Comparative attainment of 5-year undergraduate and 4-year graduate entry medical students moving into foundation training

Abstract

BackgroundGraduate entry medicine is a recent innovation in UK medical training. Evidence is sparse at present as to progress and attainment on these programmes. Shared clinical rotations, between an established 5-year and a new graduate entry course, provide the opportunity to compare achievement on clinical assessments. To compare completion and attainment on clinical phase assessments between students on a 4-year graduate entry course and an established 5-year undergraduate medicine course.MethodsOverall completion rates for the 4 and 5 year courses, fails at first attempt, and scores on 14 clinical assessments, were compared between 171 graduate-entry and 450 undergraduate medical students at the University of Nottingham, comprising two graduating cohorts. Percentage assessment marks were converted to z-scores separately for each graduating year and the normalised marks then combined into a single dataset. Z-score transformed percentage marks were analysed by multivariate analysis of variance and univariate analyses of variance for each summative assessment. Numbers of fails at first attempt were analysed aggregated across all assessments initially, then separately for each assessment using χ2.ResultsCompletion rates were around 90% overall and significantly higher in the graduate entry course. Failures of assessments overall were similar, but a higher proportion of graduate entry students failed the final OSLER. Mean performance on clinical assessments showed a significant overall difference, made up of lower performance on 4 of 5 knowledge-based exams (as well as higher performance on the first exam) by the graduate entry group, but similar levels of performance on all the skills-based and attitudinal assessments.ConclusionsHigh completion rates are encouraging. The lower performance in some knowledge-based exams may reflect lower prior educational attainment, a substantially different demographic profile (age, gender), or an artefact of the first 2 years of a new graduate entry programme.

Comparing the cognitive, personality and moral characteristics of high school and graduate medical entrants to the Tehran University of Medical Sciences in Iran

“…Some evidence supports the claim that the GE group has better knowledge based performance when compared with the HSE group, though this advantage has nothing to do with their bachelor's discipline ). However, another study denies this and claims the GE group's knowledge based performance to be weaker than that of the HSE group (Manning & Garrud 2009). In Iran, GE students go through the basic science subjects in two semesters, while HSE students study these courses in five semesters.…”

“…A study conducted in the UK in 2008 has shown both these groups complete the medical courses at the same time (Manning & Garrud 2009). Some evidence supports the claim that the GE group has better knowledge based performance when compared with the HSE group, though this advantage has nothing to do with their bachelor's discipline ).…”

Selection of student-selected component [SSCs] modules across the medical undergraduate curriculum: Relationship with motivational factors

“…Originally developed to encourage a more diverse student body in medicine, the limited research gathered to date has indicated a different profile for GEM versus direct-entry students in terms of timing and acquisition of clinical skills and biomedical sciences knowledge (Calvert et al 2009;Manning & Garrud 2009). GEM students also differ from direct-entry students with respect to prior educational experience, learning style and motivational factors (Shehmar et al 2010).…”

The impact of clinical maturity on competency in evidence-based medicine: a mixed-methods study

“…While completion rates are higher among graduate-entry trainees, evidence to date would suggest small differences in competencies between the two cohorts (table 1) 2 6–8. A common trend among studies performed to date is the superior performance of graduate-entry students on skill-based assessment, rather than knowledge, in comparison to undergraduate students 2 6–8.…”

“…While completion rates are higher among graduate-entry trainees, evidence to date would suggest small differences in competencies between the two cohorts (table 1) 2 6–8. A common trend among studies performed to date is the superior performance of graduate-entry students on skill-based assessment, rather than knowledge, in comparison to undergraduate students 2 6–8. It should be noted that several confounders may affect these results including assessment type (written, objective structured clinical examination (OSCE), mini-clinical evaluation exercise (CEX)), time of assessment (foundation/clinical years) and nature of assessment (stand-alone, integrated).…”