Preparation for practice: how can medical schools better prepare PRHOs?

There is growing evidence that new PRHOs feel unprepared for their first post. This study compared three cohorts of graduates, the first from a traditional systems-based curriculum, the second from the same systems-based curriculum, who had also taken an intercalated degree, and the third from a PBL curriculum who had not intercalated. Subjective reports of confidence in clinical skills, anxiety and feelings of preparedness for practice were assessed using a previously published instrument. Graduates from the PBL curriculum who had not intercalated felt significantly better prepared, less anxious and more confident than equivalent graduates from the systems-based curriculum. Systems-based curriculum graduates who had taken an additional intercalated degree scored as highly in these criteria as the PBL graduates who had not intercalated. Despite these improvements, absolute levels of anxiety remained high and feelings of preparedness and confidence in clinical skills remained poor.