What are the clinical skills levels of newly graduated physicians? Self-assessment study of an intended curriculum identified by a Delphi process

Objective To compare and contrast the learned and an intended curricula of practical clinical skills across the three Danish medical schools. Context The three Danish medical schools had comparable discipline-based curricula with 3 years of mainly basic science and 3 1/2 years of mainly clinical education. Danish physicians work as pre-registration house officers (PRHOs) for 1 1/2 years after graduation. Methods An anonymous questionnaire listing 210 practical clinical skills was mailed to 226 newly graduated Danish physicians. They were asked if they could meet the minimum level for each of the skills listed as identified by a previous Delphi study. Results The response rate was 80%. None of the responders met the minimum of all the 210 skills. Only 8% (14) met the minimum level for at least 90% (189) of the skills. On average the responders met the minimum of 74% (155) of the skills. More than 90% of the responders mastered basic history and examination skills. The responders did not meet 28 medical emergency procedures. Conclusions We found that the learned curriculum of clinical skills constituted 75% of the intended curriculum. Those responsible for pre- and postgraduate medical education should be aware of the discrepancy between expected and learned curriculum. We discuss the role of experts in the process of defining the core curriculum.