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BackgroundEducating doctors is expensive and poor performance by future graduates can literally cost lives. Whilst the practice of medicine is highly evidence based, medical education is much less so. Research on medical school selection, undergraduate progression, Fitness to Practise (FtP) and postgraduate careers has been hampered across the globe by the challenges of uniting the data required. This paper describes the creation, structure and access arrangements for the first UK-wide attempt to do so.OverviewA collaborative approach has created a research database commencing with all entrants to UK medical schools in 2007 and 2008 (UKMED Phase 1). Here the content is outlined, governance arrangements considered, system access explained, and the potential implications of this new resource discussed. The data currently include achievements prior to medical school entry, admissions tests, graduation point information and also all subsequent data collected by the General Medical Council, including FtP, career progression, annual National Training Survey (NTS) responses, career choice and postgraduate exam performance data. UKMED has grown since the pilot phase with additional datasets; all subsequent years of students/trainees and stronger governance processes. The inclusion of future cohorts and additional information such as admissions scores or bespoke surveys or assessments is now being piloted. Thus, for instance, new scrutiny can be applied to selection techniques and the effectiveness of educational interventions. Data are available free of charge for approved studies from suitable research groups worldwide.ConclusionIt is anticipated that UKMED will continue on a rolling basis. This has the potential to radically change the volume and types of research that can be envisaged and, therefore, to improve standards, facilitate workforce planning and support the regulation of medical education and training. This paper aspires to encourage proposals to utilise this exciting resource.

ObjectivesCurrently relative performance at medical school (educational performance measure (EPM) decile), additional educational achievements and the score on a situational judgement test (SJT) are used to rank applicants to the UK Foundation Years postgraduate medical training programme. We sought to evaluate whether these three measures were predictive of subsequent successful completion of the programme, and thus were valid selection criteria.MethodsData were obtained from the UK Medical Education Database (UKMED) on 14 131 UK applicants to the foundation programme starting in 2013 and 2014. These data included training outcomes in the form of Annual Reviews of Competency Progression (ARCPs), which indicated whether the programme was successfully completed. The relationship between applicants’ performance on the three selection measures to the odds of successful programme completion were modelled.ResultsOn univariable analyses, all three measures were associated with the odds of successful completion of the programme. Converting the SJT score to deciles to compare the effect sizes suggested that one decile increase in the EPM increased the odds of completing the programme by approximately 15%, whereas the equivalent value was 8% for the SJT scores. On multivariable analyses (with all three measures included in the model), these effects were only independently and statistically significant for EPM decile (OR 1.14, 95% CI 1.10 to 1.18, p<0.001) and SJT z-score decile (OR 1.05, 95% CI 1.01 to 1.09, p=0.02).ConclusionsThe EPM decile and SJT scores may be effective selection measures for the foundation programme. However, educational achievements does not add value to the other two measures when predicting programme completion. Thus, its usefulness in this context is less clear. Moreover, our findings suggest that the weighting for the EPM decile score, relative to SJT performance, should be increased.

Background: Gateway courses are increasingly popular widening participation routes into medicine. These six year courses provide a more accessible entry route into medical school and aim to support under-represented students' progress and graduation as doctors. There is little evidence on the performance of gateway students and this study compares attainment and aptitude on entry, and outcomes at graduation of students on the UK's three longest running gateway courses with students studying on a standard entry medical degree (SEMED) course at the same institutions. Methods: Data were obtained from the UK Medical Education Database for students starting between 2007 and 2012 at three UK institutions. These data included A-levels and Universities Clinical Aptitude Test scores on entry to medical school and the Educational Performance Measure (EPM) decile, Situational Judgement Test (SJT) and Prescribing Safety Assessment (PSA) scores as outcomes measures. Multiple regression models were used to test for difference in outcomes between the two types of course, controlling for attainment and aptitude on entry. Results: Four thounsand three hundred forty students were included in the analysis, 560 on gateway courses and 3785 on SEMED courses. Students on SEMED courses had higher attainment (Cohen's d = 1.338) and aptitude (Cohen's d = 1.078) on entry. On exit SEMED students had higher EPM scores (Cohen's d = 0.616) and PSA scores (Cohen's d = 0.653). When accounting for attainment and aptitude on entry course type is still a significant predictor of EPM and PSA, but the proportion of the variation in outcome explained by course type drops from 6.4 to 1.6% for EPM Decile and from 5.3% to less than 1% for the PSA score. There is a smaller significant difference in SJT scores, with SEMED having higher scores (Cohen's d = 0.114). However, when measures of performance on entry are accounted for, course type is no longer a significant predictor of SJT scores. Conclusions: This study shows the differences of the available measures between gateway students and SEMED students on entry to their medical degrees are greater than the differences on exit. This provides modest evidence that gateway courses allow students from under-represented groups to achieve greater academic potential.

