Papers

Ethnic and sex differences in selection for admission to Nottingham University Medical School

David James, admissions subdean,  Lisa Driver, research associate. 

Faculty of Medicine, Queen's Medical Centre, Nottingham NG7 2UH

Correspondence to: Professor James david.james{at}nottingham.ac.uk

McManus's study of applications to medical school by students in the United Kingdom and the rest of the European Union¹ refuelled the debate about discrimination. ^{2 3} McManus showed that 18 measures were independently associated with receiving an offer.¹ Applicants disadvantaged in selection included those from ethnic minority groups and men.¹

We analysed applications to Nottingham Medical School by students from the United Kingdom and the rest of the European Union for 1997, looking at sex and ethnic group.

	Methods and results

Top Methods and results Comment References

The admissions process for applicants to University of Nottingham Medical School is detailed in the school's admissions policy document, which is reviewed annually. Copies are available to all applicants on request and obtainable from us. The process comprises four stages.

	Comment

Top Methods and results Comment References

Discrimination is "the unfair treatment of a person based on an irrational preference."² Selection by ethnic group or sex would be discriminatory because neither predicts success in a medical course or career. We believe, however, that the higher rates of offers to female and white applicants do not represent discrimination. They arise at the academic and questionnaire stages, which are objectively scored without reference to ethnic group or sex. Indeed, at the statement review and interview, where true discrimination could operate, non-white and male applicants are significantly more likely to be offered a place.

Selection on the basis of academic ability is reasonable: a proved relation exists between this and success on a medical undergraduate course.⁴ Our unpublished data for the first 21 years of Nottingham Medical School show that scores at O level or GCSE and A level are significant independent predictors of success at all stages of the course. Unlike in McManus's study, for most applicants we can select only on achieved GCSE and predicted A level grades rather than achieved A level grades.

Nottingham Medical School is the only one to use a questionnaire in selection. It aims at avoiding discrimination by consistently scoring, for all academically suitable applicants, non-academic factors considered relevant to a career in medicine. We now question, however, whether such factors accurately reflect suitability for medicine. Our goal is that selection is only on the basis of evidence based predictors of success, including perhaps psychometric testing.⁵

We encourage all medical schools in the United Kingdom to examine their admission practices as we have done to ensure that the process is fair and non-discriminatory.

	Acknowledgments

   Contributors: DJ initiated the research and participated in collecting and analysing the data and in writing the paper. LD participated in data collection and analysis and writing the paper. DJ is guarantor for the study.

	Footnotes

Funding: No additional funding.

Competing interests: None declared.

	References

Top Methods and results Comment References

1.	McManus IC. Factors affecting likelihood of applicants being offered a place in medical schools in the United Kingdom in 1996 and 1997: prospective study. BMJ 1998; 317: 1111-1117[Abstract/Free Full Text].
2.	Collier J, Burke A. Racial and sexual discrimination in the selection of students for London medical schools. Med Educ 1986; 20: 86-90[Medline].
3.	McManus IC, Richards P, Winder BC, Sproston KA, Styles V. Medical school applications from ethnic minority groups: identifying if and when they are disadvantaged. BMJ 1995; 310: 496-500[Abstract/Free Full Text].
4.	McManus IC, Richards P. Prospective survey of performance of medical students during preclinical years. BMJ 1986; 293: 124-127.
5.	Powis D. How to do it: select medical students. BMJ 1998; 317: 1149-1151[Free Full Text].

(Accepted 11 March 1999)