Aptitude test fairer way of selecting medical school candidates

Medical schools that use the UK Clinical Aptitude Test (UKCAT) as part of their admissions process may create a more level playing field for candidates from disadvantaged background, finds a study published on bmj.com today.

The findings are based on 8459 applicants to 22 UK medical schools, using UKCAT as part of their admissions process in 2009.

Despite efforts to improve social mobility through access to higher education, access to the professions is still largely restricted to those from relatively advantaged backgrounds. Only around 5% of medical school entrants have parents from a non-professional background.

The UK Clinical Aptitude Test (UKCAT) was developed to address this by assessing skills, such as verbal reasoning and decision analysis, to ensure that candidates have the most appropriate abilities for a career in medicine.

But it has not been clear whether it has actually succeeded.

An assessment of the test applied by the 22 UK medical schools found three levels of use: weak (in borderline cases only), moderate (as a factor in deciding whether to offer an interview and/or place), and strong (as a threshold score in deciding whether to offer an interview and/or place).

They found candidates from under-represented groups applying to schools that used the UKCAT as a threshold score did not suffer significant disadvantage. But this was not the case for applications to schools using the test only in borderline cases.

Stronger use of the test was associated with increased proportions of men, possibly state school students and those from disadvantaged backgrounds entering medical school.

The study confirmed the previously reported patterns of application success rates for applicants, irrespective of their ethnic background, but additionally found no significant disadvantage for non-white candidates applying to medical schools with the strongest use of the UKCAT.

“Our findings suggest that placing an increased weight on an applicant’s UKCAT performance significantly reduces the disadvantage faced by most candidates from under-represented sociodemographic groups,” the authors write.

This may translate into higher numbers from some, but not all, relatively disadvantaged students entering the UK medical profession, they conclude.

Medical schools “have a duty to act in as fair a way as possible during the entire admissions process,” they say, adding that the UKCAT “appears to be a tool that has the potential to produce a more level playing field for many of those seeking access to the medical profession.”

Meanwhile a commentary in The Lancet says that medical school candidates should be required have an ‘A’ level or equivalent qualifications in physics to be better able to diagnose and treat their patients.

Professor Sir Peter Knight, President of London’s Institute of Physics, says that the UK has reversed its long term decline in the number of students taking A level physics or the equivalent, and physics teachers.

“Against this background, I would ask medical schools to consider restoring the requirement for applicants to hold A level or equivalent qualifications. Understanding the physics that underpins [new physics based techniques for diagnosis and treatment] would be a real advantage to medical practitioners, and to their patients,” he suggests.