The impact of preparatory activities on medical school selection outcomes: a cross-sectional survey of applicants to the university of Adelaide medical school in 2007

Abstract

BackgroundSelection into medical school is highly competitive with more applicants than places. Little is known about the preparation that applicants undertake for this high stakes process. The study aims to determine what preparatory activities applicants undertake and what difficulties they encounter for each stage of the application process to medical school and in particular what impact these have on the outcome.MethodsA cross-sectional survey of 1097 applicants who applied for a place in the University of Adelaide Medical School in 2007 and participated in the UMAT (Undergraduate Medicine and Health Sciences Admission Test) and oral assessment components of the selection process. The main outcome measures were an offer of an interview and offer of a place in the medical school and were analysed using logistic regression.ResultsThe odds of a successful outcome increased with each additional preparatory activity undertaken for the UMAT (odds ratio 1.22, 95% confidence interval 1.11 to 1.33; P < 0.001) and the oral assessment (1.36, 1.19 to 1.55; P < 0.001) stage of selection. The UMAT preparatory activities associated with the offer of an interview were attendance of a training course by a private organisation (1.75, 1.35 to 2.27: P < 0.001), use of online services of a private organisation (1.58, 1.23 to 2.04; P < 0.001), and familiarising oneself with the process (1.52, 1.15 to 2.00; p = 0.021). The oral assessment activities associated with an offer of a place included refining and learning a personal resume (9.73, 2.97 to 31.88; P < 0.001) and learning about the course structure (2.05, 1.29 to 3.26; P = 0.022).For the UMAT, applicants who found difficulties with learning for this type of test (0.47, 0.35 to 0.63: P < 0.001), with the timing of UMAT in terms of school exams (0.48, 0.5 to 0.66; P < 0.001) and with the inability to convey personal skills with the UMAT (0.67, 0.52 to 0.86; P = 0.026) were significantly less likely to be offered an interview.ConclusionsMedical schools make an enormous effort to undertake a selection process that is fair and equitable and which selects students most appropriate for medical school and the course they provide. Our results indicate that performance in the selection processes can be improved by training. However, if these preparatory activities may be limited to those who can access them, the playing field is not even and increasing equity of access to medical schools will not be achieved.

How effective are selection methods in medical education? A systematic review

“…Some researchers have presented evidence to support the reliability and criterion‐related, incremental or predictive validity for aptitude tests including the Medical College Admission Test (MCAT), the Graduate Australian Medical School Admissions Test (GAMSAT), the Undergraduate Medicine and Health Sciences Admissions Test (UMAT), the Health Professions Admissions Test (HPAT), the UK Clinical Aptitude Test (UKCAT), the Biomedical Admissions Test (BMAT) and Qudraat (the Saudi Arabian national aptitude examination) . Other researchers are sceptical of the effectiveness of the MCAT, UKCAT, GAMSAT, UMAT, BMAT and an unspecified aptitude test . However, some evidence suggests that students selected using an aptitude test may be more able and better motivated to study medicine than those selected using a process not including an aptitude test .…”

“…according to sex, age, language status and socio‐economic status) . Other evidence suggests that aptitude tests are equitable with respect to candidate background, are affected relatively little by candidate coaching, and remain stable over time, with the possible exception of the UMAT . It is therefore important to evaluate each aptitude test in its own right in order to draw conclusions on the quality of the tool.…”

“…The differential usage of the interview method in medical student selection may underlie the mixed findings on both the reliability and validity of interviews reported above. Other research evidence suggests that candidate performance may be significantly affected by coaching . Using interviews in a selection process also presents logistical difficulties relating to the range and type of questions and interviewer subjectivity, although numerous authors report on the successful implementation of MMIs into their medical school admission processes .…”

Medical school admission test: advantages for students whose parents are medical doctors?

“…More diversity within professional groups is desirable, especially among physicians, who work with patients who hold a broad range of professions, and thus the physicians may need a broader background to understand their patients’ needs [ 26 , 28 ]. A former medical training as such may help to communicate with patients and to have a deeper insight in patients perspective: students with former medical training show better communicative and social skills and are also more successful in passing medical school [ 29 , 30 ]. One new possibility to promote this idea in Germany is the permission for a few applicants to enter medical school without a baccalaureate, but with an equivalent to a master certificate from medical-related professions [ 19 ].…”

“…Special preparations for admission tests are common in Germany, as in other countries, but results about the effects of these preparations are inconsistent [ 31 , 32 ]. In one case, applicants who attended coaching for MMI did not perform better than applicants without coaching [ 33 ], while Laurence et al [ 29 ] described the opposite effect. As Laurence reported, more than 50% of applicants with a medical background in our group talked about the admission test with relatives, but without later benefiting in the scoring.…”