Evaluating discrepancies between high‐yield neuroscience conditions in preclerkship medical education and national clinical incidence

Medical education must balance foundational science with clinical relevance. Increasing emphasis on standardized assessments has led to prioritization of "high-yield" conditions-those most likely to be assessed. Subsequently, educators and students often prioritize these conditions. This study compared first-year neuroscience curricula from two US allopathic medical schools with four Step 1 preparatory textbooks. Conditions were categorized by curricular coverage and textbook frequency, then compared to US clinical incidence/prevalence rates per 100,000 into five rarity groups. A national survey was then distributed electronically to faculty and students from accredited US medical schools, yielding 41 responses from 22 US states and territories. Of 129 identified conditions, 19.4% were extremely rare and only 7.0% were common. Among the 73 featured in all four textbooks, 31.5% were very rare and 26% were extremely rare. Discrepancies emerged between curricular coverage, textbook emphasis, and clinical relevance, with rare conditions being overrepresented and common ones underrepresented. DO-granting institutions showed more frequent alignment between teaching and relevance than MD-granting institutions, which exhibited greater variability. This study highlights a misalignment between neuroscience curricula, preparatory textbooks, and clinical relevance across US medical schools. The overrepresentation of extremely rare conditions and reduced emphasis on common, clinically significant topics suggest that exam-driven priorities may be shaping educational content more than clinical applicability. Curricular reform will be necessary to ensure that medical education better prepares students for the realities of patient care, and not just standardized assessments.