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What is the effect of secondary (high) schooling on subsequent medical school performance? A national, UK-based, cohort study

Mwandigha, Lazaro M.; Tiffin, Paul A.; Paton, Lewis W.; Kasim, Adetayo S.; Böhnke, Jan R.

What is the effect of secondary (high) schooling on subsequent medical school performance? A national, UK-based, cohort study Thumbnail


Authors

Lazaro M. Mwandigha

Paul A. Tiffin

Lewis W. Paton

Adetayo S. Kasim

Jan R. Böhnke



Abstract

Objectives University academic achievement may be inversely related to the performance of the secondary (high) school an entrant attended. Indeed, some medical schools already offer ‘grade discounts’ to applicants from less well-performing schools. However, evidence to guide such policies is lacking. In this study, we analyse a national dataset in order to understand the relationship between the two main predictors of medical school admission in the UK (prior educational attainment (PEA) and performance on the United Kingdom Clinical Aptitude Test (UKCAT)) and subsequent undergraduate knowledge and skills-related outcomes analysed separately. Methods The study was based on national selection data and linked medical school outcomes for knowledge and skills-based tests during the first five years of medical school. UKCAT scores and PEA grades were available for 2107 students enrolled at 18 medical schools. Models were developed to investigate the potential mediating role played by a student’s previous secondary school’s performance. Multilevel models were created to explore the influence of students’ secondary schools on undergraduate achievement in medical school. Results The ability of the UKCAT scores to predict undergraduate academic performance was significantly mediated by PEA in all five years of medical school. Undergraduate achievement was inversely related to secondary school-level performance. This effect waned over time and was less marked for skills, compared with undergraduate knowledge-based outcomes. Thus, the predictive value of secondary school grades was generally dependent on the secondary school in which they were obtained. Conclusions The UKCAT scores added some value, above and beyond secondary school achievement, in predicting undergraduate performance, especially in the later years of study. Importantly, the findings suggest that the academic entry criteria should be relaxed for candidates applying from the least well performing secondary schools. In the UK, this would translate into a decrease of approximately one to two A-level grades.

Citation

Mwandigha, L. M., Tiffin, P. A., Paton, L. W., Kasim, A. S., & Böhnke, J. R. (2018). What is the effect of secondary (high) schooling on subsequent medical school performance? A national, UK-based, cohort study. BMJ Open, 8(5), Article e020291. https://doi.org/10.1136/bmjopen-2017-020291

Journal Article Type Article
Acceptance Date Apr 13, 2018
Online Publication Date May 23, 2018
Publication Date May 23, 2018
Deposit Date May 24, 2018
Publicly Available Date Mar 29, 2024
Journal BMJ Open
Publisher BMJ Publishing Group
Peer Reviewed Peer Reviewed
Volume 8
Issue 5
Article Number e020291
DOI https://doi.org/10.1136/bmjopen-2017-020291

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Publisher Licence URL
http://creativecommons.org/licenses/by/4.0/

Copyright Statement
© Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/





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