Implementing early medical curriculum exposure for premedical students

In a large-scale retrospective analysis, nearly 85% of undergraduate premedical students do not complete medical school prerequisites and ultimately do not apply to medical school, often due to the increasing difficulty of prerequisite courses and the mismatch between student expectations and the reality of medical education. There is limited early exposure to clinical concepts in undergraduate coursework, and many students lose interest in pursuing medical school.1 Despite this statistic, few studies evaluate the impact of undergraduate exposure to medical education on attrition rates. This study investigates how early medical education exposure impacts undergraduate students' motivation to pursue a medical career through the design and implementation of an electrocardiography (ECG) interpretation curriculum. A 10-week ECG course was developed and offered as an optional supplement to the core undergraduate curriculum, limited to 20 third- and fourth-year undergraduate students at a large public university in the United States. ECG was chosen as the course focus as it does not require extensive prior medical knowledge; foundational cardiac anatomy, physiology and electrical vectors were taught in the first two lectures, enabling students to engage with subsequent lectures. The course mirrored that of a first-year medical school ECG curriculum, covering key concepts including rate and rhythm determination and the interpretation of common cardiac pathology such as arrhythmia, preexcitation syndromes and acute coronary syndrome. Weekly synchronous online lectures were delivered with embedded poll questions throughout to check students' understanding. Problem sets were given after each lecture. A midterm and final exam were administered to assess comprehension, with a course passing threshold of 60%. Students were surveyed on demographics, prior exposure to medical education and interest in further medical education. This study was deemed exempt by our institutional review board. Eighteen of 20 students completed the post-course survey. The ECG curriculum demonstrated positive outcomes for our institution's premedical students: 100% of participants passed the course, and 77.8% reported that the workload was manageable alongside their other studies. Additionally, 94.4% of students expressed a desire for more courses involving medical education. Students were surveyed on their motivation to pursue a career in medicine before and after the ECG course using a Likert scale (1, Very unmotivated; 3, Neutral; 5, Very motivated). The mean motivation score before taking the course was 3.89, which subsequently increased to 4.40 after the course. This outcome demonstrates that medical education exposure for undergraduate students is feasible in difficulty and increases student motivation to pursue a career in medicine. The increase in motivation may be attributed to learning content more aligned with students' career interests, whereas current medical school prerequisites focus primarily on basic sciences. Moving forward, we aim to refine the course based on student feedback and expand access within our institution to improve retention among premedical students. Future plans include longitudinal tracking of participants to assess the long-term impact of undergraduate medical education exposure on their pursuit of medical careers and on populations underrepresented in medicine. Yaseen Maqsood Hakim: Conceptualization; investigation; writing—original draft; writing—review and editing; data curation; formal analysis. Ellie Tsang: Conceptualization; investigation; writing—original draft; writing—review and editing; formal analysis; data curation. Dali Fan: Writing—review and editing; supervision. None. Institutional review board exemption was received. The data that support the findings of this study are available from the corresponding author upon reasonable request.