Intended for healthcare professionals


Selection to medical school in Great Britain

BMJ 1999; 318 doi: (Published 03 April 1999) Cite this as: BMJ 1999;318:937

Admissions procedure at St Andrews is driven by purely academic criteria

  1. C Michael Steel, Professor in medical science.,
  2. David Jackson, Admissions officer medical science.,
  3. David W Sinclair, Prodean medical science.,
  4. Stephen R Magee, Director of admissions
  1. University of St Andrews, School of Biomedical Sciences, St Andrews, Fife KY16 9TS
  2. University of Dundee Medical School, Ninewells Hospital and Medical School, Dundee DD1 9SY
  3. St George's Hospital Medical School, London SW17 0QT
  4. Medical Research Council Biostatistics Unit, Cambridge CB2 2SR
  5. Royal Free and University College School of Medicine, Whittington Hospital, London N19 5NF

    EDITOR—Readers of McManus's paper might be misled into believing that, in 1997, it would have been unwise for a prospective medical student from an ethnic minority to apply to St Andrews.1The reality is that for those who met, or were predicted to meet, our clearly published academic entry requirements, the chance of receiving an offer was 98.5% (compared with 97% for comparably qualified white applicants). It is doubtful whether these offer rates were equalled by any other medical school in the United Kingdom.

    The difference between perception and reality can be explained as follows. First, McManus based his calculations on achieved A level or Highers grades whereas, for the former at least, selection to medical school has to be based largely on predicted grades. At St Andrews, and probably elsewhere, the relationship between predicted grades and likelihood of an offer is far from linear but shows a marked threshold effect, offer rate below the threshold being effectively zero. Second, for those applicants attempting to achieve the required entry grades at a second or third sitting, we take account of achieved grades at previous sittings and at GCSE, which were not included in McManus's dataset.

    There are other deficiencies in McManus's approach. It may, however, be sufficient to note that fewer than 50% of candidates from ethnic minorities met our academic threshold (compared with over 70% of whites), that ethnic minority applicants who were resitting had correspondingly weaker academic credentials when GCSE and first sitting A level results were assessed, and that, overall, the simple odds ratio for receiving an offer from St Andrews (ethnic minority versus white applicants) corresponds exactly to the odds ratio for meeting our academic entry requirements.

    Although the number of applicants from different subgroups taking up places in particular medical schools measures student choice …

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