Medical student research is recognized as a critical component of undergraduate medical education. Current studies focusing on curricular improvements to promote student research are limited by lack of objective outcome data. At the Mayo Medical School, research has been an integral component of the curriculum since its inception in 1972. In 2006, selectives (periods of time free from competing didactic or clinical responsibilities) were implemented, which permitted students flexibility in their pre-clinical years to pursue service projects, research endeavors, and career exploration. The purpose of this study was to quantify the effects of this curricular revision on research productivity by Mayo medical students. Publications by Mayo medical students graduating in the 2004-2011 time period were queried in the PubMed database. The number, impact factor, and time to publication for these publications was assembled and analyzed in a cohort of students that graduated before and after selectives were implemented. We found that students who participated in selectives published more papers, papers with a higher impact factor, and published papers earlier in their training than students who graduated prior to the implementation of selectives. We propose that selectives are an effective means to increase research productivity in the Mayo medical school curriculum.

The ability to form an accurate differential diagnosis is of paramount importance to the physician in training, but is a skill often relegated to practice during the clinical years of the traditional medical school curriculum. Further complicating matters is the subjective nature of what constitutes an accurate differential and the fact that a widely accepted metric or template for feedback does not currently exist. Our group created a collaborative metric that assessed differential diagnosis formation and provided feedback to 47 first-year, preclinical medical students through their practice of various clinical vignettes as part of the Mayo Medical School Pathology course. We found that first-year students not only improved significantly in their ability to form a more accurate differential but also reported engagement in self-directed learning as well as developing positive attitudes toward early clinical integration. Given the importance of these skills for future physicians, and the successes of our intervention, we propose that such metrics be used for guiding feedback to students learning to create differentials in the early undergraduate medical curriculum.