Do school exams predict doctors' success?: Author's reply

BMJ 2003; 327 doi: https://doi.org/10.1136/bmj.327.7418.810-b (Published 02 October 2003) Cite this as: BMJ 2003;327:810
  1. I C McManus (i.mcmanus{at}ucl.ac.uk), professor of psychology and medical education
  1. Department of Psychology, University College London, London WC1E 6BT

    EDITOR—A levels should not be the sole basis for the selection of students. Our study assessed only some of the skills possessed by good doctors, and A levels predicted only some of them.

    A casual reader might see the partial validation of A levels as the main finding of our study. Equally important though, with government and pressure groups arguing that A levels might be better replaced by “aptitude tests,” is the negative finding of the minimal predictive value of intelligence. That matters when, to answer a question of Chaturvedi and Chaturvedi, medical schools in the United Kingdom and elsewhere are using tests such as GAMSAT and BMAT, which partly measure intellectual ability.

    Chaturvedi and Chaturvedi say our use of prospective is rather misleading. If they have been misled it probably results from their own idiosyncratic definition of prospective. Dictionaries define prospective study as synonymous with cohort study, follow up study, and longitudinal study.1 2 Bland describes how in a prospective design, “We take a group of people, the cohort… We then follow them over time.”3 That is what we also did.

    Chaturvedi and Chaturvedi also say that at the start no prospective study was planned. The reality is that Chaturvedi and Chaturvedi were not present in 1975, and their retrospective analysis of the late Peter Fleming's intentions is wrong; from my discussions with him from 1988 onwards, a long term follow up had always been intended.


    • Competing interests None declared.


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