Factors associated with the national medical internship exam: Effects of university licensing

Introduction: Licensing of medical programs is a fundamental process to ensure the quality of medical education. However, the evidence regarding the impact of these processes remains controversial. Objective: To describe the academic and institutional characteristics of students who took the National Examination of the Social Health Insurance (EsSalud) and explore their association with the score obtained. Method: Analytical cross-sectional study of a secondary database of medical students who took the EsSalud examination in Peru on December 27, 2022. We evaluated the factors associated with the EsSalud examination score using linear regression. Results: We evaluated 1228 medical students who took the EsSalud examination. The median score on the Es-Salud examination was 12.2 (range 10.2 to 13.8); 35.9% of the students passed the exam, and only 26.5% came from a university that has a program of medicine already licensed. In the adjusted model, the score on the EsSalud examination was higher in students who belonged to a university with an already graduated medicine program (β 0.5; 95% CI: 0.2 to 0.8) and those with a weighted average higher than or equal to 13. And the score was lower in students from societal (β –1.2; –1.6 to –0.8) or associative (β –2.0; 2.4 to–1.6) universities with respect to students from national universities. Discussion: We examined the factors associated with performance in the National Medical Internship Exam in Peru. Licensing of medical programs and belonging to national universities were associated with higher scores on the EsSalud examination. We recommend improving the transparency of these exams and continuing with the licensing of programs. Conclusions: Medical students from national universities, universities with a graduate medicine program, and a weighted university average greater than or equal to 13 performed better in the EsSalud national medical internship exam.