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BackgroundMisconduct during medical school predicts subsequent fitness to practise (FtP) events in doctors, but relatively little is known about which factors are associated with such issues during undergraduate education. This study exploits the newly created UK medical education database (UKMED), with the aim of identifying predictors of conduct or health-related issues that could potentially impair FtP. The findings would have implications for policies related to both the selection and support of medical students.MethodsData were available for 14,379 students obtaining provisional registration with the General Medical Council who started medical school in 2007 and 2008. FtP declarations made by students were available, as were various educational and demographic predictor variables, including self-report ‘personality measures’ for students who participated in UK Clinical Aptitude Test (UKCAT) pilot studies. Univariable and multivariable logistic regression models were developed to evaluate the predictors of FtP declarations.ResultsSignificant univariable predictors (p < 0.05) for conduct-related declarations included male gender, white ethnicity and a non-professional parental background. Male gender (OR 3.07) and higher ‘self-esteem’ (OR 1.45) were independently associated with an increased risk of a conduct issue.Female gender, a non-professional background, and lower self-reported ‘confidence’ were, among others, associated with increased odds of a health-related declaration. Only ‘confidence’ was a significant independent predictor of a health declaration (OR 0.69). Female gender, higher UKCAT score, a non-professional background and lower ‘confidence’ scores were significant predictors of reported depression, and the latter two variables were independent predictors of declared depression.ConclusionsWhite ethnicity and UK nationality were associated with increased odds of both conduct and health-related declarations, as were certain personality traits. Students from non-professional backgrounds may be at increased risk of depression and therefore could benefit from targeted support. The small effect sizes observed for the ‘personality measures’ suggest they would offer little potential benefit for selection, over and above those measures already in use.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1167-5) contains supplementary material, which is available to authorized users.

ObjectiveTo determine whether scores on two undergraduate admissions tests (BioMedical Admissions Test (BMAT) and University Clinical Aptitude Test (UCAT)) predict performance on the postgraduate Membership of the Royal Colleges of Physicians (MRCP) examination, including the clinical examination Practical Assessment of Clinical Examination Skills (PACES).DesignNational cohort study.SettingDoctors who graduated medical school between 2006 and 2018.Participants3045 doctors who had sat BMAT, UCAT and the MRCP.Primary outcome measuresPassing each section of the MRCP at the first attempt, including the clinical assessment PACES.ResultsSeveral BMAT and UCAT subtest scores displayed incremental predictive validity for performance on the first two (written) parts of the MRCP. Only aptitude and skills on BMAT (OR 1.34, 1.08 to 1.67, p=0.01) and verbal reasoning on UCAT (OR 1.34, 1.04 to 1.71, p=0.02) incrementally predicted passing PACES at the first attempt.ConclusionsOur results imply that the abilities assessed by aptitude and skills and verbal reasoning may be the most important cognitive attributes, of those routinely assessed at selection, for predicting future clinical performance. Selectors may wish to consider placing particular weight on scales assessing these attributes if they wish to select applicants likely to become more competent clinicians. These results are potentially relevant in an international context too, since many admission tests used globally, such as the Medical College Admission Test, assess similar abilities.

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