School exam results matter in medical job applications

BMJ 2004; 328 doi: https://doi.org/10.1136/bmj.328.7439.585-a (Published 04 March 2004) Cite this as: BMJ 2004;328:585
  1. R E Weir, visual science research fellow1,
  2. F H Zaidi, visual science research fellow2,
  3. D E J Whitehead, senior house officer3,
  4. R E MacLaren, lecturer in human anatomy4
  1. Institute of Ophthalmology, London EC1V 9EL
  2. Department of Ophthalmology, Imperial College, London W6 8RP
  3. Charing Cross Hospital, Ear Nose and Throat, London W6 8RF
  4. Merton College, University of Oxford, Oxford OX1 4JD

    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.13

    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.


    • Competing interests None declared


    View Abstract

    Sign in

    Log in through your institution

    Free trial

    Register for a free trial to thebmj.com to receive unlimited access to all content on thebmj.com for 14 days.
    Sign up for a free trial