Abstract
Introduction
Medical admissions must balance two potentially-competing missions: to select those who will be successful medical students and clinicians, and increase the diversity of the medical school population and workforce. Many countries address this dilemma by reducing the heavy reliance on prior educational attainment, complementing this with other selection tools. However, evidence to what extent this shift in practice has actually widened access is conflicting.
Aim
To examine if changes in medical school selection processes significantly impact on the composition of the student population.
Methods
Design and setting: Observational study of medical students from 18 UK 5-year medical programmes who took the United Kingdom Clinical Aptitude Test (UKCAT) from 2007-2014; detailed analysis on four schools
Primary outcome: Proportion of admissions to medical school for four target groups ( lower socio-economic classes, non-selective schooling, non-white, male).
Data analysis: Interrupted time-series framework with segmented regression was used to identify the impact of changes in selection practices in relation to invitation to interview to medical school. Four case study medical schools were utilised looking at admissions within for the four target groups.
Results
There were no obvious changes in the overall proportion of admissions from each target group over the eight-year period, averaging at 3.3% lower socio-economic group51.5% non-selective school, 30.5% non-white and 43.8% male. Each case study school changed their selection practice in decision making for invite to interview during 2007-2014. Yet this within-school variation made little difference locally, and changes in admission practices did not lead to any discernible change in the demography of those accepted into medical school.
Conclusion
Although our case schools changed their selection procedures, these changes did not lead to any observable differences in their student populations. Increasing the diversity of medical students, and hence the medical profession, may require different, perhaps more radical, approaches to selection.
Medical admissions must balance two potentially-competing missions: to select those who will be successful medical students and clinicians, and increase the diversity of the medical school population and workforce. Many countries address this dilemma by reducing the heavy reliance on prior educational attainment, complementing this with other selection tools. However, evidence to what extent this shift in practice has actually widened access is conflicting.
Aim
To examine if changes in medical school selection processes significantly impact on the composition of the student population.
Methods
Design and setting: Observational study of medical students from 18 UK 5-year medical programmes who took the United Kingdom Clinical Aptitude Test (UKCAT) from 2007-2014; detailed analysis on four schools
Primary outcome: Proportion of admissions to medical school for four target groups ( lower socio-economic classes, non-selective schooling, non-white, male).
Data analysis: Interrupted time-series framework with segmented regression was used to identify the impact of changes in selection practices in relation to invitation to interview to medical school. Four case study medical schools were utilised looking at admissions within for the four target groups.
Results
There were no obvious changes in the overall proportion of admissions from each target group over the eight-year period, averaging at 3.3% lower socio-economic group51.5% non-selective school, 30.5% non-white and 43.8% male. Each case study school changed their selection practice in decision making for invite to interview during 2007-2014. Yet this within-school variation made little difference locally, and changes in admission practices did not lead to any discernible change in the demography of those accepted into medical school.
Conclusion
Although our case schools changed their selection procedures, these changes did not lead to any observable differences in their student populations. Increasing the diversity of medical students, and hence the medical profession, may require different, perhaps more radical, approaches to selection.
| Original language | English |
|---|---|
| Article number | 023274 |
| Number of pages | 11 |
| Journal | BMJ Open |
| Volume | 8 |
| Issue number | 10 |
| Early online date | 8 Oct 2018 |
| DOIs | |
| Publication status | Published - Oct 2018 |
Bibliographical note
Our thanks to the Medical Schools Council for funding and to the UKCAT Consortium for access to data. Neither organisation was involved in determining the study design or results reporting.FUNDING STATEMENT
This work was supported by Medical Schools Council (MSC) of the UK under the Selecting for Excellence programme.
Keywords
- medical education and training
- Admission/selection/minority recruitment
- continuing medical education