A practical problem for any comparison of medical schools is that in some countries there are relatively few of them, and comparison across countries is even harder, and we are aware of no comparable studies to the present one in the USA or elsewhere. In Aspiring to excellence: findings and recommendations of the independent inquiry into modernising medical careers, led by Professor Sir John Tooke, Available for download at https://www.medschools.ac.uk/media/2578/aspiring-to-excellence-report.pdf). A particular issue is with data based on University of London, which exist in earlier datasets whereas later datasets have the five separate London medical schools. Chester is taking only international students because of the government cap on UK medical student numbers. handing over care of a patient e.g. We are very grateful to Nick Hillman and HEPI for providing us with a complete set of data from the Student Academic Experience Surveys for 2006 to 2017; to Katie Petty-Saphon and Peter Tang for the help with HEFCE data; to Sophie Lumley, Peter Ward, Lesley Roberts and Jake Mann for providing additional data from their survey of self-regulated learning time [39]; to Hugh Alberti and colleagues for providing additional data from the survey of authentic GP teaching [26]; to Thomas Gale, Paul Lambe and Martin Roberts for providing data on rates of graduates applying for anaesthetic training (Gale T, Lambe P, Roberts M: UKMED Project P30: demographic and educational factors associated with junior doctors' decisions to apply for general practice, psychiatry and anaesthesia training programmes in the UK, Plymouth, unpublished); and to Katherine Woolf, Celia Taylor and Katie Petty-Saphon for comments on an earlier draft of the manuscript. We know of no data which can ask at present about stress levels (although that is included now in NTS), or about well-roundedness or humanitarian attitudes. However, the Bonferroni correction is probably overly conservative for social science research where zero correlations are not a reasonable prior expectation, statistical tests are not independent and not all hypotheses are of primary interest. Medical school differences: beneficial diversity or harmful deviations? Strong or moderate paths are shown in these diagrams if they directly enter or leave the measure of interest, and indirect paths to or from the measure of interest remain if they are strong (but not moderate), other paths being removed. ADS, AJa, ASo, BAP, CAC, CDAM, EL, HB, HLH, JAC, JBe, JCE, JWK, LD, NAbb, NABe, OBFR, OJ, RJS, RM, RSa, RTaj, RTNC, SD, SPh, TC, THG, TJ, TMA and WM were lead investigators at each site. Cookies policy. A large-scale meta-analysis of SJTs [80] has shown an important moderating effect of SJT question type. You're in the right place! How competitive is medical school in the UK? Professor Ian Cumming, the chief executive of Health Education England (HEE), put the position clearly when he said: Its not rocket science. Lancet. [2] There are twenty-five such schools in England, five in Scotland, two in Wales and two in Northern Ireland. Two different reviews are cited [20, 21], but reach conflicting conclusions on the specific effects of PBL. That would be a start, but it cannot take into account that different students may apply to or be selected by medical schools for a host of non-academic or non-cognitive reasons (such as location, course type etc.). 5. 5 shows no evidence for that suggestion. The UK is a popular destination for undergraduate medical students. Similarly, a number of applications to use the UK Medical Education Database (UKMED) [6] have wished to consider medical school differences, and a systematic database of UK Medical School Course Descriptors would be useful, with data at the level of medical school courses. 1 do not take into account the complex inter-correlations of Fig. Goldstein H. Multilevel statistical models. Foundation entry scores (2 measures). Self-regulated learning in the clinical context: a systematic review. 2013;11:244. https://doi.org/10.1186/1741-7015-11-244. Certainly, medical schools differ on it and those differences are reliable. When all variables are measured, rather than latent, path modelling can be carried out using a series of nested, ordered, regression models, following the approach of Kenny [66]. 