Objective To assess whether A level grades (achievement) and
intelligence (ability) predict doctors' careers.
Design Prospective cohort study with follow up after 20 years by
Setting A UK medical school in London.
Participants 511 doctors who had entered Westminster Medical School
as clinical students between 1975 and 1982 were followed up in January
Main outcome measures Time taken to reach different career grades in
hospital or general practice, postgraduate qualifications obtained
(membership/fellowships, diplomas, higher academic degrees), number of
research publications, and measures of stress and burnout related to A level
grades and intelligence (result of AH5 intelligence test) at entry to clinical
school. General health questionnaire, Maslach burnout inventory, and
questionnaire on satisfaction with career at follow up.
Results 47 (9%) doctors were no longer on the Medical Register. They
had lower A level grades than those who were still on the register (P <
0.001). A levels also predicted performance in undergraduate training,
performance in postregistration house officer posts, and time to achieve
membership qualifications (Cox regression, P < 0.001; b=0.376, SE=0.098,
exp(b)=1.457). Intelligence did not independently predict dropping off the
register, career outcome, or other measures. A levels did not predict diploma
or higher academic qualifications, research publications, or stress or
burnout. Diplomas, higher academic degrees, and research publications did,
however, significantly correlate with personality measures.
Conclusions Results of achievement tests, in this case A level
grades, which are particularly used for selection of students in the United
Kingdom, have long term predictive validity for undergraduate and postgraduate
careers. In contrast, a test of ability or aptitude (AH5) was of little
predictive validity for subsequent medical careers.