before the age of 25 and without the opportunity to pursue interests or experiences outside of classroom academic work following college graduation [ 1 ]. This situation is also true in schools outside of the US ( i . e ., UK ), although internationally , the medical track is often pursued even earlier . Making such a weighted decision so early in life with limited exposure and previous experience may be challenging , especially when students move from the familiar classroom environment to the “ real-life ” clinical setting . Students often describe difficulty and stress in the transition from the preclinical to clinical years of medical school [ 2 , 3 ]. Students attribute these challenges to many factors , such as the change of learning environment from classroom to on-the-job learning , professional socialization , longer working hours than other professional peers , the breadth of knowledge needed for clinical medicine , and a feeling of being useless in their new role [ 2 , 3 ].
It has been shown that prior work experience , problem-based learning , and confidence in baseline knowledge and skills may ease the transition into the clinical years of medical education [ 4 ]. There is anecdotal evidence that medical schools are emphasizing the importance of prior experience and maturity before entering medical school . Yet , little work has been done in the US to investigate the shift of medical schools accepting older , more experienced students . As of 2016 , the average age of matriculation was 24.4 years [ 1 ], with a larger proportion of students starting medical school over the age of 25 . This is older than the traditional age of students entering medical school immediately upon completion of an undergraduate degree . This change is reflected in the way medical school admissions committees emphasize the diversity of each class often through students ’ interest in pursuing other opportunities prior to the long commitment of attending medical school and beginning residency training . The competitive nature of medical school applications has also pushed students to differentiate themselves on their applications , which is often achieved by exploring other opportunities such as professional work or research .
Moreover , older students do not have lower grades than younger students in higher education as a whole [ 5 ]. In fact , studies have suggested that older students ( specifically women ) perform better than both older men and younger women in medical school [ 6 ]. Other studies have shown that age is positively associated with clerkship grades in fields such as internal medicine [ 7 ]. It has been hypothesized that older students at the graduate school level are able to perform at a level equal to or better than that of their younger peers because they often have more motivation , mature learning skills , more life direction and experience , and better time management skills [ 8 – 10 ]. This translates into less anxiety when transitioning into the clinical years of their education [ 9 ].
The authors ’ previous qualitative work has shown that life experience , work experience , and age are vital factors that shape students ’ perceptions of their expectations and roles in the clinical years of their medical education [ 11 ]. This study built upon these findings to assess the impact of these factors on medical students during their clinical rotations . The aim of this study was to characterize the influence of age at medical school matriculation ( traditional versus nontraditional ) on clinical medical training experience , including reasons for pursuing the career of medicine , interactions in the clinical environment , performance on clinical rotations , and medical specialty choice for residency training . We hypothesized that age plays a role in how medical students perceive their clinical experiences and career decision-making .
Methods
An anonymous online quantitative survey consisting of 21 questions was sent to medical students enrolled in clinical rotations at The George Washington University School of Medicine and Health Sciences , Yale School of Medicine , Case Western Reserve University School of Medicine , and University of Texas Health Science Center at San Antonio from June
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