Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis
Introduction Medical admissions must balance two potentially competing missions: to select those who will be successful medical students and clinicians and to increase the diversity of the medical school population and workforce. Many countries address this dilemma by reducing the heavy reliance on...
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BMJ Publishing Group
2018-10-01
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| Series: | BMJ Open |
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| author | Jennifer Cleland Amanda J Lee Sandra Nicholson Paul Alexander Tiffin Rachel Greatrix Shona Fielding Fiona Patterson |
| author_facet | Jennifer Cleland Amanda J Lee Sandra Nicholson Paul Alexander Tiffin Rachel Greatrix Shona Fielding Fiona Patterson |
| author_sort | Jennifer Cleland |
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| description | Introduction Medical admissions must balance two potentially competing missions: to select those who will be successful medical students and clinicians and to increase the diversity of the medical school population and workforce. Many countries address this dilemma by reducing the heavy reliance on prior educational attainment, complementing this with other selection tools. However, evidence to what extent this shift in practice has actually widened access is conflicting.Aim To examine if changes in medical school selection processes significantly impact on the composition of the student population.Design and setting Observational study of medical students from 18 UK 5-year medical programmes who took the UK Clinical Aptitude Test from 2007 to 2014; detailed analysis on four schools.Primary outcome Proportion of admissions to medical school for four target groups (lower socioeconomic classes, non-selective schooling, non-white and male).Data analysis Interrupted time-series framework with segmented regression was used to identify the impact of changes in selection practices in relation to invitation to interview to medical school. Four case study medical schools were used looking at admissions within for the four target groups.Results There were no obvious changes in the overall proportion of admissions from each target group over the 8-year period, averaging at 3.3% lower socioeconomic group, 51.5% non-selective school, 30.5% non-white and 43.8% male. Each case study school changed their selection practice in decision making for invite to interview during 2007–2014. Yet, this within-school variation made little difference locally, and changes in admission practices did not lead to any discernible change in the demography of those accepted into medical school.Conclusion Although our case schools changed their selection procedures, these changes did not lead to any observable differences in their student populations. Increasing the diversity of medical students, and hence the medical profession, may require different, perhaps more radical, approaches to selection. |
| format | Article |
| id | doaj-art-5195a04d99c1499eab45856a9947d492 |
| institution | Kabale University |
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| language | English |
| publishDate | 2018-10-01 |
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| series | BMJ Open |
| spelling | doaj-art-5195a04d99c1499eab45856a9947d4922025-02-01T22:00:12ZengBMJ Publishing GroupBMJ Open2044-60552018-10-0181010.1136/bmjopen-2018-023274Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysisJennifer Cleland0Amanda J Lee1Sandra Nicholson2Paul Alexander Tiffin3Rachel Greatrix4Shona Fielding5Fiona Patterson66 Centre for Healthcare Research and Innovation, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UKFaculty of Health Sciences, Manchester Metropolitan University, Manchester, UKreader medical educationHealth Professions Education Unit, Hull York Medical School, York, UKUCAT, School of Medicine, University of Nottingham, Nottingham, UKInstitute of Applied Health Sciences, University of Aberdeen, Aberdeen, UKprofessorIntroduction Medical admissions must balance two potentially competing missions: to select those who will be successful medical students and clinicians and to increase the diversity of the medical school population and workforce. Many countries address this dilemma by reducing the heavy reliance on prior educational attainment, complementing this with other selection tools. However, evidence to what extent this shift in practice has actually widened access is conflicting.Aim To examine if changes in medical school selection processes significantly impact on the composition of the student population.Design and setting Observational study of medical students from 18 UK 5-year medical programmes who took the UK Clinical Aptitude Test from 2007 to 2014; detailed analysis on four schools.Primary outcome Proportion of admissions to medical school for four target groups (lower socioeconomic classes, non-selective schooling, non-white and male).Data analysis Interrupted time-series framework with segmented regression was used to identify the impact of changes in selection practices in relation to invitation to interview to medical school. Four case study medical schools were used looking at admissions within for the four target groups.Results There were no obvious changes in the overall proportion of admissions from each target group over the 8-year period, averaging at 3.3% lower socioeconomic group, 51.5% non-selective school, 30.5% non-white and 43.8% male. Each case study school changed their selection practice in decision making for invite to interview during 2007–2014. Yet, this within-school variation made little difference locally, and changes in admission practices did not lead to any discernible change in the demography of those accepted into medical school.Conclusion Although our case schools changed their selection procedures, these changes did not lead to any observable differences in their student populations. Increasing the diversity of medical students, and hence the medical profession, may require different, perhaps more radical, approaches to selection.https://bmjopen.bmj.com/content/8/10/e023274.full |
| spellingShingle | Jennifer Cleland Amanda J Lee Sandra Nicholson Paul Alexander Tiffin Rachel Greatrix Shona Fielding Fiona Patterson Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis BMJ Open |
| title | Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis |
| title_full | Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis |
| title_fullStr | Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis |
| title_full_unstemmed | Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis |
| title_short | Do changing medical admissions practices in the UK impact on who is admitted? An interrupted time series analysis |
| title_sort | do changing medical admissions practices in the uk impact on who is admitted an interrupted time series analysis |
| url | https://bmjopen.bmj.com/content/8/10/e023274.full |
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