There is a growing interest in investigating factors that predict intern doctors’ performance to help select those who have the required competencies and are likely to succeed in the postgraduate medical education program. Academic factors such as medical licensing examination scores and medical school grade point averages (GPAs) are known to be associated with intern doctors’ performance [1-3]. A systemic review of studies on medical students’ summative assessments indicates their objective structured clinical examinations (OSCEs) and written examination scores have significant relationships with their clinical performance in the trainee intern year [4]. Yet, using these assessments as predictive measures for intern performance is limited due to a small body of evidence and large variations in the predictive strength of the relationships identified [4]. Furthermore, research indicates factors such as the type of assessment and the context in which it is conducted can influence this relationship [5,6].

There has been research exploring the relationship between junior doctors’ performance and their academic achievements in medical school using various measurement tools. Some studies of workplace performance assessment of junior doctors using the Junior Doctor Assessment Tool found significant correlations with their academic performance in medical school (i.e., GPA, clinical attachment, and written exam scores) [5,7]. Another studies highlighted the association between sociodemographic factors of UK foundation program doctors with their workplace performance using educational performance measure decile as an outcome measure [8] and between medical student selection criteria and workplace performance of junior doctors, as measured by supervising consultants’ reports [6].

Among various measures of junior doctors’ workplace performance, literature indicates that peer evaluation is a feasible tool for assessing physician competency [9-11]. Peer evaluation among medical students or healthcare professionals has existed for centuries, which assesses physicians’ performance based on peer’s judgments on observations they have made in the clinical setting over time [9]. Although there are several different ways of conducting peer evaluation, a structured questionnaire is often used as a workplace-based assessment tool [12]. Peer evaluation is best used as part of a multi-source approach to performance assessment in areas of clinical practice, humanistic qualities, and communication skills, as medical knowledge alone is not an adequate predictor of doctors’ performance [13]. However, peer evaluation can be subject to rater bias, which is not only affected by the rater’s standards but may also be influenced by personal relationships, stakes, and equivalence [9,11].

Although studies have been conducted on factors associated with intern doctors’ workplace performance, research is scant on its relationship with their academic achievements in medical school using measurement tools other than clinical knowledge or evaluations received by program directors. This study investigated the relationship between medical interns’ performance as assessed by their peers and their academic achievements in medical school as a preliminary study on factors predicting workplace performance in the intern year.

This study investigated intern doctors’ performance assessed by their peers and its association with their academic achievements in medical school as a preliminary study of factors predicting their performance in the intern year. Participants’ peer ratings did not differ across demographics, which indicates medical students’ demographics do not predict their performance as interns. Participants’ peer ratings showed moderate to strong positive associations with academic achievements at the medical school. Among these achievements, exit assessment and KMLE scores showed stronger associations with interns’ peer ratings than with their medical school GPAs. In particular, peer ratings were more strongly associated with outcomes in OSCEs than those in written tests in the medical school. This finding indicates medical students’ achievements in clinical performance tests is a stronger predictor of their performance as intern doctors. These findings align with previous studies, which indicate that medical students’ clinical performance in medical school is a more valid predictor of their workplace performance as doctors than written tests [4].

This study indicates clinical performance assessments in medical school are a valid method for predicting medical students’ performance as doctors. However, it can be argued that the current format of the OSCE is limited in predicting medical students’ performance as interns because it does not fully mimic real-life situations [15]. In the OSCE, students are expected to perform in a clinical setting independently, whereas junior doctors often do their work as part of a clinical team under the supervision of senior medical staff. Therefore, it is suggested that more authentic scenarios be provided in the OSCE to assess medical students’ clinical competence to make it an even more valid and reliable measure for predicting their workplace performance as interns. Moreover, more comprehensive and authentic assessment methods for medical students are warranted to enhance their predictive validity. For doing so, it is suggested that more various workplacebased assessments be implemented in medical schools to assess medical students’ clinical performance at the ‘Does’ level in the hierarchy of clinical competence assessment [14].

The limitations of this study should be acknowledged, as they also have implications for future studies. First, this was a preliminary study with a small sample, which limits the generalizability of the findings. A regression analysis study with a larger sample is needed to validate factors for predicting intern performance. Second, this study measured intern performance from the perspective of their peers, which can be subject to several biases when used alone as an assessment tool [9,11]. Thus, a more comprehensive study of factors that predict intern performance using multiple sources of feedback on intern performance is warranted to better understand the relationship between them.