Medical licensing examinations in both Sweden and the US favor pharmacology over lifestyle
(2021) In Preventive Medicine Reports 23.- Abstract
Low priority of disease prevention and health promotion in medical education may contribute to lack of lifestyle-counseling in clinical practice. Pharmacology-related knowledge is valued 5 times higher compared to lifestyle-related knowledge in examinations on noncommunicable diseases (NCDs) in undergraduate medical education in Sweden. This study aims to establish (i) whether medical licensing examinations are biased to favor pharmacology- over lifestyle-related knowledge and (ii) whether such a bias is present in both Sweden and the US. We identified 204 NCD-related questions from previous Swedish licensing examinations, and 77 cases from a U.S. question bank commonly used to prepare for the United States Medical Licensing... (More)
Low priority of disease prevention and health promotion in medical education may contribute to lack of lifestyle-counseling in clinical practice. Pharmacology-related knowledge is valued 5 times higher compared to lifestyle-related knowledge in examinations on noncommunicable diseases (NCDs) in undergraduate medical education in Sweden. This study aims to establish (i) whether medical licensing examinations are biased to favor pharmacology- over lifestyle-related knowledge and (ii) whether such a bias is present in both Sweden and the US. We identified 204 NCD-related questions from previous Swedish licensing examinations, and 77 cases from a U.S. question bank commonly used to prepare for the United States Medical Licensing Examination® (USMLE®) Step 3. With the help of expected correct answers, we determined distribution of points attainable for knowledge in the respective category (lifestyle / pharmacology / other) for 5 major NCDs: coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and stroke. The percentage of points attainable for lifestyle-related knowledge was 6.7 (95% CI 4.1–9.3) in Sweden and 4.6 (95%CI 0.0–9.1) in the U.S. The respective percentages for pharmacology-related knowledge were 32.6 (95% CI 26.3–38.8) and 44.5 (95% CI 33.2–55.8) percent. The pharmacology vs. lifestyle-quotas were 4.9 in Sweden and 9.8 in the U.S. Likelihoods of equal emphasis on lifestyle and pharmacology in NCDs was < 0.001 in both countries. There is a marked preference for pharmacology over lifestyle in medical licensing examinations in both Sweden and the U.S. Newly qualified doctors may be inadequately prepared to address preventable causes of NCDs.
(Less)
- author
- Krachler, B. ; Jerdén, L. ; Tönnesen, H. LU and Lindén, C.
- organization
- publishing date
- 2021
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Assessment, Graduate, Health behavior, Living habits, Medical education, Step 3
- in
- Preventive Medicine Reports
- volume
- 23
- article number
- 101453
- publisher
- Elsevier
- external identifiers
-
- pmid:34194960
- scopus:85108278299
- ISSN
- 2211-3355
- DOI
- 10.1016/j.pmedr.2021.101453
- language
- English
- LU publication?
- yes
- id
- 15090b8f-4246-4c4d-9eab-7700c8119a63
- date added to LUP
- 2021-08-11 11:17:54
- date last changed
- 2024-08-10 19:00:22
@article{15090b8f-4246-4c4d-9eab-7700c8119a63,
abstract = {{<p>Low priority of disease prevention and health promotion in medical education may contribute to lack of lifestyle-counseling in clinical practice. Pharmacology-related knowledge is valued 5 times higher compared to lifestyle-related knowledge in examinations on noncommunicable diseases (NCDs) in undergraduate medical education in Sweden. This study aims to establish (i) whether medical licensing examinations are biased to favor pharmacology- over lifestyle-related knowledge and (ii) whether such a bias is present in both Sweden and the US. We identified 204 NCD-related questions from previous Swedish licensing examinations, and 77 cases from a U.S. question bank commonly used to prepare for the United States Medical Licensing Examination® (USMLE®) Step 3. With the help of expected correct answers, we determined distribution of points attainable for knowledge in the respective category (lifestyle / pharmacology / other) for 5 major NCDs: coronary heart disease (CHD), chronic obstructive pulmonary disease (COPD), diabetes, hypertension, and stroke. The percentage of points attainable for lifestyle-related knowledge was 6.7 (95% CI 4.1–9.3) in Sweden and 4.6 (95%CI 0.0–9.1) in the U.S. The respective percentages for pharmacology-related knowledge were 32.6 (95% CI 26.3–38.8) and 44.5 (95% CI 33.2–55.8) percent. The pharmacology vs. lifestyle-quotas were 4.9 in Sweden and 9.8 in the U.S. Likelihoods of equal emphasis on lifestyle and pharmacology in NCDs was < 0.001 in both countries. There is a marked preference for pharmacology over lifestyle in medical licensing examinations in both Sweden and the U.S. Newly qualified doctors may be inadequately prepared to address preventable causes of NCDs.</p>}},
author = {{Krachler, B. and Jerdén, L. and Tönnesen, H. and Lindén, C.}},
issn = {{2211-3355}},
keywords = {{Assessment; Graduate; Health behavior; Living habits; Medical education; Step 3}},
language = {{eng}},
publisher = {{Elsevier}},
series = {{Preventive Medicine Reports}},
title = {{Medical licensing examinations in both Sweden and the US favor pharmacology over lifestyle}},
url = {{http://dx.doi.org/10.1016/j.pmedr.2021.101453}},
doi = {{10.1016/j.pmedr.2021.101453}},
volume = {{23}},
year = {{2021}},
}