Medical school link to wide variations in pass rate for specialist exam

The authors assessed the first time pass rate for doctors who had graduated from UK medical schools for both parts of the membership exam of the Royal College of Obstetricians and Gynaecologists (MRCOG) between 1998 and 2008.

Membership is a prerequisite for doctors who want to complete specialist training in obstetrics and gynaecology.

In all, 1335 doctors took Part 1 and 822 took Part 2 MRCOG during the study period. The researchers assessed the potential impact of medical school, gender, and overall academic (A level) performance of the university's students on the pass rate.

Their analysis revealed considerable variations in the pass rate, depending on the medical school the candidate had attended.

Doctors who had studied medicine at Oxford had the highest pass rate (82.5%+), followed by graduates from Cambridge (75%), Bristol (just under 60%), and Edinburgh (57.5%) for the Part 1 exam.

At the other end of the spectrum, graduates from Southampton (just under 22%), and Wales (18%) had the lowest pass rates.

For Part 2, graduates from Newcastle upon Tyne had the highest pass rate at just under 89%, followed by those from Oxford (82%+), Cambridge (81%), and Edinburgh (78%+).

Conversely, only around half of those from Glasgow (49%+) and just over a third of those from Leicester (36%+) passed the written exam.

Overall academic performance of the university's students was associated with the pass rate in Part 1, but not in Part 2, the findings showed.

There were no gender differences in the pass rate for Part 1, but women outshone men in Part 2, with around two thirds of them making the grade (65.5%+) compared with just over half (almost 53%) of the men.

But even after taking account of the gender difference, the variation among medical school pass rates still remained.

The authors caution that variations in the performance of candidates from different medical schools are likely to be attributable to several factors, so should not be considered the sole indicator of a medical school's excellence, or otherwise.

They point to other research showing variations in medical school performance for the membership exams of the Royal Colleges of General Practitioners and Physicians, and the fellowship of the Royal College of Anaesthetists.

And they highlight the various reforms to UK undergraduate medical education that have taken place over the past two decades.

"Undergraduate and postgraduate medical education are now considered as a continuum in the training of a specialist in all fields of medicine," they write, but "little consideration is given to the effect that changes in style of learning, the curriculum and objectives of undergraduate education might have on postgraduate performance."

Provided by British Medical Journal