Unprepared Retesting of First Year Knowledge: How Much Do Second Year Medical Students Remember?

Introduction: With the implementation of integrated curricula, less time is spent on teaching basic sciences to the benefit of subjects with more clinical relevance. Even though learning in a clinical context seems to benefit medical students, concerns have been raised about the level of (bio)medical knowledge students possess when they enter their rotations. This study aimed to obtain empirical data on the level of knowledge retention of second year medical students at the University Medical Center Utrecht, the Netherlands. Method: A longitudinal study was performed in which second year medical students were retested for retention of first year knowledge by a study test consisting of questions from two course examinations of year 1, each with an interval of 8 to 10 months. Results were compared in a within-participants design. Results: The results of 37 students were analysed. Students scored on average 75% (±8.2%) correct answers during the initial unit examinations and 42% (±8.8%) for the knowledge retention test. With correction for guessing this was 71% (±9.3%) versus 33% (± 9.9%), which means knowledge retention was on average 46%. Knowledge retention was higher for multiple choice questions (MCQs) (53%) versus non-MCQs (41%), and somewhat different for the two courses (53% and 40%). Conclusion: After an interval of 8–10 months, more than half of first year knowledge cannot be reproduced. Medical students and faculty should be aware of this massive loss of knowledge and provide means to improve long-term retention.