The University of Nottingham

A clinical aptitude test originally pioneered by The University of Nottingham has been proven to be a significant predictor of performance in medical students.

The UKCAT was launched in 2006 in response to a need to widen access to medical education and provide a supplementary assessment in the context of so-called A level grade inflation. The test has become a market leader in the selection process and is now used by 26 out of the 32 medical and dental schools in the UK.

Now new research into its fairness and effectiveness, published in the open access journal BMC Medicine, has revealed that the UKCAT is a powerful indicator of performance of medical students in their first year examinations.

Fair competition

The collaborative study, ‘UKCAT-12’, examined 4,811 students in 12 medical schools using the UKCAT from 2006, when it was first launched, to 2008. First year medical school exam results from these cohorts were available in 2008 to 2010.

UKCAT scores and educational attainment measures such as A-levels and Scottish Highers, were found to be significant predictors of outcome in the analysed data from the study. Overall there was a highly significant correlation between prior educational attainment and overall first year medical school mark. The UKCAT predicted outcome better in female students than male students, and better in mature than non-mature students.

Examining the data

The UKCAT-12 study used four key measures considered in turn, and in relation to each other:

• Medical school performance in the first year exams
• Two important sets of predictors (measures of prior educational attainment and scores on the UKCAT test)
• A wide range of background measures (demographic, secondary schooling, socio-economic and other measures)

Of 4,811 medical students, using a four-point outcome scale, 4,056 (84.3%) passed all their first year examinations without re-sits, 565 (11.7%) progressed from the first year after re-sits, 94 (2.0%) were required to repeat the first year, and 96 (2.0%) left the medical school following examination failure. Altogether 109 students left medical school, in 55 cases for Academic Reasons, and in 49 for non-Academic reasons (3 after repeating the first year, and 10 after passing the first year exams) and in five cases for reasons unknown.

Towards a level playing field

Medical school performance was also predicted by a contextual measure of secondary schooling, with students from secondary schools with greater average attainment at A-level (irrespective of public or private sector) performing less well. This is important information for medical schools trying to level the playing field for applicants and widen participation in the medical profession.

The results show the power of large scale studies of medical education for answering previously unanswerable but important questions about selection, education and training. The research suggests that the UKCAT is continuing to provide a more level playing field for prospective undergraduates seeking access to the medical profession.

The UKCAT-12 study: Educational attainment, aptitude test performance, demographic and socio economic contextual factors as predictors of first year outcome in a cross-sectional collaborative study of twelve UK medical schools. IC McManus, Chris Dewberry, Sandra Nicholson and Jonathan S Dowell BMC Medicine 2013, 11:244, doi:10.1186/1741-7015-11-244 http://www.biomedcentral.com/1741-7015/11/244 

UKCAT is an admission test used by 26 Universities within admissions to medicine and dentistry.  The test is taken by around 25,000 candidates a year.  The test comprises separately timed subtests assessing verbal, quantitative and abstract reasoning, decision making and situational judgement.  Further details regarding the test can be found on the UKCAT website (www.ukcat.ac.uk).