Evaluation of the mandatory internships completed by sixth-year medical students at a foundation university in various healthcare institutions affiliated with the Republic of Türkiye Ministry of Health in terms of professional gains

Aim: This thesis targeted evaluating the professional gains of final-year medical students at Biruni University Faculty of Medicine during their mandatory internships at various health institutions affiliated with the Republic of Türkiye Ministry of Health, based on comparative feedback from different institutions, as well as the opinions and recommendations of faculty members and physicians responsible for clinical education.The general, clinical, and public health competencies and practical skills targeted for these internships, as listed in the intern doctor records, were evaluated in comparison with the core competencies and core diseases/clinical problems/clinical findings/conditions listed in Turkish National Core Education Program (NCEP-2020) which lists clinical symptoms/findings/conditions, problems/core diseases/clinical problems, and basic medical practices. Material and Methods: During the 2022-2023 Academic year, medical interns in their sixth year at Biruni University Faculty of Medicine completed their mandatory external rotations in Emergency Medicine, Pediatrics, Obstetrics and Gynecology, Public Health/Family Medicine and Psychiatry.The extent to which the evaluated rotations were consistent with the competencies and qualifications specified in NCEP-2020 and how the medical interns' professional knowledge, skills, and concerns changed after these internships were investigated. In this context, feedback from intern doctors and after each internship was collected through electronic surveys created using Google Forms. In this context, feedback from intern doctors after each internship was collected via electronic surveys created using Google Forms. The single-sample chi-square test was used to compare the data obtained within and between groups. Besides, the feedback provided by faculty members of Biruni University Medical Faculty and supervising physicians responsible for internships at institutions where mandatory external rotations are conducted in response to open-ended questions was also qualitatively evaluated. Results: Of the participants (n=77), 59.74% were male and 40.26% were female, with the vast majority (98.70%) being citizens of the Republic of Turkey. The majority of intern doctors participating in the study preferred to pursue specialty training in an intörnal medicine field in Turkey after graduation, followed by surgical fields. The vast majority of intern doctors gained significant competence in skills such as taking purposeful history, performing physical examinations, and gaining speed and efficiency in emergency interventions as feedback in the Emergency department setting (p<0.001). However, their knowledge and skills in pre-hospital emergency services (p=0.453), forensic examination, and filling out patient referral forms remained at insufficient levels in terms of distribution (p=0.436). In Pediatrics Rotations, intern doctors were generally found to have gained sufficient skills in evaluating pediatric patients, requesting laboratory tests, and interpreting results (p<0.001). However, it was determined that the skills acquired in child nutrition and metabolism were mostly insufficient (p>0.05). In the Obstetrics and Gynecology rotation, intörns achieved sufficient proficiency in managing the delivery process, performing gynecological examinations, and approaching obstetric conditions (p<0.001). However, their level of primary patient responsibility was found to be relatively low. In the Public Health and Family Medicine Rotation, it was determined that intern doctors achieved a good level of knowledge in community health services, primary health care, and patient management (p<0.001). In the Psychiatry Rotation, it was determined that they mostly achieved sufficient proficiency in understanding the importance of patient confidentiality, mental status examination, and psychiatric patient management (p<0.001). However, in the intern doctors' feedback, they were mostly inadequate in psychiatric history taking (p=0.419), assessing psychiatric symptoms and findings (p=0.387), and communicating with patients and their relatives (p=0.569). Conclusion: In this thesis research, the effect of mandatory internships completed by final-year medical students at a foundation university's medical faculty at various health institutions affiliated with the Republic of Türkiye Ministry of Health on their professional gains was evaluated comparatively. According to their feedback, it shows that intern doctors largely acquire basic clinical skills, but deficiencies in skills related to certain procedure-focused practical applications persist. The need for more practical training and supervision, particularly for the acquisition of certain practical skills, was emphasized. Reorganizing the duration, location, and distribution of medical school sixth-year doctor internships in a more effective manner will advance the professional competence of intern doctors. Key Words: Medical internship, Clinical rotation, Medical education, Medical skills, Gaining professional competence, Internship evaluation