Permanencia del conocimiento adquirido en los dos primeros a？os de la Licenciatura de Médico Cirujano.: ？Persiste al evaluarlo en el cuarto a？o?

introduction. students generally go deep into the knowledge according to the type of questions they are evaluated with, if they only will support mechanical and repetitive learning that remains just a short time in the memory, if they understand and apply their learning then these supports significant learning. materials and methods. analytical observational study by the method of judges there were selected 88 questions of the three levels of knowledge from tests of anatomy, psychology, physiology and surgery. the same test was randomized and applied to 13 groups of second and fourth grade. the evaluation and the analysis were performed with an electronic system. the u of mann-whitney was applied to identify differences and percentiles with inter-quartiles rank for the dispersion. results. 310 students of second grade and 247 of fourth grade were answered and analyses. the reliability of the test was of 0.9009 and 0.9102, respectively. significant differences were identified (p = 0.000) in the global examination and the answers of surgery and psychology, considering right answers and level of knowledge and psychology. considering right answers and level of knowledge (memory and understanding). there were no differences in anatomy (p = 0.527) and physiology (p = 0.203). there median of right answers was 39 and 43, respectively. the dispersion of items in the global analysis and by subject maintained an inter-quartiles rank between 3 and 4. conclusions. it is important to include as many items of high cognitive levels in assessments to facilitate meaningful learning.