A new aptitude test, aimed at increasing diversity and fairness in selecting school leaver applicants for medical school, still has inherent gender and socioeconomic bias, a study finds.
The UK Clinical Aptitude Test (UKCAT) was first used in 2006 as part of the admissions process by a consortium of 23 medical and dental schools. UKCAT’s aim was to make selection to medical school fairer and more transparent. With A Level grade inflation, discriminating between large numbers of highly able applicants on their academic achievement alone has become increasingly difficult, and participation in the profession needs to be widened.
The test is an appraisal of skills such as verbal reasoning and decision analysis, and is designed to ensure that candidates have the most appropriate mental abilities, attitudes and professional behaviours to be successful in their professional careers.
To determine whether this test provides a more equitable assessment of aptitude, Professor David James and colleagues, at University of Nottingham Medical School, analysed data from the first group of applicants who sat the UKCAT in 2006 and who achieved at least three passes at A Level in their school leaving examinations.
They found a modest correlation between A Level and UKCAT scores, which confirms that the test can be used as a reasonable proxy for A Levels in the selection process.
However, the test had an inherent favourable bias to male applicants and those from a higher socioeconomic class or from independent or grammar schools.
“These findings lead us to be cautious about use of the UKCAT and the value of any one specific sub-test within an admissions policy,” conclude the authors. They also call for further research to clarify the practical value of the UKCAT in a wider range of applicants and, importantly, its predictive role in performance at medial or dental school.
In an accompanying editorial, in the BMJ, Professor David Powis, from the University of Newcastle in Australia, says that measuring cognitive ability is a step in the right direction, but it doesn’t tackle “widening participation” - the admission of people from lower socioeconomic groups or those whose education has been compromised by attending poorer schools.
And neither does UKCAT yet provide selectors with information on the non-cognitive characteristics and personal qualities that are fundamentally essential (and those that are undesirable) in the generic good doctor, he adds. This challenge remains for the future.
Read the full paper.
Read more on improving access to the profession.
THAT’s the reason medical school intake is 55-75% female
Another triumph for equality
It would be good to match UKCAT (and the London equivalent ?Gamsat) to outcome. All older consultants have done the 11 plus-and the sample UKCAT looked like it- research on us! Poor spatial awareness? Not a neurosurgeon then. Good verbal skills- perhaps a career in psychiatry. Picking up differences in shapes? Pathology is for you. Do surgeons score differently from physicians?There are many different pathways in medicine and perhaps different attributes are required. Let’s have an evidence base for what we are selecting for!