Dr Final year of medical school in Spain: a student perspective on clinical rotations, examination and readiness for practice.
Abstract
The final year of medical school represents a critical but underexamined transition point toward clinical practice. This paper argues that the current structure of Spanish undergraduate medical education generates a systematic gap between theoretical knowledge acquisition and clinical competence, which manifests most acutely during the final year. We propose that this gap is not an inevitable feature of medical training but rather the result of a curriculum design that prioritises knowledge-based assessment over competency-based learning. Drawing on evidence from competency-based medical education (CBME) frameworks, simulation research and mental health literature, we describe the main components of the final year—clinical rotations, OSCEs and the Final Degree Project—and analyse the structural and pedagogical factors that undermine students' readiness for practice. We conclude with evidence-informed recommendations and a call for curricular reform.
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