5, there was moderate evidence for the null hypothesis being true in 105 (26.3%) of paths (i.e. Biometrics. Ucas, the admissions service, says fewer than 16% of applications to study medicine and dentistry resulted in an offer this year down from 20.4% in 2021. Hill AB. Without random allocation, differential application by applicants would almost inevitably result in higher qualified applicants choosing to apply to schools of perceived higher status and performance [107]. Article Pearl J, Mackenzie D. The book of why: the new science of cause and effect. London: General Medical Council Available from www.gmc-uk.org/guidance/good_medical_practice/GMC_GMP.pdf; 2014. Quartiles and deciles are normed locally within medical schools, and therefore, schools show no differences in mean scores. Medical Schools Council: Entry requirements for UK medical schools: 2020 entry. Manchester: General Medical Council (Available at https://www.gmc-uk.org/Be_prepared___are_new_doctors_safe_to_practise_Oct_2014.pdf_58044232.pdf); 2014. What is clear is that any answers need to be based on data fully describing the many differences between medical schools. Fitness to practise (2 measures). In aggregating data across years, there is also the potential problem that schools themselves may be changing, either as courses change within a single school or sometimes by the merger or fission of schools. University of Glasgow - 70% acceptance rate. While these are in part explained by lower entry grades, a surprising finding is that schools such as PBL schools which reported greater student satisfaction with feedback also showed lower performance at postgraduate examinations. Med Educ. In October 2017, the UK Royal College of Psychiatrists also suggested that. In an ideal world, data would be modelled within single cohorts of entrants and graduates into specific courses, comparing across cohorts to assess stability, and combining within-cohort causal relationships to gain statistical power (and also additional leverage on causal mechanisms). Regression lines in dark blue are for all points, pale blue for all points excluding imputed values and green for all points excluding Oxbridge (blue circles). Then look no further! 2 and 5, as well as Table1, confirm that medical schools differ in many and correlated ways. rate of production of hospital and GP specialists in the past), curricular influences (e.g. The eventual conclusions of the GMCs report are less sanguine than the suggestion that variation might not in itself [be] a cause for concern, as variation in preparedness can highlight problematic issues across medical education [which may be] tied to particular locations perhaps with causes that can be identified and addressed [1] [our emphasis]. Kumwenda B, Cleland JA, Walker K, Lee AJ, Greatrix R. The relationship between school type and academic performance at medical school: a national, multi-cohort study. A cohort study using multiple-imputation and simulation. However, he says this is currently impossible. PBL and non-PBL schools differed on a range of teaching measures. 2019. https://doi.org/10.1007/s10459-019-09938-w. Morgan H. How can recruitment be improved in obstetrics and gynaecology? You will need to complete the Academic test, which is for those who wish to study. 8b) or NSS_Feedback (r=0.049, p=0.803, blue line, Fig. Imperial College London. McManus, I.C., Harborne, A.C., Horsfall, H.L. Specialties are separated by the horizontal and vertical blue lines, with examination and non-examination measures separated by solid green lines. Data linkage comparison of PLAB and UK graduates performance on MRCP (UK) and MRCGP examinations: equivalent IMG career progress requires higher PLAB pass-marks. 5 are shown by very thick lines for BF>100, thick lines for BF>30 and medium lines for BF >10, with thin lines for moderate paths with BF >3, positive and negative path coefficients being shown by black and red lines respectively. Vienna: R Foundation for Statistical Computing (https://www.R-project.org/); 2017. The causal inter-relations between the various measures will be considered below. An exception is the clear link between higher Teach_GP and higher proportion of doctors becoming GP trainees (Trainee_GP) (Fig. Taylor CA, Gurnell M, Melville CR, Kluth DC, Johnson N, Wass V. Variation in passing standards for graduation-level knowledge items at UK medical schools. Overall schools could be classified in terms of two dimensions or factors, PBL vs traditional and structured vs non-structured, and those two summary measures are included in the current set of fifty measures. Peninsula medical school began to split into Exeter and Plymouth from 2013, but for most purposes here can be treated as one medical school, with averages used for the few recent datasets referring to them separately. Terms and Conditions, Lack of reliability attenuates correlations, so that if two measures have alpha reliabilities of, say, 0.8 and 0.9, then the maximum possible empirical correlation between them is (0.80.9)=0.85. 