Influence of a problem-based learning curriculum on the selection of pathology as a career: evidence from the Canadian match of 1993-2004

Since the introduction of problem-based learning (PBL) to North American medical education more than 30 years ago, there have been a number of analyses of its educational outcomes. Several authors have suggested that PBL may influence medical students' career choices. The balance of opinion in the pathology literature appears to assume that PBL curricula limit students' contact with pathologists and hypothesizes that PBL may impair recruitment into pathology residency programs. To evaluate this latter hypothesis, evidence from the 1993-2004 Canadian residency match was considered. During this period, 8 of 13 English-language medical schools in Canada changed from a non-PBL to a PBL curriculum; 1 had been using a PBL curriculum even before the 1993 start point and 4 remained using a non-PBL curriculum throughout the period under consideration. The proportion of medical school graduates ranking pathology first in their residency application match is compared between PBL and non-PBL medical schools. On average, 1.1% of non-PBL graduates and 1.2% of PBL graduates ranked a pathology residency program first. In general, there were proportionately slightly more pathology recruits from non-PBL schools at the beginning of the 1993-2004 period and slightly more pathology recruits from PBL schools toward the end of the period. In the absence of a nationally or internationally recognized standard for what constitutes a PBL school, this analysis must remain somewhat subjective. However, it does indicate that graduates from PBL schools are approximately as likely as those from non-PBL schools to rank pathology first in residency applications.