Methods of selection of students for entry to medical courses have changed in recent years to include components other than previous academic achievement (Mercer 2009
). The inclusion of alternative components of selection such as aptitude tests and some form of interview has been controversial (Powis 2008
) and the paradigm shift away from the exclusive use of academic scores has been slow (Edwards et al. 2001
). In Australia, the use of the three components: academic score, selection interview and the Undergraduate Medicine and Health Sciences Admission Test (UMAT), has been common among the undergraduate medical schools since the late 1990s. These three components are used in quite different ways in the selection processes of the various universities and each university has developed its own form of interview (Mercer 2009
The significant increase in demand for a medical education has contributed to shaping new methods of selection at both the graduate and undergraduate levels (Elliott & Epstein 2005
). A major issue in these alternative methods is the determination of a valid, reliable, fair and transparent method of distinguishing between the many applicants who are suitably academically qualified to enter a medical course. One of the major reasons for the proliferation of intellectual aptitude tests (McManus et al. 2005
) in the UK is the difficulty in distinguishing between the growing numbers of applicants achieving three A grades at A-level. A similar situation exists in Australia (Story & Mercer 2005
) with a large number of medical school applicants achieving a high Tertiary Entrance Rank (TER, ). The Australian Council of Educational Research, the developers of UMAT, specify that it is designed to assess general attributes and abilities gained through prior experience and learning; specifically, the acquisition of skills in critical thinking and problem solving, understanding people and abstract non-verbal reasoning. These abilities are considered important to the study and later practice of professions in the health sciences (Mercer & Chiavaroli 2006
). Each of these attributes is operationalised as a cognitive skill, hence UMAT assesses skills different from those assessed in the interview.
Selection into the 6-year undergraduate medical course at the UWA.
- A structured interview emphasising communication skills can add value to the selection of school-leavers into a medical course.
- The interview score was most closely associated with clinical outcomes.
- Previous academic achievement and female sex were consistent predictors of course outcomes.
- The effects of interview scores and aptitude test scores should continue to be evaluated post-graduation.
Furthermore, an understanding of the characteristics of a good doctor is evolving with general agreement from most quarters that both interpersonal and cognitive characteristics are important qualities for doctors to possess (Fones et al. 1998
; McGaghie 2002
; Cullen et al. 2003
; Powis 2008
). Foremost amongst these characteristics is the ability to communicate with peers and patients, and the selection interview has developed in its many forms in an attempt to assess such qualities (Powis 2008
; Mercer 2009
). The use of the modern structured or semi-structured interview has a relatively short and controversial history in this context (Mercer 2009
). It is costly to administer and results on its predictive validity for student performance have been inconsistent (Hughes 2002
). This has led to at least one graduate medical school in Australia abandoning its use and relying on aptitude tests and academic performance alone (Wilkinson et al. 2008
Good communication skills are seen as important attributes for both medical students and doctors. Modern medical curricula generally include units on the development of these skills, in spite of complaints from students about time spent on such courses (Rees et al. 2003
). An Australian study (Hyde et al. 2010
) which surveyed doctors recently registered to practise found that when asked which medical course areas helped them most in accessing further training, they put the area of Communication Skills training first. The authors concluded that the personal qualities of doctors were considered more influential in accessing further training than the features of a medical course. Hence, they suggested that more emphasis should be put on selecting candidates with the required attributes and they noted the implications for medical schools’ admissions criteria.
In 1998, the Faculty of Medicine and Dentistry at The University of Western Australia (UWA) introduced a new form of admission to its 6-year undergraduate MBBS course. Details can be seen in . This study reports on Standard entrants who have just completed secondary school and who comprise more than 80% of students in the course. Non-standard (some tertiary study) entry students who may have completed as little as 1 year of tertiary study have been similarly studied, but the results will not be reported in detail here, mainly due to the considerably smaller numbers involved (249 over the 11-year period) and the different academic scores used for entry (Grade Point Average, GPA). The faculty also conducts a graduate entry programme which was not included in this study.
The aim of this study was to determine the relationship between the combination of Standard (school-leaver) medical students’ entry scores and some demographic characteristics and subsequent student performance in the undergraduate course. The role of the interview score was a particular focus in the study. The study was approved by the university's Human Research Ethics Committee.