Aptitude test may be fairer way of selecting medical school candidates

Medical schools that use the UK Clinical Aptitude Test (UKCAT) as part of their admissions process reduce the relative disadvantage faced by certain socioeconomic groups, finds a study published in the British Medical Journal today.

Despite efforts to improve through access to higher education, access to the professions is still largely restricted to those from relatively advantaged backgrounds. In medicine, only around 5% of entrants have parents from a non-professional background.

This desire to widen participation in medicine led to the development of the UK Clinical (UKCAT) in 2006. It assesses skills such as verbal reasoning and decision analysis and is designed to ensure that candidates have the most appropriate for a career in medicine.

But it is still not clear whether the UKCAT has addressed this issue.

So a team of researchers, led by Dr Paul Tiffin at Durham University, set out to determine whether the use of the UKCAT in the medical schools admissions process reduces the relative disadvantage encountered by certain when applying for a place at a UK medical school.

Their findings are based on 8,459 applicants to 22 UK medical schools using UKCAT as part of their admissions process in 2009.

Three levels of test usage were identified: weak use (in borderline cases only), moderate use (as a factor in deciding whether to offer an interview and/or place), and strong use (as a threshold score in deciding whether to offer an interview and/or place).

They found candidates from under-represented groups applying to schools that used the UKCAT relatively heavily (as a threshold score) did not suffer significant disadvantage. But this was not the case for applications to schools using the test more weakly (e.g. only in borderline cases).

Stronger use of the test was associated with increased proportions of males, possibly state school students and those from entering .

The study confirmed the previously reported patterns of application success rates in White/non-White applicants but reported that no significant disadvantage was observed for non-White candidates applying to medical schools with the strongest use of the UKCAT.

"Our findings suggest that placing an increased weight on an applicant's UKCAT performance significantly reduces the disadvantage faced by most candidates from under-represented sociodemographic groups," say the authors.

This may translate into higher numbers from some, but not all, relatively disadvantaged students entering the UK medical profession, they conclude.

They add that medical schools "have a duty to act in as fair a way as possible during the entire admissions process," and that the UKCAT "appears to be a tool that has the potential to produce a more level playing field for many of those seeking access to the medical profession."

More information: www.bmj.com/cgi/doi/10.1136/bmj.e1805

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