Impact of performance in a mandatory postgraduate surgical examination on selection into specialty training

Abstract

BackgroundThe Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination is undertaken by large numbers of trainees in the UK and internationally as a mandatory step within surgical training. Unlike some high‐stakes medical examinations, the MRCS is yet to be validated. A quantitative study was undertaken to assess its predictive validity by investigating the relationship between MRCS (Parts A and B) and national selection interview scores for general and vascular surgery in the UK.MethodsPearson correlation coefficients were used to examine the linear relationship between each assessment, and linear regression analyses were employed to identify potential independent predictors of the national selection score. All UK medical graduates who attempted the interview in 2011–2015 were included.ResultsSome 84·4 per cent of the candidates (1231 of 1458) were matched with MRCS data. There was a significant positive correlation between the first attempt score at Part B of the MRCS examination and the national selection score (r = 0·38, P < 0·001). In multivariable analysis, 17 per cent of variance in the national selection first attempt score was explained by the Part B MRCS score and number of attempts (change in R 2 value of 0·10 and 0·07 respectively; P < 0·001). Candidates who required more than two attempts at Part B were predicted to score 8·1 per cent less than equally matched candidates who passed at their first attempt.ConclusionThis study supports validity of the MRCS examination, and indicates its predictive value regarding entry into specialist training.

Prediction of success at UK Specialty Board Examinations using the mandatory postgraduate UK surgical examination

“…Research to date has found that Part A MRCS performance predicts performance at Part B, and that Part B MRCS performance itself predicts surgical training outcomes. For example, score and number of attempts at Part B MRCS were found to be significant independent predictors of both selection into higher surgical training (HST, year 3 onwards of training) and performance during HST. Similar relationships have been observed between the written papers and clinical exams of the equivalent physician examination in the UK, the Membership of the Royal College of Physicians (MRCP), and for the Medical Licensing Examination® (USMLE®) in the USA.…”

“…Age at graduation was included, as older doctors (defined in previous studies as age 29 years or more at graduation from medical school) have been found to be more likely to have problems progressing through training in the UK.…”

“…Research to date has found that Part A MRCS performance predicts performance at Part B, and that Part B MRCS performance itself predicts surgical training outcomes. For example, score and number of attempts at Part B MRCS were found to be significant independent predictors of both selection into higher surgical training (HST, year 3 onwards of training) and performance during HST.…”

“…The MRCS is one of the most widely offered postgraduate surgical exams in the world, with over 6000 UK and overseas doctors taking it each year. MRCS comprises two parts (A and B).…”

Medical education research: aligning design and research goals

“…Positivist research questions typically focus on testing and confirming a provisional (null) hypothesis. For example, you might want to examine whether early performance predicts later performance, 5 , 6 whether students spend more time preparing web‐based compared with paper‐based portfolios, 7 or how much variance in Mini‐Clinical Evaluation Exercise (Mini‐CEX) ratings is attributable to raters' social judgments 8 . On the other hand, social constructivist research questions tend to be about hypothesis generation — they are open and exploratory, seeking to understand phenomena such as student culture in a medical school, 9 the unintended consequences of a curriculum reform, 10 or how residents learn 11 .…”