Oxford Medicine THE NEWSLETTER OF THE OXFORD MEDICAL ALUMNI OXFORD MEDICINE . DECEMBER 2011
Selecting the next generation of Oxford-trained doctors Vast numbers of school leavers and graduates aspire to become doctors, and many of those aspire to study at Oxford. The numbers of school leavers applying for the 150 places on our standard medical course has doubled from about 750 in 2001 to more than 1500 in 2011; the number of applicants for the 30 places on our graduate-entry medical course is also about ten applicants per place (342 in 2011). More than that, given the desirability of the Oxford medical school, these applicants are already self- and school- selected as some of the highest achievers of their generation. Given this wealth of applicants, how should Oxford go about choosing those to whom we offer a place? We should first ask “What does any medical school want from the doctors it trains?” For any doctor this should be the ability to interact effectively and ethically with patients and with other professionals; competence over the increasingly broad area of medicine coupled with the ability to develop specialist skills demanded by their chosen area of work; the ability to think from basic principles and to solve problems; and — considering the pace of medical progress — and ability for self-directed learning and adaptation. Both medical courses at Oxford have always been upfront about the fact that, given we have some of the very best qualified applicants, we hope to select those who will be prominent among the movers and shakers of medicine in the future. But how should we do this, and what tools should we use? What is the evidence base for what we do? Increasingly we are also asked to demonstrate that our admissions procedures take into account the advantage or disadvantage of the candidates’ background, and that it is clear and transparent. Oxford has always been clear that the future of medicine requires a strong science base and our courses reflect this. Straight academic ability is therefore one criterion, but some evidence suggests that previous academic achievement predicts less than a third1 of the variance in success in medical school, and much less thereafter. Problem solving clearly has links with academic ability, but other abilities like team working, empathy and communication skills are also clearly important. Some of the latter develop more slowly and there are few agreed ways of assessing them.
While there are some personality traits one would arguably wish to exclude as unsuitable for medicine, a moment’s thought about the range of different jobs within medicine shows that there can be no one personality profile that would be optimum. Medical schools have devised a variety of different admissions processes and increasingly are evaluating them. Some rely largely on previous academic record; some use observed simulated tutorials, some — given the concerns about interviewer variance in single interviews — use multiple mini-interviews. A number use some form of aptitude test. What procedure has Oxford, with the added complication of its historic collegiate structure, devised to address these many considerations? Evidence from previous years when all candidates were interviewed strongly suggested that the chances of being offered a place in part could be predicted from previous academic achievement. Interviews for the standard course are therefore offered to ~450 candidates (i.e. ~3 per place) on the basis of an algorithm that uses two measures: their school academic achievement as represented by their GCSE performance (proportion of A*s (pA*)) adjusted for their school’s average performance (i.e. are they doing better or less well than the average at the school); and a biomedical aptitude (BMAT) test used by Oxford, Cambridge and some London schools, which has three sections — problem solving, GCSE science knowledge, and a short essay on a given topic — which is sat in early November. The data for pA* is very heavily skewed to the right; that for BMAT approximates to a normal distribution. The dossiers of all candidates who would not be offered an interview on the basis of the algorithm are sent to tutors who can ‘flag up’ candidates for whom the algorithm might be misleading by reason of disrupted schooling or other problems. These are then considered by a panel and the final 40 places determined on this basis. A similar process is adopted by the G-E course except that the algorithm is based on the UKCAT score and rankings by panels of tutors of the very diverse application dossiers which include those in the final year of undergraduate courses, through those with DPhils, and those with a wide variety of posteducation working experience.
Photography: Khadar Mohamed Abdul Clinical Skills Laboratory
Contents Clinical admissions to the Oxford Medical School . . . . . . . . . . . . . . . . . . . .2 OMA President’s News . . . . . . . . . . .3 A Profile of Michael Dunnill . . . . .4 The Anglo-French Medical Society . . . . . . . . . . . . . . . . . . . . . . .5 New name for NHS Trust People in the News
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Saving Oxford Medicine
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Osler House Report . . . . . . . . . . .10 Obituaries
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Alumni events
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