Should UK medical students sit a national qualifying exam?

YES Imagine if the best universities admitted only pupils who had been in the top 25% of ability in their particular school. This would pose a curious dilemma for parents—should they choose the best school with the highest academic standards but face the risk that their child may not be in the top quarter of ability, and so miss out on the best universities? Or should they send their children to the worst school possible where they have a better chance of being at the top of the class?

Clearly such university admissions policies would be nonsensical, but this is exactly what is happening in medical schools throughout the United Kingdom. Not only are standards set individually in each medical school, but the examinations are different and use different metrics to assess students.1 The result is that it is easier to achieve a top academic score in a medical school with weaker academic competition, and it also fails to guarantee an objective consistent standard in graduates from different medical schools.2

The foundation programme was introduced in August 2005 to modernise the process by which junior doctors apply for training jobs.3 Students from each medical school are ranked by academic quartiles, which are used in combination with short answer questions4 to help determine the first jobs of each graduate. All schools are assumed to be academically identical: “Students ranked in the top 25% of any medical school will be regarded as equivalently ranked to those in the …