Predictors of success in a cohort of medical students

Secondary school results were compared with personality test scores as predictors of achievement in medical school in a study of a cohort of students, using simple correlation and multiple linear regression. The cohort of 151 students completed 28 courses in the 6 years. We have previously reported that the scores obtained could be reduced to five independent factors: 'physical science'; 'biological science'; 'paraclinical science'; 'basic clinical science'; and 'clinical science'. Both secondary school scores and personality test scores correlated with medical school achievement factors, but school scores correlated best with 'physical' and 'biological' science. Considering secondary school scores, English was the best predictor of 'clinical science', physics was the best predictor of 'basic clinical science' and scores obtained in physics and languages were better predictors of medical school 'biological science' than was school biology. Personality factors were better predictors of 'biological', 'paraclinical' and 'clinical science' than secondary school scores and the combined secondary school score (CSS) was the best predictor of 'physical science' and of 'overall achievement'. We conclude that incorporation of personality measurement with school academic achievement could be of value in selection procedures for applicants for medical school.     

Demographic and socio-economic associations with academic attainment (UCAS tariff scores) in applicants to medical school

BACKGROUND: In the United Kingdom medical students are selected predominantly on their academic merit. Their academic achievement marks are equated via the tariff point score structure administered by the Universities and Colleges Admissions Service (UCAS). We studied the applicant databases for 1998-2003 for one English medical school to determine the factors that predict high tariff point scores. METHODS: Complete demographic data and relative socio-economic status, educational institution attended and tariff point score was available for 8997 UK applicants aged 21 years or younger to the 5-year Bachelor of Medicine/Bachelor of Surgery (BM BS) course at Nottingham University medical school (and partially complete data for a further 1891 applicants). The data were subjected to standard univariate and multivariate analyses and to path analysis. RESULTS: In these samples, the independent predictors of a high tariff point score were being younger and male. The effect sizes were small, although significant. Higher tariff point scores were achieved by those from households less materially disadvantaged. Ethnicity was also a predictor with white, Chinese and those of mixed ethnic origin achieving higher tariff point scores than those from other groups. Finally, the type of school attended predicted academic achievement with applicants from further education colleges, independent schools and grant-maintained schools achieving higher tariff point scores. CONCLUSION: Notwithstanding the relatively homogeneous (predominantly young, white, high academic achievers) applicant pool to a single UK medical school we identified consistent significant predictors of high tariff point scores. As high tariff point scores are still the major entry criterion to UK medical schools, our findings will be of value in informing policy decisions concerning 'widening access' schemes being established at government request.     

School results as predictors of medical school achievement

In Queensland, scores in the final 2 years of secondary school scaled by an independent aptitude test are used to determine admission to tertiary education. The validity of this procedure for medical school enrollment has been investigated. Data were from four cohorts which entered the medical school to commence the course in each of the years 1975-1978, a total of 943 students. In addition to the school subject scores, overall order of merit scores and results of an independent aptitude test used to scale these scores were included with the predictors. Criteria were derived from the grades obtained in the 33 medical school subjects over the 6-year course, or from a broad pass/fail classification. We demonstrate that the school science subjects were of moderate value for prediction of preclinical achievement, but that school English was the most important predictor of performance in the clinical years, which is perhaps an indication of the value of communication skills.     

Factors in medical school that predict postgraduate mental health problems in need of treatment. A nationwide and longitudinal study

CONTEXT: Physicians show an increased prevalence of mental health problems, the first postgraduate years being particularly stressful. OBJECTIVES: To study the prevalence of mental health problems during the fourth postgraduate year, and to investigate whether it is already possible to predict such problems at medical school. SUBJECTS: A cohort of medical students (n=396) from all Norwegian universities, who were approached in their graduating semester (baseline) and in their fourth postgraduate year. METHODS: A nationwide and longitudinal postal questionnaire survey, including measures of perceived mental health problems in need of treatment, personality, perceived stress and skills, and ways of coping. Data were analysed using logistic regression. RESULTS: Mental health problems in need of treatment during the fourth postgraduate year were reported by 17.2% (n=66), with no gender difference, possibly because of a higher prevalence among the men compared with the general population. A majority had not sought help. Univariate medical school predictors of mental health problems included: previous mental health problems; not being married/cohabitant; the personality traits 'vulnerability' (or neuroticism) and 'reality weakness'; perceived medical school stress, and lack of perceived diagnostic skills. In addition, the coping variables avoidance, blamed self and wishful thinking were univariate predictors. Multivariate analysis identified the following adjusted predictors: previous mental health problems; 'intensity' (extraversion); perceived medical school stress, and wishful thinking. Medical school variables were inadequate for predicting which individual students would experience postgraduate mental health deterioration. However, the perceived medical school stress instrument may be used for selecting a subgroup of students suitable for group-oriented interventions.     

