Predictive value of the admissions process and the UK Clinical Aptitude Test in a graduate-entry dental school

Abstract Objective To determine whether the sensitivity and specificity of SNP chips are adequate for detecting rare pathogenic variants in a clinically unselected population. Design Retrospective, population based diagnostic evaluation. Participants 49 908 people recruited to the UK Biobank with SNP chip and next generation sequencing data, and an additional 21 people who purchased consumer genetic tests and shared their data online via the Personal Genome Project. Main outcome measures Genotyping (that is, identification of the correct DNA base at a specific genomic location) using SNP chips versus sequencing, with results split by frequency of that genotype in the population. Rare pathogenic variants in the BRCA1 and BRCA2 genes were selected as an exemplar for detailed analysis of clinically actionable variants in the UK Biobank, and BRCA related cancers (breast, ovarian, prostate, and pancreatic) were assessed in participants through use of cancer registry data. Results Overall, genotyping using SNP chips performed well compared with sequencing; sensitivity, specificity, positive predictive value, and negative predictive value were all above 99% for 108 574 common variants directly genotyped on the SNP chips and sequenced in the UK Biobank. However, the likelihood of a true positive result decreased dramatically with decreasing variant frequency; for variants that are very rare in the population, with a frequency below 0.001% in UK Biobank, the positive predictive value was very low and only 16% of 4757 heterozygous genotypes from the SNP chips were confirmed with sequencing data. Results were similar for SNP chip data from the Personal Genome Project, and 20/21 individuals analysed had at least one false positive rare pathogenic variant that had been incorrectly genotyped. For pathogenic variants in the BRCA1 and BRCA2 genes, which are individually very rare, the overall performance metrics for the SNP chips versus sequencing in the UK Biobank were: sensitivity 34.6%, specificity 98.3%, positive predictive value 4.2%, and negative predictive value 99.9%. Rates of BRCA related cancers in UK Biobank participants with a positive SNP chip result were similar to those for age matched controls (odds ratio 1.31, 95% confidence interval 0.99 to 1.71) because the vast majority of variants were false positives, whereas sequence positive participants had a significantly increased risk (odds ratio 4.05, 2.72 to 6.03). Conclusions SNP chips are extremely unreliable for genotyping very rare pathogenic variants and should not be used to guide health decisions without validation.

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Listening to student voice-understanding student and faculty experience at two UK graduate entry programmes

BMC Medical Education ◽

10.1186/s12909-021-02634-7 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

M. Abdulhadi Alagha ◽

Linda Jones

Keyword(s):

Sense Of Self ◽

Field Analysis ◽

Small Scale ◽

Successful Implementation ◽

Graduate Entry ◽

Self Regulated Learning ◽

Point Of Entry ◽

Shortage Of Physicians ◽

Elite Interviews ◽

The Uk

Abstract Context Shortage of physicians in the UK has been a long-standing issue. Graduate entry medicine (GEM) may offer a second point of entry for potential doctors. However, the challenges of developing and implementing these programmes are still unrecognised. This small-scale study aimed to briefly explore the opportunities and challenges facing students at two UK GEM programmes. Methods Two case studies were conducted at Imperial College and Scotland’s GEM (ScotGEM) and used a triangulated qualitative approach via semi-structured and elite interviews. Data analysis, informed by grounded theory, applied thematic and force-field analysis in an empirical approach to generate evidence and instrumental interpretations for Higher Education Institutions. Results Although GEM forms an opportunity for graduates to enter medicine, the different drivers of each programme were key in determining entry requirements and challenges experienced by postgraduates. Three key dilemmas seem to influence the experiences of learners in GEM programmes: (a) postgraduate identity and the everchanging sense-of-self; (b)self-directed and self-regulated learning skills, and (c) servicescape, management and marketing concepts. Conclusions Graduate entry programmes may support policy makers and faculty to fill the workforce gap of healthcare professionals. However, their successful implementation requires careful considerations to the needs of graduates to harness their creativity, resilience and professional development as future healthcare workers.

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Are efforts to attract graduate applicants to UK medical schools effective in increasing the participation of under-represented socioeconomic groups? A national cohort study

BMJ Open ◽

10.1136/bmjopen-2017-018946 ◽

2018 ◽

Vol 8 (2) ◽

pp. e018946 ◽

Cited By ~ 5

Author(s):

Ben Kumwenda ◽

Jennifer Cleland ◽

Rachel Greatrix ◽

Rhoda Katharine MacKenzie ◽

Gordon Prescott

Keyword(s):

Medical Student ◽

Medical School ◽

Student Population ◽

Multiple Logistic Regression ◽

Sociodemographic Characteristic ◽

Universities And Colleges ◽

Graduate Entry ◽

Socioeconomic Groups ◽

National Cohort ◽

The Uk

IntroductionAttracting graduates was recommended as a means of diversifying the UK medical student population. Graduates now make up nearly a quarter of the total medical student population. Research to date has focused on comparing the sociodemographic characteristics of applicants to and/or students on traditional and graduate entry programmes (GEMs), yet GEMs account for only 40% of the graduate medical student population. Thus, we aimed to compare the sociodemographic characteristic and outcomes of graduates and non-graduate applicants across a range of programmes.MethodsThis was an observational study of 117 214 applicants to medicine who took the UK Clinical Aptitude Test (UKCAT) from 2006 to 2014 and who applied to medical school through Universities and Colleges Admissions Service (UCAS). We included applicant demographics, UKCAT total score and offers in our analysis. Applicants were assigned as graduates or non-graduates on the basis of their highest qualification. Multiple logistic regression was used to predict the odds of receiving an offer, after adjusting for confounders.ResultsIrrespective of graduate or non-graduate status, most applicants were from the highest socioeconomic groups and were from a white ethnic background. Receiving an offer was related to gender and ethnicity in both graduates and non-graduates. After adjusting for UKCAT score, the OR of an offer for graduates versus non-graduates was approximately 0.5 (OR=0.48, 95% CI 0.46 to 0.49).DiscussionOur findings indicate that the aim of diversifying the medical student population on socioeconomic grounds by attracting graduates has been only marginally successful. Graduate applicants from widening access backgrounds are less likely than others to be offered a place at medical school. Different approaches must be considered if medicine is to attract and select more socially diverse applicants.

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