4. Evaluating the validity of the selection measures used for the UKs Foundation medical training programme: a national cohort study. CAS Overall, there are 276 correlations between the 24 measures. Schools that taught more general practice did have more graduates entering GP training, but those graduates performed less well in MRCGP examinations, the negative correlation resulting from numbers of GP trainees and exam outcomes being affected both by non-traditional teaching and by greater historical production of GPs. Commentary: Membership magazine of the Royal College of Physicians 2018, June 2018: 1217. 1998;75:3352. study fits in that tradition. [1] [our emphasis]. 1, with detailed differences in teaching methods and content also described in the AToMS paper [22]. Basic statistics are calculated using IBM SPSS v24, and more complex statistical calculations are carried out within R 3.4.2 [58]. Prof Ian Fussell, associate dean of education at Exeter Universitys medical school, said: We knew it would be very competitive this year and it has been. Many of Exeters places for this year are already taken because last summer the university offered medical students 10,000 and a years free accommodation to defer until 2022, after the number of successful applicants with the course as their first choice shot up from 20% to 60%. World Directory of Medical Schools: World Directory of Medical Schools. However, the data for all of the main measures used here are available in Supplementary File 2 for secondary analysis by other researchers. Correlates of F1_Preparedness were assessed by considering the 30 measures categorised as institutional history; curricular influences; selection; teaching, learning and assessment; student satisfaction (NSS); and foundation (UKFPO) in Table1. Sociol Methodol. Provided by the Springer Nature SharedIt content-sharing initiative. Alpha reliabilities could be calculated for 32 of the 50 measures and are shown in Table 1. Brit Med J. 4b; r=0.069, p=0.721), amount of anaesthetics teaching (Teach_Anaes) is uncorrelated with the numbers of anaesthetics trainees (TraineeApp_Anaes) (Fig. If those events later in a doctors career are positive or negative, then it surely makes sense, though, to talk of some schools being better than others [1]. Rushd S, Landau AB, Khan JA, Allgar V, Lindow SW. An analysis of the performance of UK medical graduates in the MRCOG part 1 and part 2 written examinations. 13 minute read Medical Schools In Uk: Are you searching for Medical Schools in the UK for International students? There is some evidence that assessment methods and standards for passing exams vary across medical schools. [1]. 1993;341:9414. Office for Students: National Student Survey - NSS. Article Several of those measures are designed to assess aspects of clinical competence, so that Cavenaghs criterion of being clinically competent is seemingly not being met. DTS is employed in the GMC as a data analyst working on the UKMED project and is a member of the UKMED Advisory Board and the UKMED Research Subgroup. Google Scholar. Most of our measures are therefore aggregated across a number of years, and for these, the reliabilities of between-medical school differences are reasonably high, with a median of 0.84. Comparing outcomes at graduation from different UK medical schools is difficult, since schools currently have no common final assessment (and indeed may set different standards [8]), although the UK Medical Licensing Assessment (UKMLA) should change that [9]. The Medical Schools Council (MSC) recommends that the number of medical students should be increased by 5,000 making a total of 14,500 graduating doctors per year. This means that while clear differences between schools can be found [8, 21], further research is impossible. The postgraduate outcome measures in the study are inevitably limited: examination performance, specialty choice, ARCP problems and GMC sanctions, and NTS perceptions. Six specialties (General Practice, Psychiatry, Anaesthetics, Obstetrics and Gynaecology, Internal Medicine, Surgery) were examined in more detail. Kenny DA. prioritising tasks effectively), 6 work environment (e.g. Dalmaijer ES, Bignardi G, Anwyl-Irvine AL, Smith TA, Siugzdaite R, Uh S et al. Clinical experience of clerks and dressers: a three-year study of Birmingham medical students. A further complication is that for a number of years some schools awarded degrees in partnership with other medical schools, such as Keele with Manchester. Lockwood DNJ, Goldman LH, McManus IC. In terms of a frequentist approach to statistics, some form of correction is therefore needed to take type I errors into account. This paper began by considering the GMCs position paper on the specific question of differences in preparedness between medical schools [1], and it is therefore worth now returning to the various thoughts of the GMC. It is a possibility therefore that feedback in medical schools differs according to teaching styles and induces different mindsets. McDaniel MA, Hartman NS, Whetzel DL, Grubb WLI. Whether variation is indeed a great merit or potentially cause for concern is actually far from clear. 