Training for medical teachers: a UK survey, 1993†

Summary: Opportunities and resources for training of medical teachers have been criticized in recent UK reports. A survey of undergraduate and postgraduate medical deans showed that training courses were available at most institutions, though only a few were specifically designed for medical teachers. Many new and specific courses are being planned and many new appointments are being made in medical education at both medical school and postgraduate levels. While the outcome of greater resources for training of medical education cannot yet be determined, we conclude that criticisms are being speedily addressed.     

Medical education: the discontinuers' view point

A postal questionnaire was distributed to all students who had discontinued, for any reason, their studies at Aberdeen Medical School. Opinions were sought about their experiences while there, as well as their reactions to the discontinuation therefrom. Claiming that learning to cope with stress was an essential aspect of their professional development, these students were dissatisfied with the extent to which the staff responded to students in need and took their problems not to professional welfare agencies but mainly to family and friends. Almost unanimously they supported the notion of a Student Counselling Service. Problems of adaptation and content of studies were the two items regarded as having made the greatest contribution to their discontinuation. For some of these students and their families, discontinuation had been a distressing experience, but all but one student agreed that they had gained something from their period at medical school, however brief. The medical school can learn much from those who pass out prematurely and not only from those successful on the final day.     

The modified essay question: an evaluation of its use in a family medicine clerkship

This paper describes the extensive experience of the Department of Family Medicine at Jefferson Medical College in utilizing the modified essay question (MEQ) as a final examination for its required third-year clerkship in family medicine. The results of a preliminary study are presented, comparing the MEQ as a method of evaluation with the multiple choice question (MCQ) format on similar content material. MCQ performance was found to be a better predictor of National Board Part I and II scores, but neither format was found to be a good predictor of postgraduate performance. The data were statistically significant (P less than 0.05) that MEQ performance was related to postgraduate performance in the area of professional attitude while the MCQ was not; however, the number of students in the analysis was small. Additional studies are planned to test this hypothesis further.     

Achievement factors and personality in a cohort of medical students

Factor analysis has been used to identify achievement factors in tests attempted by a student cohort during a 6-year medical course.
In the second year of the course students completed a battery of psychometric tests which measured both cognitive and non-cognitive personality traits. Scores derived from these personality tests were used as predictors of the achievement factors.
The cohort completed 28 courses in the 6 years. Analysis of grades reported for these courses demonstrated five independent factors which could be labelled: (a) basic physical science; (b) biological science; (c) paraclinical science; (d) basic clinical science; (e) clinical science.
Over 24% of the variance of the factor scores in 'biological science' could be predicted from psychometric test scores. In contrast no measured personality trait contributed significantly to achievement in 'basic clinical science'. Over 12% of the variance could be predicted for achievement in 'paraclinical' and 'clinical science' while 6% of the variance could be predicted for 'physical science'.
Personality profiles favouring achievement differed significantly between achievement factors. In some cases attributes favouring achievement in one factor operated against achievement in another. In particular, a personality trait associated with extroversion favoured achievement in 'clinical science' but operated against achievement in 'biological science'.
Consideration is given to the use of psychometric tests as a tool for the selection of candidates proposing to enter the medical faculty.     

Selecting candidates for a medical school: an evaluation of a selection model based on cognitive and personality predictors

Two studies were conducted to attempt to evaluate the selection procedures used in Hadassah Medical School. The predictors assessed were the Israeli high school matriculation examinations, a general aptitude test, an interview and a semi-projective test designed to assess personality pathology. In the first study 145 students of the 1975 and 1976 cohorts were assessed, the criteria being a combination of peer evaluations, evaluation of supervisors and academic record. Results showed the matriculation average score to be the only effective predictor for all criteria. In the second study 155 students of the 1979, 1980 and 1981 cohorts were assessed, the criteria being evaluation of supervising doctors, BSc grades and grades during the clinical period. Results again indicated that the matriculation test is the most effective predictor. In this study, however, the other variables added to the prediction of criteria based on clinical evaluations. The results were discussed, raising several possible explanations for the relatively high validity of the matriculation scores. It was suggested the matriculation scores capture personality dimensions, such as motivation and adjustment to the learning environment, which are important factors for success in medical training.     

An assessment of academic performance and personality

This study examines whether personality profiles, using personality factors, or clusters of personality factors, are associated with academic success. One hundred and forty medical students of the University of Wales College of Medicine were invited to complete a personality questionnaire (Cattell 16 PF) as they sat their final examinations in June 1988. A total of 129 usable forms were obtained. The students were divided into four groups dependent on their academic performance, which had been monitored throughout the course. The majority (62%) had no academic problems, but 16 (12%) students had serious difficulties, which entailed delaying qualification by at least 6 months. There was no relationship between the scores obtained for the students' first attempt at A-level and their subsequent medical school academic performance. However, students who obtained a degree either before or during their medical course were significantly less likely to have academic problems. Academic success was not associated with any of Cattell's personality factors. This was true of previously reported groups of factors associated with the poor student performance, and regardless of first or second order factors. We conclude that this personality profile is unlikely to be helpful in selecting future intakes of medical students, although a prospective study would be required for a definite answer to this question.