scholarly journals 220 Choice of UK Medical School Predicts Success in The Intercollegiate Membership of The Royal College of Surgeons (MRCS) Examination

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
R Ellis ◽  
D Scrimgeour ◽  
J Cleland ◽  
A Lee ◽  
P Brennan

Abstract Background UK medical schools vary in terms of factors such as mission, specific curricula and pedagogy. As relatively little is understood about the impact of these differences at a post-graduate level, we examined the relationship between medical school and MRCS success. Method Using the UKMED database we analysed data on UK medical graduates who attempted MRCS Part A (n = 9729) and MRCS Part B (n = 4644) between 2007-2017. Univariate analysis characterised the relationship between medical school and first attempt MRCS success. Logistic regression modelling identified independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P < 0.001). Trainees from standard-entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses ((Part A (Odds Ratio (OR) 3.72 [95% Confidence Interval (CI) 2.69-5.15]); Part B (OR 1.67 [1.02-2.76])). Non-graduates were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]). Russell Group graduates were more likely to pass MRCS Part A (OR 1.79 [1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])). Conclusions Medical programme and medical school are associated with MRCS success. Further research is needed to tease out the relationship between individual factors, medical school and MRCS performance.

2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ricky Ellis ◽  
Duncan Scrimgeour ◽  
Jennifer Cleland ◽  
Amanda Lee ◽  
Peter Brennan

Abstract Aims UK medical schools vary in their mission, curricula and pedagogy, but little is known of the effect of this on postgraduate examination performance. We explored differences in outcomes at the Membership of the Royal College of Surgeons examination (MRCS) between medical schools, course types, national ranking and candidate sociodemographic factors. Methods A retrospective longitudinal study of all UK medical graduates who attempted MRCS Part A (n = 9730) and MRCS Part B (n = 4645) between 2007 and 2017, utilising the UK Medical Education Database (https://www.ukmed.ac.uk). We examined the relationship between medical school and success at first attempt of the MRCS using univariate analysis. Logistic regression modelling was used to identify independent predictors of MRCS success. Results MRCS pass rates differed significantly between medical schools (P < 0.001). Russell Group graduates were more likely to pass MRCS Part A (Odds Ratio (OR) 1.79 [95% Confidence Interval (CI) 1.56-2.05]) and Part B (OR 1.24 [1.03-1.49])).  Trainees from Standard-Entry 5-year programmes were more likely to pass MRCS at first attempt compared to those from extended (Gateway) courses, Part A OR 3.72 [2.69-5.15]; Part B (OR 1.67 [1.02-2.76]. Non-graduates entering medical school were more likely to pass Part A (OR 1.40 [1.19-1.64]) and Part B (OR 1.66 [1.24-2.24]) than graduate-entrants. Conclusion Medical school, course type and socio-demographic factors are associated with success on the MRCS. This information will help to identify surgical trainees at risk of failing the MRCS in order for schools of surgery to redistribute resources to those in need.


2021 ◽  
Author(s):  
David Hope ◽  
David Kluth ◽  
Matthew Homer ◽  
Avril Dewar ◽  
Richard Fuller ◽  
...  

Abstract Background Due to the diverse approaches to medical school assessment, making meaningful cross-school comparisons on knowledge is difficult. Ahead of the introduction of national licensing assessment in the UK, we evaluate schools on “common content” to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content. Methods We undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants for a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools. Results Schools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5% of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40%, whereas a passing standard that would see 5% of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail. Conclusions Candidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standard setting approaches that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional gaps in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.


2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
R Ellis ◽  
D Scrimgeour ◽  
J Cleland ◽  
A Lee ◽  
P Brennan

