Effects of the 'preresidency syndrome' on students' selection of fourth-year courses

The influence of the "preresidency syndrome" on students' selection of fourth-year courses was examined. The fourth-year courses selected by the classes of 1982 and 1986 in the Brown University Program in Medicine were compared. The author considered that members of the 1982 class were less likely than those in the 1986 class to have been influenced by perceptions of increased competition for residency positions. The students in the class of 1986 were found to have deferred third-year clerkships into the fourth year more often than the class of 1982. The class of 1986 selected more courses related to their intended specialty than did the class of 1982, particularly for those intending to pursue residencies in orthopedics. Also, the class of 1986 spent a greater proportion of their fourth year in electives at hospitals where they intended to apply for residencies. These data support the contention that medical students' perception that residency positions were more difficult to obtain led to changes in selecting courses in the fourth-year of medical school.