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Background  Electives are perceived by medical students as a valuable, highly regarded experience, allowing them to customize learning experiences and enabling them to early differentiate during medical training. The present work aims to uncover students’ major determinants of satisfaction and how they interfere with their future elective choices in order to identify the best approach to implement electives in medical curricula.    Methods  A cross-sectional study was conducted through a written evaluation survey concerning the electives available in the academic year 2015–2016. Our institution provides 106 electives to students from the 2 nd  to the 5 th  year. Students’ satisfaction was assessed through a validated questionnaire with eight sentences expressing opinions related to electives global satisfaction. Data from 538 inquiries from 229 students were analyzed quantitatively using regression and correlation models, and qualitatively through phenomenography.    Results  Quantitative analysis of the questionnaires allowed to establish both: 1) The determinants of students’ satisfaction with electives, which were  Agreement with teaching and learning methodologies,  followed by  Agreement with assessment methodologies employed ,  Perception of the workload demanded  and  Requirement for continuous work  and 2) The predictors of students preferences in the following years, namely,  Agreement with assessment methodologies employed ,  Classes attendance  and  Ranking of the allocated elective established in the previous year . Qualitative analysis of questionnaires revealed that students consider electives as being innovative and interesting, claiming that some, for their relevant content, could be integrated into the medical core curriculum.    Conclusions  Our work raises awareness on the best practices when it comes to electives’ organization to meet students’ satisfaction. We can conclude that medical schools should measure students satisfaction as a tool to organize and predict future needs of electives and placements when designing and implementing this alternative student-centred curriculum or even to improve the existing practices regarding electives in medical courses.

Electives in the medical curriculum – an opportunity to achieve students’ satisfaction?