This study aimed to identify if students on a modern degree programme who did an optional intercalated degree performed better in subsequent undergraduate degree exams than their peers who did not intercalate. When we adjusted for performance in the early years of the course along with maturity and other covariates, intercalating was associated with gaining high CAS marks in three of the six degree assessments which took place after rejoining the course. These assessments reflected the range of assessment methods: written, clinical and essay-based.
We know that intercalating confers benefits in terms of gaining additional points in the academic ranking system for applications for FY1 posts. Our data indicates that intercalating was also associated with additional benefits in terms of improved performance in Years 4 and 5 of the MBChB. Improved performance will further contribute to higher academic ranking.
The relatively low numbers of students who choose to intercalate in Aberdeen (just under 18%) suggests that our students are not aware of these benefits – intercalating may become more attractive if they become so. Moreover, the proportion of Aberdeen students intercalating is well under the average proportion intercalating across all UK medical schools of 36% [2
]. Thus, we believe we have scope to increase the number of Aberdeen students intercalating without any dilutational effect on the benefits [2
]. However, it would be interesting to repeat this study for quality assurance purposes if we were to have a large increase in the numbers of students intercalating.
Intercalating students do significantly better in their final year elective project. This is a research project so it is not surprisingly that IC students, who had received more training and practice in the skills required to produce this kind of work than those who did not intercalate [7
], do better than their colleagues.
Why do students who intercalate do better once they rejoin the medical course? We suggest this is probably due to a combination of maturity [20
] and gaining new learning skills [2
]. However, given the retrospective nature of this study, we were unable to directly measure if student learning styles changed as a result of intercalating, nor could we formally assess cause and effect.
Given that entry into the Aberdeen intercalated degree programme is based on attainment in third year, we expected IC students to do better than their colleagues on early exams. This was indeed apparent on several of the written exams. We propose that this might suggest that those who chose to do an intercalated degree are more academically-inclined than the average student. Thus, rather than an intercalated degree encouraging entry into academic medicine [4
], it may be that those students who are more academic are attracted to intercalating as the first step of an academic career [8
]. Further research is required to explore this possibility. Nonetheless, we did adjust the multivariate analysis for performance in 3rd
year of the matching exam type and therefore our overall findings are not simply a reflection of a higher academic ability of the IC students.
Intercalating students did better than their colleagues on the 3rd
year clinical (OSCE) exam. This pattern was maintained when the IC students rejoin the MBChB programme. IC students have no clinical contact in their intercalating year, so any improvement is likely due to maturity [20
] and/or better learning strategies [2
Younger students were more likely to do an IC degree. This may be associated with the fact that many older students were graduates, or simply with the fact that more mature students may have financial and/or family commitments, beyond those of the average school-leaver, which make an additional year of study difficult. While one would not expect a graduate to do an IC degree, we were initially surprised that no overseas student had ever intercalated. The most probable explanation for this is additional cost, especially in light of the increased amount overseas students pay in fees.
This is the first study exploring the short-term benefits, in terms of improved performance on subsequent undergraduate assessment, of intercalating in a population of students doing a modern (post Tomorrow's Doctors [13
]) MBChB in which intercalating is optional (as is the case for the majority of UK medical schools). As far as we are aware, there is no published comparison data available on the breakdown of students who intercalate at other institutions. This paper presents retrospective, observational data derived from a single institution, so we would not claim that our results are necessarily applicable to other medical schools. However, we were able to look at five cohorts of students, giving the study high numbers and statistical strength in terms of power. We also looked at data from all students intercalating, not only those doing one intercalated option [11
The design of this study does not allow for exploration of whether intercalating predisposes a medical student towards an academic career, or whether those who are predisposed towards an academic career are more likely to intercalate. If the former, the short-term gains from intercalating identified in this study may attract more medical students to intercalate, and hence, more graduates to academic medicine.