Variation in medical school graduates

[Spencer Wells]

This was published yesterday. Makes for an interesting read.
http://www.biomedcentral.com/1741-7015/6/5/abstract

[moin]

Obviously this article is suggesting some universities are better than others in producing doctors of higher caliber. But what really makes these universities better than the others. Is it the amount of student resources, the style of teaching? Or could it simply be because these universities tend to teach students of a higher caliber to begin with (Oxford), so even with the same kind of education these students excel over others simply because of their own steam and initiative...

[heed]

what are they taking to be a "better" doctor? good marks in MRCP/PACES ? the study looked at those sitting their MRCP, what about people who are doing MRCS, MFEM, FRCA, MRCOG, MRCPCH ? are oxford really producing better doctors (overall) than liverpool - or are they producing students who get better marks in their MRCP? Do good marks mean good doctors - even at an undergrad level there are those who have never got less than an A but who I wouldnt trust with an elastoplast.... so many questions raised, but no real answers offered

[-Petrie-]

hmmm... interesting. Especially when you consider that Oxford has the highest average spend per student in the country.

[Spencer Wells]

hmmm... interesting. Especially when you consider that Oxford has the highest average spend per student in the country.

RFUCMS is the medical school with the highest average spend per student.

To moin - the study method adjusted for standards of entry to university in terms of A level grades, but you raise interesting points in terms of motivation.

heed - the membership exams are probably the best way we have for measuring a doctor's competency, but I agree, they are a narrow set of exams and they don't examine all the qualities that you'd look for in a doctor - however, I don't believe any exam does. Passing the MRCP is the important part in career progression for a physician, and it's the thing that we have lots of data for.

[-Petrie-]

RFUCMS is the medical school with the highest average spend per student.

Ahh you're right I just checked, Oxford's second with £42,348 versus UCL's £50,103. I got mixed up, apologies.

[Jul!eT]

Hmmm... I agree with Heed - what does it really mean that they perfom better in certain exams? As a teacher, I can train any 12 year old with an average IQ to pass an exam. Does that make him a better student than a highly intelligent one who wasn't drilled on that particular test and therefore didn't pass?
The way I see it, you can go about it in different ways: Memorise loads of info tailored for passing a particular exam or teach skills and learn things that will make you a good doctor.
Also - Oxford and Cambridge are single universities. But how many medical schools does "London" include? Or "Wales"? It doesn't seem fair to compare one school's results against a bunche's combined averages... Or am I missing something?

[rjm]

This paper does not in any way suggest that certain universities produce better doctors, you cannot assume "cause and effect" from this. All it tells you is that certain uni grads have a higher pass rate for MRCP. It could be derived that they are better doctors, but passing an exam does not necessarily make you clinically a better doctor. For example, I as an F2, have passed MRCPCH part 1, but have very little clinical experience. Many ST2s have not passed this exam, but have nearly 2 years clinical experience. Does that mean that because I have passed that exam I am a better doctor. Absolutely not, practically they are better, their clinical knowledge application is probably better.
They do control for better entry grades to university and suggest this takes out having higher calibre candidates - I would be interested to know if a person that enters as a "high calibre" candidate also completes med school as one, has anyone ever done a study comparing entry grades to finals results to actually suggest this is true?
Finally, they also suggest that people who sit this exam sooner after leaving university have a better pass rate. They did not appear to look at when applicants from certain universities sit the exam, is it simply that graduates from these "better" universities are encouraged to sit the exams sooner because they have a very academic/exam achievement mentality? And do they come from more exam-centred universities?

[yazoo]

There will never be difinitive evidence that one university produces better Drs than another. Never! Not a potential UKMLE, not MRCP/S etc etc.

Also, one has to question the validity of making inferences from data collected in the 80s and 90s, as so much has changed in school exams and med education since then.

However, passing exams is important in medicine. Career progression is directly linked to exam passes. If you value choice in job selection, exams are one way of providing evidence of committment and motivation. It takes effort to pass these exams. There is a reason why some of these exams have a high fail rate, and that some people simply can't pass them.

I would say that passing post grad exams is related to being a good Dr - the final, fully qualified and trained version. But exam passes represent a minimum criteria, and it is the other things that differentiate beyond this minimum standard.

[Spencer Wells]

Wales is classed as 1 university as the date used comes from before Swansea medical school was set up, so they only have data from Cardiff. Similarly, all London graduates, until this year, received their degrees form the university of London, not whichever constituent college they went to. Therefore, the data on individual London schools is simply not available.

I'm pretty confident that I've come across at least one study which reports that those with higher A level grades get better results in med school finals. I shall try and hunt for a reference when I have more time.