The relationship between medical students' academic achievement and patterns of initial postgraduate placement.

Purpose: To explore the relationship between various levels of academic achievement and the spectrum of initial specialty placements for graduates.

Method: The authors studied the initial specialty placements of all 1984-1994 graduates of the University of Kentucky College of Medicine. Statistical analyses were used to determine the nature and strength of the relationships between initial specialty selection and students' achievement indicators and changes in that relationship over time.

Results: Students tended to aggregate across time into discernible levels of achievement. The relationships between academic achievement levels and initial specialty placements were highly variable.

Conclusion: Although students with higher levels of achievement had broader choices available to them, graduates at every level of achievement entered a wide variety of specialties. Thus, the authors believe that academic achievement should not be used to the exclusion of other performance characteristics in determining how students and residencies should be matched.