Background
Especially when there is not an academic medical center associated with a medical school, there can be large variations in what is taught to students. This can potentially lead to lower scores and higher failure rates. A series of weekly case-based learning sessions (CBL) was created for each of the core clerkships to try and moderate the difference in teaching and learning experience by students.

Purpose
The purpose of this study was to determine the impact (positive or negative) of instituting required weekly CBLs in Psychiatry on NBME Clinical Subject Examination equated percent correct scores (scores) and failure rates.

Methods
Data on students taking their core clerkships from 2019-to summer 2023 was compared to students taking their core clerkships from fall 2023 to summer 2024. The scores on the NBME Clinical Subject Examination in Psychiatry were compared. Furthermore, the percentage passing (score > 2 SD below the national mean) the examination on their first attempt were compared between the groups. The data was compared using a non-directional hypothesis. Continuous normal statistics were compared with an unpaired t-test while percentages were compared with a Chi-square test.

Results
Four hundred and thirty-one students were found to have taken their first attempt at a NBME Clinical Subject Examination in Psychiatry during the designated time period. Three hundred thirty four of the students did not have their core clerkships augmented with CBLs. The scores and failure rates were compared to the ninety-seven students who took the exam for the first time after the addition of required weekly CBLs. The mean scores rose from 75.1 (95% CI: 74.2, 76.1) to 79.2 (95%CI: 78.1, 80.3) (p-value <0.001). The failure rate dropped from 21.0% on their first attempt in there-group to 4.1% in the post-group (p-value <0.001).

Conclusions
The introduction of required weekly CBL sessions can have a statistically significant impact on increasing scores and decreasing failure rates.