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Purpose: Within a school, the formerly fourth year emergency medicine clerkship was added to the third year curriculum in a sequence with general surgery and surgical subspecialty clerkships. Together, a student can be placed in any permutation of the three clerkships, but a student will take the Surgery and EM NBME exam after the completion of the respective clerkship regardless of the order of clerkships. The purpose of this project was to look to see if there was a significance difference in NBME scores between four different sequences of clerkships and to see if sequence of a third year student’s clerkship affects NBME scores.

Methods: The study cohort consisted of medical students graduating in 2021 (n = 125). The primary measure of interest and data collected was the sequence of three clerkships (emergency medicine, general surgery, and surgical subspecialty), Surgery NBME subject exam score, and Emergency Medicine NBME subject exam score. We reported the descriptive statistics and conducted a one-way ANOVA analysis to answer the research question.

Results and Conclusions: Completion of emergency medicine, general surgery, and surgery subspecialties clerkships in the four possible sequences offered at this school had no significant difference in the means of Surgery NBME and Emergency Medicine NBME subject exam scores. The order in which students complete the three clinical clerkships were not associated with any difference in NBME subject exam scores for Surgery and Emergency Medicine. The findings may be taken into consideration for curriculum re-design at other medical schools.