year and faculty ratings of clinical and general medical competence for 661 medical students identified two uncorrelated factors clearly reflecting this distinction. The clinical performance factor, accounting for 48% of the communality of the matrix, was more or less unpredictable from aptitude and premedical academic achievement indices; it was marginally predictable from scales on the Adjective Check List. The academic performance factor, accounting for 31% of the variance among criteria, was forecast with acceptable accuracy (cross-validated R=0.43) by equations based on the Medical College Admission Test and premedical grade point average. Future study should stress the clinical performance factor; this criterion appears to be more important than academic attainment, and it is also less accurately predicted by current measures.