1882. Privacy More research is undoubtedly needed on the details of how teaching, learning and feedback take place in medical schools. Although historical production of specialists shows no influences within Psychiatry (Hist_Psyc), O&G (Hist_OG) and Surgery (Hist_Surgery), nevertheless, Hist_GP does relate to Trainee_GP, MRCP_AKT and MRCGP_CSA, and historical production of physicians (Hist_IntMed) also relates to performance at MRCP (UK) (MRCP_Pt1, MRCP_Pt2 and MRCP_PACES). Causal inference in statistics: a primer. At the individual level, UKFPO-EPM and UKFPO-SJT correlate about 0.32, similar to the meta-analytic correlation with knowledge instructions (mean of 69 correlations=0.32, SD=0.17, n=24,656) and higher than correlations with behavioural instructions (mean of 26 correlations=0.17, SD=0.13, n=6203). Ethical permission was not therefore required. One great merit of the present system lies in the elasticity which is produced by the variety and number of educational bodies Nothing should be done to weaken the individuality of the universities [2, 3] (p.x, para 37). Bigsby E, McManus IC, McCrorie P, Sedgwick P. Which medical students like problem-based learning? 6, higher postgraduate performance in a medical school is related to nine prior measures, higher exam performance relating to higher UKFPO-SJT marks, higher entry grades, having more self-regulated learning, less NSS overall satisfaction and satisfaction with feedback, not being a post-2000 school or a PBL school and being a school with more entrants or which is historically larger. Some of those analyses were motivated by the GMCs analysis in particular of differences in preparedness and their discussions about underlying processes and mechanisms. Scattergrams for all combinations of the measures are available in Supplementary Files 3, 4, 5, 6, 7, 8 and 9, Supplementary File 3 containing an index of the scattergrams, and Supplementary Files 4, 5, 6, 7, 8 and 9 containing the 1225 individual graphs. All of the raw and imputed data used in these analyses are openly available as an Excel file in Supplementary File 2. 2023 BioMed Central Ltd unless otherwise stated. 2008;6:5 http://www.biomedcentral.com/1741-7015/6/5. Always confirm the information on medical schools' websites. Excel file of raw data and kNN-imputed data, RawAndImputedData.xlsx. See text for discussion. The various London schools underwent successive mergers in the 1980s and 1990s, but were then grouped by the GMC under a single awarding body, the University of London. It should also be emphasised, though, that many medical school differences are surprisingly stable, often across decades, as with the relative output of GPs [19] or performance on the MRCP (UK) examinations [10]. [editorial]. Bligh J, Eva K, Galbraith R, Ringsted C, van der Vleuten C, Brice J: Appendix 4: selection and assessment procedures used in selection for specialist training: report of an expert advisory panel for the Tooke enquiry (July 2007). Section 2. Raw significance levels with p<0.05 are shown, but a Tukey-corrected level is 0.05/sqrt (48)=0.0072. It demonstrates commitment and builds your story., A spokesperson for the Department for Education said: Every year we work with universities to ensure full capacity on vital courses like medicine and dentistry and that these numbers reflect Englands workforce requirements to help protect NHS services.. 2017;25:12842. It's very competitive to get into Medical School. The Guardian: University guide 2010: Medicine. Does choice of medical school affect a student's likelihood of becoming a surgeon? Excluding the two Oxbridge schools, there is a significant correlation of NSS_Feedback with GMC_PGexams (r=0.621, p=0.0005, green line, Fig. 8a of NSS_Satisn and NSS_Feedback of 0.762 (p<0.001) showing that they share much but not all their variance (blue line). Im hearing that we have several thousand medical applicants without any firm choice.. Alberti H, Randles HL, Harding A, McKinley RK. The GMC report considers a wide range of issues beyond preparedness itself, and together, they survey much of the terrain that any analysis of medical school differences must consider. It is no secret that admission to medical school is competitive. How many medical school places are there in the UK? Obstet Gynaecol. 6 is emphasised by a bright green box, and it can be seen that there are four direct causal influences upon postgraduate examination performance from prior measures, but no influences on subsequent measures. A simple description of better than others is contrasted with a value-added approach, which accepts that the students enrolled at some schools may vary in their potential. BMC Med 18, 136 (2020). Medical schools are social institutions embedded in complex educational systems, and there are potentially very many descriptive measures that could be included at all stages. 