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Medical licensing examinations in both Sweden and the US favor pharmacology over lifestyle.
Dalarna University, School of Health and Welfare, Medical Science. Center for Clinical Research Dalarna-Uppsala University, Falun.ORCID iD: 0000-0001-6549-1611
2021 (English)In: Preventive Medicine Reports, E-ISSN 2211-3355, Vol. 23, article id 101453Article in journal (Refereed) Published
Abstract [en]

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.

Place, publisher, year, edition, pages
2021. Vol. 23, article id 101453
Keywords [en]
Assessment, Graduate, Health behavior, Living habits, Medical education, Step 3
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:du-37823DOI: 10.1016/j.pmedr.2021.101453ISI: 000684931900043PubMedID: 34194960Scopus ID: 2-s2.0-85108278299OAI: oai:DiVA.org:du-37823DiVA, id: diva2:1582855
Available from: 2021-08-04 Created: 2021-08-04 Last updated: 2023-04-14Bibliographically approved

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Jerdén, Lars

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CiteExportLink to record
Permanent link

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Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • chicago-author-date
  • chicago-note-bibliography
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
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  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
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