Comparing and contrasting undergraduate competence in musculoskeletal medicine with cardiovascular medicine and neurology

Objectives. With an increasing prevalence of musculoskeletal conditions within the UK, specialty bodies are concerned that graduating medical students may lack appropriate knowledge in this system. We investigated the knowledge base of final year Sheffield medical students in the musculoskeletal system, compared with other major body systems. Methods. A computer-based assessment was designed covering core topics that a pre-registration house officer should know about in musculoskeletal medicine, cardiology and neurology, using a predesigned testing format. The test was blueprinted against internal and external guidelines. It comprised 24 extended matching questions, each with three stems. A sample of 74 volunteer students from the final year (year 5) of the medical course at the University of Sheffield took part in the assessment. Results. Overall scores of students on the test ranged from a baseline of 45% to a maximum of 85%. Test reliability was 0.75 (Cronbach's alpha). On stratifying the overall percentages into marks for individual systems, it was found that there were no significant differences between scores in musculoskeletal medicine, cardiovascular medicine or neurology. Conclusions. Despite the disparity of teaching between musculoskeletal medicine and other major organ systems within Sheffield's integrated medical curriculum, the knowledge base of medical students in the basic and clinical musculoskeletal sciences appears to be similar to that for cardiovascular medicine and neurology by the time of graduation. Nevertheless, several important issues must be addressed before these findings can be generalized.