Private school students perform less well at medical school

Students from private and grammar schools perform less well at medical school than students from non-selective schools, a study has found.1

The study analysed the first year exam results of 4811 students at 12 UK medical schools, in light of their performance in the UK Clinical Aptitude Test (UKCAT). It found that students from grammar and private schools performed less well than those educated at non-selective schools. This was despite recent findings that private school pupils are still disproportionately represented in medical schools.2

Using data from secondary schools in England, the study also found that students who came from secondary schools with higher achievement in key stage five or A-levels performed less well in their first year medical exams.

Commenting on the findings, Chris McManus, professor of psychology and medical education at University College London and one of the study’s authors, said, “In predicting performance within medical school, there was a negative effect of attending a school with high average A-level points.

“A grade of AAA from a typical high achieving (selective) school resulted in medical school achievement equivalent to a grade of AAB from a typical lower achieving (non-selective) school.

“The underachievement of those from high achieving schools was broadly similar in size to the effect of being a non-mature student, of being a non-white student, or of being male.”

McManus said that there were two possible reasons behind the findings. “One is that [these students] have been buoyed up by the other people at the school, and the other is that the school is polishing them in some way and is getting an extra grade or two out of them. But when they go to medical school, where you’re very much on your own, then that doesn’t help them anymore.”

The study also found that the UKCAT was better at predicting how well female students would perform at university than male students. This finding was, the researchers said, “reflecting in part the fact that males do less well at medical school but somewhat better overall at UKCAT.” McManus said that the subtests within the UKCAT were a “bit skewed” towards tests in which men traditionally performed well but that it was still unclear why men did better than women.

The study also found that the UKCAT was better at predicting how well mature students would do at medical school than non-mature students. “That’s something that the medical schools are quite pleased with,” McManus said. “They are a difficult group in whom to make good predictions . . . Finding that UKCAT works better for them is actually quite a useful test.”

McManus said that one of the most important findings of the study was that UKCAT had “some predictive value,” even when educational attainment was taken into account. “That suggests there is probably more to what’s going on than people have thought in the past—these tests have got some utility,” he said. “What we’re not sure about is how much better they could become.”