An assessment of musculoskeletal knowledge in graduating medical and physician assistant students and implications for musculoskeletal care providers

Background: The purpose of the present study was to evaluate musculoskeletal knowledge among graduating medical students and physician assistant students with use of a National Board of Medical Examiners (NBME) examination. We hypothesized that there would be no difference in scores between the two groups. In addition, we looked for relationships between examination scores and both the student-reported musculoskeletal experiences and the school-reported musculoskeletal curriculum. Methods: One hundred and forty-four students from three medical schools and ninety-one students from four physician assistant schools were included in the present study; both groups were graduating students in the final semester of education. The National Board of Medical Examiners Musculoskeletal Subject Examination (NBME MSK) was utilized to assess musculoskeletal knowledge. Results: Themean examination score (and standard deviation) was 73.8% ± 9.7% formedical students and 62.3% ± 11% for physician assistant students (95% confidence interval [CI], 213.8 to 0.00; p < 0.05). Medical students with an interest in orthopaedics as a career scored significantly higher than those without an expressed orthopaedic interest, andmedical students without an expressed career interest in orthopaedics scored significantly higher than physician assistant students (p < 0.05). Among medical students, a longer duration of a clinical rotation in orthopaedics was associated with a higher examination score (p < 0.05). The average number of hours of preclinicalmusculoskeletal education in the first two years of school was significantly higher for medical schools (122.1 ± 25.1 hours) than for physician assistant schools (89.8 ± 74.8 hours) (p < 0.05). Conclusions: Graduating medical students scored significantly higher than graduating physician assistant students on the NBME MSK. This may be related to multiple factors, and further studies are necessary to evaluate the overall musculoskeletal clinical competence of both groups of students.