2017 through March 2018 . These institutions were identified as representative of different regions of the country . Additionally , we had established contacts at each of these medical centers who were willing to disseminate our survey to students . Nontraditional students were defined as students who were 25 years or older when entering medical school . Traditional students were defined as students below the age of 25 when entering medical school .
Survey questions were adapted from a qualitative study on the experiences of mature-aged medical students [ 11 ]. The questions asked students to identify the amount of time ( if any ) they had between college and medical school and state the activities or jobs they had during that time . Also , the survey asked about the factors that influenced student choice to attend medical school . Students also had to rate the impact that certain factors such as age , life experience , and work experience had on their clinical rotations . Other questions asked students to rate the aspects of clinical rotations that were most important to them , such as independent time to learn , guidance by attendings , and level of teaching . These ratings were assessed on a scale of 1 to 5 . Students also provided information on their expected specialty choice , and they rated factors that most impacted that choice . Additionally , students identified attributes in their peers that correlated with success on clerkships . There were also response questions for students to explain their answer choices . Demographic information was collected on the age at matriculation , age at expected graduation , gender , ethnicity , marital status , and number of children . A statistical t-test analysis was conducted using SPSS software to determine any significant differences in responses between the two groups . This project was considered exempt by the institutional review board at The George Washington University ( IRB # 051224 ).
Results
A total of 196 students responded to the survey , which was about a 14 % participation rate . The average age upon entering medical school was 24.1 years , with a range of 23 to 44 . Among the respondents , 51 % were female , 46 % were male , and 3 % responded other or did not answer the question . About two-thirds ( n = 121 ; 66.1 %) of the respondents were classified as traditional , with 95.7 % of this group taking 1 or 2 years after finishing their undergraduate degree before starting medical school . In contrast , 79.1 % of students characterized as nontraditional had 3 or more years between finishing their undergraduate degree and starting medical school , with 100 % working professionally during this time ; 34.7 % of these students volunteered in some capacity , with another 25.3 % attending graduate school .
The most common reason for entering medical school was altruism ( 69.3 % of nontraditional students , 73.6 % of traditional students ) followed by prior exposure to the field ( 50.7 % of nontraditional students , 64.5 % of traditional students ) ( Figure 1 ). Both groups of students ranked preparedness ( 81.3 % of nontraditional vs . 88.4 % of traditional ), interactions with attendings ( 78.7 % of nontraditional vs . 85.1 % of traditional ), interactions with patients ( 72.0 % of nontraditional vs . 77.7 % of traditional ), and clinical acumen ( 69.3 % of nontraditional vs . 74.4 % of traditional ) as the attributes most often found in their peers that resulted in a strong performance on clinical rotations . Both groups also gave age the lowest ranking among the attributes ( Figure 2 ).
Compared with traditional students , nontraditional students were more likely to report that life experience ( 82.2 % vs . 64.7 %, p < 0.001 ), previous work experience ( 63.9 % vs . 35.6 %, p < 0.001 ), and age ( 54.8 % vs . 26.1 %, p < 0.001 ) had an impact on their clinical rotations . Additionally , nontraditional students felt that previous work experience ( p < 0.004 ) and age ( p < 0.001 ) had more influence on specialty choice than usual-age students ( Table 1 ). In terms of specialty choice , both sets of students were most likely to enter internal medicine ( 14.7 % of nontraditional , 14.0 % of traditional ), then obstetricsgynecology and emergency medicine in similar numbers ( 10.7 % each of nontraditional students , 10.7 % each of traditional students ) ( Figure 3 ). Older students agreed more strongly with the idea that they wanted to maximize their clinical experience , even if it impinged on personal time ( p < 0.048 ).
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