selecting students for medical school jon cohen. admission to medical school what are we trying to...
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Medical school admissions: key requirements
• To select the best candidates who will become outstanding doctors
The UltimateGood Doctor
Able to applyknowledge
Technicalcompetence
Teamworker
Organised, conscientiousReliable
EmpatheticCommunication
skills
Ethical,High integrity,professional
Calm under pressure
Good at decision making
Life longlearner
Problem solverConceptual thinker
Adapted & simplified from Powis, Bore & Munro
We generally agree about what we are looking foralthough we don’t agree how to get there
“The stated criteria for admission to medical school show commonality. Universities differ greatly, however, in how they apply these criteria…”
Parry et al, BMJ 2006 332:1005
Admissions processes for five year medical courses at English schools: review
Difficult question #1:
How do we capture the diversity we need formedicine, both in terms of skill sets:
• paediatric neurology vs forensic pathology• primary care vs tertiary care• individualised care vs public health vs global health
and in terms of social & societal experience
Difficult question #2:
At what point do you measure the outcome?
What is success?
How will we know when we have got it right?
Note: most papers that talk about “predicting outcome” arereferring to successful completion of the degree course
• the number of failing doctors?• the number of complaints to the GMC?• junior doctors’ sense of preparedness?• patients’ input?
And when?• At graduation?• At the end of Foundation?• After 5 years in practice?
What should we measure?
F1 doctors failing = 159 (2.2%) F2 doctors failing = 228 (3.2%)
UKFPO Annual Report, 2010
The number of doctors in difficulty was 266 (4.6%). Half of these were relatedto the doctors’ health, the remainder (very small numbers) to other reasons.
UKFPO Annual Report, 2010
Of the 266 doctors in difficulty, > 80% were expected to be successfully signed off.
UKFPO Annual Report, 2010
Medical school admissions: key requirements
• To select the best candidates who will become outstanding doctors
• A system that is robust, fair, transparent and which actively supports the WP agenda
Widening participation – specific schemes
Widening participation in “general” applicants:The real challenge
Increasing concerns with all “non-academic”elements of UCASProbably all of them suffer from risk of unintended biasKeen interest in exploring alternatives, e.g. :
• all graduate entry• Admissions centres• MMIs
Medical school admissions: key requirements
• To select the best candidates who will become outstanding doctors• A system that is robust, fair, transparent and which actively supports the WP agenda
• Evidence-based, defensible process, not open to challenge under Equalities legislation
• Not overly expensive/cumbersome to operate
UCAS Application(Academic
only)
Interview Decision
UCAS Application (Academic
only)
UKCAT Score
Interview Decision
UCAS Application
Interview Decision
1 School
2 Schools
2 Schools
1 School
UCAS application (Academic
only)
BMAT
UCAS Application
BMAT Score
Interview Decision
Different schools use different approaches
Data provided courtesy of GMC, 2011
A final thought: in-course selection
The current model favours retention on thecourse for reasons of:
• reputation• finance• humankindness!
That being the case, academic criteria are boundto be the best “predictors” of success, since successis usually measured as completing the course
Alternative approaches to in-course selection
Y1 Y1
Current model: selectionthrough the course based onacademic failure and rarely,FtP
Alternative model: expanded Y1entry with major selection onacademic & non-academic criteriaat end Y1, thereafter mainly by FtPor severe academic failure.
Summary
• Admissions is a tough area: we welcome constructive discussion & debate, and we are actively exploring alternative models
• We are particularly keen to expand, develop & improve our WP work
• In the absence of better data, the current variety of approaches is a strength that encourages diversity; there is almost certainly no single “right answer”