5 are generally plausible and coherent, and an overall description of them can be found in Supplementary File 1, and some are also considered in the Discussion section. Cavenagh also mentions effective recruitment strategies, the implication being that PBL schools have sometimes found it difficult to recruit medical students, which itself may be a cause of somewhat lower entry qualifications than for more traditional schools (Fig. The three direct effects upon NSS-Feedback are in parallel and hence additive (although signs can mean that they cancel out by acting in different directions as with Hist_Female and PBL_School). 7 shows scattergrams for the relationship of EntryGrades to GMC_PGexams, as well as to GMC sanctions for fitness to practise issues (GMC_Sanctions) and ARCP problems not due to exam failure (ARCP_NonExam), the latter two being discussed in Supplementary File 1. Recently, however, concerns about school differences in postgraduate performance have led the GMC itself to publish a range of outcome data for named medical schools [53], arguing that its statutory duty of regulation requires schools to be named. The environment and disease: association or causation? London: Royal College of General Practitioners: http://www.rcgp.org.uk/gp-training-and-exams/mrcgp-exam-overview/mrcgp-annual-reports.aspx; 2013. 2014;71:6676. Differences between medical schools are different from differences between individuals, and it is possible in principle for differences between individuals to be highly reliable, while differences in mean scores between medical schools show little or no reliability, and vice-versa. If so, that would mean that the primary problem is that qualification rates from different medical schools are very similar, which perhaps makes little sense given differences in both entry standards and postgraduate performance. The UKFPO-SJT almost entirely uses knowledge instructions [80] (e.g. In contrast, there are plenty of clear opinions about why medical schools might differ. BMC Med. Dowell J, Cleland J, Fitzpatrick S, McManus IC, Nicholson S, Opp T, et al. Most Medical schools require students to have either a Grade 5-9 (A*-C) in at least the five core subjects: Mathematics, English, Physics, Chemistry, and Biology. Academic attainment differences may result from differences in selection methods, as well as decisions to increase diversity or accept a wider range of student attainments (potential as the GMC puts it [1]). As well as effects on postgraduate exam performance, PBL schools have a moderate direct effect on ARCP non-exam problems, which are more frequent in graduates of PBL schools and which are not mediated via NSS-Feedback. As a result, schools producing more GP trainees perform less well in examinations, with the association driven by a history of producing GPs and having less traditional teaching, there being no direct link between producing more GP trainees and overall poorer exam performance. Lancet. Clearly, there is much here on the role of feedback that needs further investigation, at the level of schools and of students, perhaps using mixed-methods, as the negative relationship between satisfaction with feedback and subsequent exam performance needs explanation. Structural model of the causal relationships of the 29 measures in Supplementary Fig. Choice of specialty training (4 measures). The mechanism therefore is unclear. The RCP has been calling for 7,500 more medical school places to be funded each year in the UK at an annual cost of 1.85bn, but Goddard says the Treasury is blocking expansion. For all analyses, the imputed data matrix was used, for which a correlogram is shown in Fig. That was clear in the AToMS paper [22], where in terms of teaching hours alone there are dozens of measures, and in addition, there are many other statistics available, as for instance on the GMCs website, which has data on examination performance on individual postgraduate examinations, broken down by medical school. Work Psychology Group: GP selection process: summary of evaluation evidence. In recent years, it has become clear that graduates from different medical schools vary substantially in their performance on postgraduate assessments, including MRCP (UK) [10, 11], MRCGP [11,12,13,14], MRCOG [15] and FRCA [16], direct comparison being possible as the exams are identical for graduates of all medical schools. And those differences are reliable alpha reliabilities could be calculated for 32 of the government cap UK... 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