I agree with the concerns voiced by Koralage and Kmietowicz
(18/03/06), regarding the rising trend of candidate selecting by number
rather than face-to-face interview and true ‘holistic’ appraisal of their
potential. These changes, however, are not limited to those exiting their
basic medical training into the new Modernising Medical Careers (MMC)
process, and are also a worry for those prospective candidates wishing to
enter medical training.
With the ‘BioMedical Admissions Test’ (BMAT) already used by four UK
medical schools, and the new ‘UK Clinical Aptitude Test’ (UKCAT) due to be
enforced next year by the remainder, selectors should take care to ensure
that the tried-and-tested interview system is not hastily abandoned
altogether in favour of 'universalising' entry procedures. As this article
concurs, with the increasing numbers of ‘grade-A’ applicants for medical
places, it is agreed that there is a genuine need for methods to
differentiate the many ‘good’ from the few ‘excellent’. Certainly the
return of including A-level marks or A+ and A++ grades has been
considered, however despite being a relatively simple extra solution,
these ideas have yet to materialise. Whilst aptitude testing may be a step
in the right direction, a single extra form or an exam will never be the
solution by itself; with tomorrow’s doctor required not only to be a
scientist, but also a lawyer, a politician, a manager, a presenter, a
teacher, an author, as well as a moral and ethical carer, over-reliance on
a single test to eliminate students may lead to promising candidates being
lost from the system. Despite the BMAT’s youth, it appears that
overwhelming demand for places has already made some selectors ‘cave-in’
to the safety-net that it offers. I have met several frustrated candidates
with strong applications who were rejected without interview after failing
to secure top-marks in the BMAT, whilst ‘weaker’ candidates with higher
scores were invited to interview. The same 'rejected' candidates
subsequently gained places at 'non-BMAT' universities, whilst a number of
the high-scorers are without any offers. Hopefully the UKCAT (solely an
aptitude test rather than an aptitude and science test) will help, however
this should be utilised as an adjunct - not the a single candidate ranking
solution. As the previous letter states, in the USA and Australia the 'pay
hundreds of dollars and we guarantee good scores on the entry test'
business is booming - a great barrier to the fairness of entrance tests,
which should test potential ability and not prior cramming and knowledge.
Throughout our training we are taught to ‘treat the patient, not the
number’. Yet surprisingly, when it comes to selecting prospective and
current doctors, the systems are growing increasingly reliant upon
numbers. UK school A-level examination results have proven to correlate
with success at degree level, but has the relatively medically unexplored
territory of aptitude testing actually proven an association with success
at doctor level? Like MMC, the theory may be good, but this time the
substance and implementation should not be hurried, and should first be
approved of by both selectors and candidates alike. Applicant numbers may
rise, but with a profession’s future at stake, key changes to selection
processes should not cut corners just to simplify, universalise and
modernise the task – particularly when good candidates are lost as part of
the ‘guinea-pig’ phase. Each university still needs to have a degree of
freedom to select candidates that the tutors feel will be suited to the
unique learning environment that it offers. Appropriate assessments of the
more generic abilities required in doctors may help, but potential
students and doctors should be selected upon the strength of their whole
application, and not solely eliminated based upon the outcome of a single
score. Interviews may be scary, but they do actually work. Let’s not rush
to rid ourselves of them just yet.
1. Nadeeja Koralage. BMJ 2006 332: 675
2. Zosia Kmietowicz. BMJ 2006 332: 625
3. Jayne Parry et al. BMJ 2006; 0: bmj.38768.590174.55v1
Rapid Response:
More medicine by numbers
I agree with the concerns voiced by Koralage and Kmietowicz
(18/03/06), regarding the rising trend of candidate selecting by number
rather than face-to-face interview and true ‘holistic’ appraisal of their
potential. These changes, however, are not limited to those exiting their
basic medical training into the new Modernising Medical Careers (MMC)
process, and are also a worry for those prospective candidates wishing to
enter medical training.
With the ‘BioMedical Admissions Test’ (BMAT) already used by four UK
medical schools, and the new ‘UK Clinical Aptitude Test’ (UKCAT) due to be
enforced next year by the remainder, selectors should take care to ensure
that the tried-and-tested interview system is not hastily abandoned
altogether in favour of 'universalising' entry procedures. As this article
concurs, with the increasing numbers of ‘grade-A’ applicants for medical
places, it is agreed that there is a genuine need for methods to
differentiate the many ‘good’ from the few ‘excellent’. Certainly the
return of including A-level marks or A+ and A++ grades has been
considered, however despite being a relatively simple extra solution,
these ideas have yet to materialise. Whilst aptitude testing may be a step
in the right direction, a single extra form or an exam will never be the
solution by itself; with tomorrow’s doctor required not only to be a
scientist, but also a lawyer, a politician, a manager, a presenter, a
teacher, an author, as well as a moral and ethical carer, over-reliance on
a single test to eliminate students may lead to promising candidates being
lost from the system. Despite the BMAT’s youth, it appears that
overwhelming demand for places has already made some selectors ‘cave-in’
to the safety-net that it offers. I have met several frustrated candidates
with strong applications who were rejected without interview after failing
to secure top-marks in the BMAT, whilst ‘weaker’ candidates with higher
scores were invited to interview. The same 'rejected' candidates
subsequently gained places at 'non-BMAT' universities, whilst a number of
the high-scorers are without any offers. Hopefully the UKCAT (solely an
aptitude test rather than an aptitude and science test) will help, however
this should be utilised as an adjunct - not the a single candidate ranking
solution. As the previous letter states, in the USA and Australia the 'pay
hundreds of dollars and we guarantee good scores on the entry test'
business is booming - a great barrier to the fairness of entrance tests,
which should test potential ability and not prior cramming and knowledge.
Throughout our training we are taught to ‘treat the patient, not the
number’. Yet surprisingly, when it comes to selecting prospective and
current doctors, the systems are growing increasingly reliant upon
numbers. UK school A-level examination results have proven to correlate
with success at degree level, but has the relatively medically unexplored
territory of aptitude testing actually proven an association with success
at doctor level? Like MMC, the theory may be good, but this time the
substance and implementation should not be hurried, and should first be
approved of by both selectors and candidates alike. Applicant numbers may
rise, but with a profession’s future at stake, key changes to selection
processes should not cut corners just to simplify, universalise and
modernise the task – particularly when good candidates are lost as part of
the ‘guinea-pig’ phase. Each university still needs to have a degree of
freedom to select candidates that the tutors feel will be suited to the
unique learning environment that it offers. Appropriate assessments of the
more generic abilities required in doctors may help, but potential
students and doctors should be selected upon the strength of their whole
application, and not solely eliminated based upon the outcome of a single
score. Interviews may be scary, but they do actually work. Let’s not rush
to rid ourselves of them just yet.
1. Nadeeja Koralage. BMJ 2006 332: 675
2. Zosia Kmietowicz. BMJ 2006 332: 625
3. Jayne Parry et al. BMJ 2006; 0: bmj.38768.590174.55v1
Competing interests:
None declared
Competing interests: No competing interests