School exam results matter in medical job applications
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《英国医生杂志》
EDITOR—Last month's report from the Working Group on 14-19 Reform announced 6-7 point assessment scales reforming current A level grading, welcoming counteraction of grade inflation and findings that A level mathematics fail to meet higher education needs.1-3
McManus et al identified speed of career progression and attainment of postgraduate qualifications as indicators of vocational success in medicine.4 These principal outcome measures were used to justify the use of A level results as intelligence indicators during selection for medical school.
However, A level results continue to exert a post-selection bias during postgraduate training, and nowadays, these indicators can inversely correlate with vocational success if applicants undertake full time postgraduate research or general medical or surgical training.
We surveyed 51 registrars in various specialties in London to test the hypothesis that A levels influence postgraduate medical applications and career progression. Fifty of them had time to answer standard questions anonymously.
Eleven reported having been asked for A level results at or before interview and 28 had put A level results on CVs during postgraduate medical applications. Furthermore, 37 knew of colleagues who had used A level results for these applications, and only three doubted that colleagues had used A level results at all.
This shows that A level results are used in postgraduate medical recruitment. It indicates "expectancy effects" influencing training and advancement, casting doubt on A levels as independent, proved intelligence predictors, useful in anticipating career success.
The universities of Oxford and Cambridge and University College London use the biomedical admissions test (BMAT, www.bmat.org.uk/) to aid selection of candidates with predicted As at A level. A study of Nottingham medical students found that only high GCSE grades were consistent independent predictors of success during both preclinical and clinical studies.5 BMAT and GCSE results are currently less likely to influence the postgraduate selection process, although they would be better markers to test as "intelligence predictors" of medical success than A levels.
The BMAT might also apply to school leavers from outside England and Wales. Twenty three per cent of hospital consultants in the United Kingdom were foreign graduates in 2002 (Department of Health, medical and dental workforce status. www.dh.gov.uk/PublicationsAndStatistics/Statistics/fs/en), as were a fifth of the registrars in our study. Of course, once a marker is identified as a predictor of success, it will undoubtedly feature in the future application process and thus select itself, regardless of its underlying worth.
R E Weir, visual science research fellow
Institute of Ophthalmology, London EC1V 9EL
F H Zaidi, visual science research fellow
Department of Ophthalmology, Imperial College, London W6 8RP
D E J Whitehead, senior house officer
Charing Cross Hospital, Ear Nose and Throat, London W6 8RF
R E MacLaren, lecturer in human anatomy
Merton College, University of Oxford, Oxford OX1 4JD
Competing interests: None declared.
References
Working Group on 14-19 Reform. 14-19 curriculum and qualifications reform. Interim report, February 2004. Available at www.14-19reform.gov.uk/docs_general/ (accessed 27 Feb 2004).
Lea R. A business blueprint for reform. London: Institute of Directors Education and Training, 2002.
Smith A. Making mathematics count. Report of Professor Adrian Smith's inquiry into post-14 mathematics education, 24 February 2004. Available at www.mathsinquiry.org.uk/ (accessed 27 Feb 2004).
McManus IC, Smithers E, Partridge P, Keeling A, Fleming P. A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study. BMJ 2003;327: 139-42.
James D, Chilvers C. Academic and non-academic predictors of success on the Nottingham undergraduate medical course 1970-1995. Med Educ 2001;35: 1056-64.
McManus et al identified speed of career progression and attainment of postgraduate qualifications as indicators of vocational success in medicine.4 These principal outcome measures were used to justify the use of A level results as intelligence indicators during selection for medical school.
However, A level results continue to exert a post-selection bias during postgraduate training, and nowadays, these indicators can inversely correlate with vocational success if applicants undertake full time postgraduate research or general medical or surgical training.
We surveyed 51 registrars in various specialties in London to test the hypothesis that A levels influence postgraduate medical applications and career progression. Fifty of them had time to answer standard questions anonymously.
Eleven reported having been asked for A level results at or before interview and 28 had put A level results on CVs during postgraduate medical applications. Furthermore, 37 knew of colleagues who had used A level results for these applications, and only three doubted that colleagues had used A level results at all.
This shows that A level results are used in postgraduate medical recruitment. It indicates "expectancy effects" influencing training and advancement, casting doubt on A levels as independent, proved intelligence predictors, useful in anticipating career success.
The universities of Oxford and Cambridge and University College London use the biomedical admissions test (BMAT, www.bmat.org.uk/) to aid selection of candidates with predicted As at A level. A study of Nottingham medical students found that only high GCSE grades were consistent independent predictors of success during both preclinical and clinical studies.5 BMAT and GCSE results are currently less likely to influence the postgraduate selection process, although they would be better markers to test as "intelligence predictors" of medical success than A levels.
The BMAT might also apply to school leavers from outside England and Wales. Twenty three per cent of hospital consultants in the United Kingdom were foreign graduates in 2002 (Department of Health, medical and dental workforce status. www.dh.gov.uk/PublicationsAndStatistics/Statistics/fs/en), as were a fifth of the registrars in our study. Of course, once a marker is identified as a predictor of success, it will undoubtedly feature in the future application process and thus select itself, regardless of its underlying worth.
R E Weir, visual science research fellow
Institute of Ophthalmology, London EC1V 9EL
F H Zaidi, visual science research fellow
Department of Ophthalmology, Imperial College, London W6 8RP
D E J Whitehead, senior house officer
Charing Cross Hospital, Ear Nose and Throat, London W6 8RF
R E MacLaren, lecturer in human anatomy
Merton College, University of Oxford, Oxford OX1 4JD
Competing interests: None declared.
References
Working Group on 14-19 Reform. 14-19 curriculum and qualifications reform. Interim report, February 2004. Available at www.14-19reform.gov.uk/docs_general/ (accessed 27 Feb 2004).
Lea R. A business blueprint for reform. London: Institute of Directors Education and Training, 2002.
Smith A. Making mathematics count. Report of Professor Adrian Smith's inquiry into post-14 mathematics education, 24 February 2004. Available at www.mathsinquiry.org.uk/ (accessed 27 Feb 2004).
McManus IC, Smithers E, Partridge P, Keeling A, Fleming P. A levels and intelligence as predictors of medical careers in UK doctors: 20 year prospective study. BMJ 2003;327: 139-42.
James D, Chilvers C. Academic and non-academic predictors of success on the Nottingham undergraduate medical course 1970-1995. Med Educ 2001;35: 1056-64.