Abstract Aim The number of clinicians with disabilities is increasing, however there is no data on the performance of doctors with registered disabilities in the postgraduate environment. If we are to ensure diversity and equality within the workforce, we must first identify whether attainment differences exist in markers of performance. To address this, we assessed the impact of disabilities on performance in the MRCS. Method All UK medical graduates who had attempted MRCS Part A (n = 9,597) and Part B (n = 4,562) between 2007-2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included. Univariate analysis identified associations with MRCS performance and logistic regression models identified independent predictors of success. Results Candidates with registered disabilities (n = 635) had lower MRCS Part A pass rates (46.3% vs 59.8% (p < 0.001)) but similar Part B pass rates (68.2% vs 70.9% (p = 0.339)). They were nearly twice as likely to fail Part A (odds ratio 0.55 [95% Confidence Interval 0.46-0.64]). When prior academic attainment (A-Levels and medical school performance) was accounted for, there was no statistically significant difference in the likelihood of MRCS success (p>0.05). Pass rates were similar for candidates with specific learning difficulties and those with other registered disabilities (p>0.05). Conclusions This is the first study to assess the impact of disability status and type on performance at a postgraduate medical examination. It appears that candidates with registered disabilities performed less well in formal, written examinations generally. Although our data indicate that current MRCS testing accommodations are fair, enabling performance unrestricted by disability.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Ricky Ellis ◽  
Peter Brennan ◽  
Jennifer Cleland ◽  
Amanda Lee ◽  
Duncan Scrimgeour

Abstract Aims The number of medical students and doctors with disabilities is increasing, however there is a paucity of data on the performance of doctors with registered disabilities in the postgraduate environment. To address this gap in knowledge, we assessed the impact of disabilities on performance in the MRCS. Methods All UK medical graduates who had attempted MRCS Part A (n = 9,597) and Part B (n = 4,562) between 2007-2017 with linked disability data in the UK Medical Education Database (https://www.ukmed.ac.uk) were included. Univariate analysis identified associations with MRCS performance and logistic regression models identified independent predictors of success. Results Candidates with registered disabilities had lower MRCS Part A pass rates (46.3% vs 59.8% respectively (p < 0.001)) but similar Part B pass rates (68.2% vs 70.9% (p = 0.339). They were nearly twice as likely to fail Part A (odds ratio 0.55 [95% Confidence Interval 0.46-0.64]). When prior academic attainment (A-Levels and medical school performance) was taken into account, there was no statistically significant difference in the likelihood of success at MRCS (p > 0.05). MRCS pass rates were similar for candidates with specific learning difficulties and those with other registered disabilities p > 0.05). Conclusions This is the first study to assess the impact of disability status and type on performance at a postgraduate medical examination. It appears that candidates with registered disabilities perform less well in formal, written examinations generally. Our data indicate that the MRCS itself is fair for candidates with registered disabilities and that the current testing accommodations enable performance unrestricted by disability.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
David Hope ◽  
David Kluth ◽  
Matthew Homer ◽  
Avril Dewar ◽  
Richard Fuller ◽  
...  

Abstract Background Due to differing assessment systems across UK medical schools, making meaningful cross-school comparisons on undergraduate students’ performance in knowledge tests is difficult. Ahead of the introduction of a national licensing assessment in the UK, we evaluate schools’ performances on a shared pool of “common content” knowledge test items to compare candidates at different schools and evaluate whether they would pass under different standard setting regimes. Such information can then help develop a cross-school consensus on standard setting shared content. Methods We undertook a cross-sectional study in the academic sessions 2016-17 and 2017-18. Sixty “best of five” multiple choice ‘common content’ items were delivered each year, with five used in both years. In 2016-17 30 (of 31 eligible) medical schools undertook a mean of 52.6 items with 7,177 participants. In 2017-18 the same 30 medical schools undertook a mean of 52.8 items with 7,165 participants, creating a full sample of 14,342 medical students sitting common content prior to graduation. Using mean scores, we compared performance across items and carried out a “like-for-like” comparison of schools who used the same set of items then modelled the impact of different passing standards on these schools. Results Schools varied substantially on candidate total score. Schools differed in their performance with large (Cohen’s d around 1) effects. A passing standard that would see 5 % of candidates at high scoring schools fail left low-scoring schools with fail rates of up to 40 %, whereas a passing standard that would see 5 % of candidates at low scoring schools fail would see virtually no candidates from high scoring schools fail. Conclusions Candidates at different schools exhibited significant differences in scores in two separate sittings. Performance varied by enough that standards that produce realistic fail rates in one medical school may produce substantially different pass rates in other medical schools – despite identical content and the candidates being governed by the same regulator. Regardless of which hypothetical standards are “correct” as judged by experts, large institutional differences in pass rates must be explored and understood by medical educators before shared standards are applied. The study results can assist cross-school groups in developing a consensus on standard setting future licensing assessment.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Emily R Bligh ◽  
Ellie Courtney ◽  
Rebecca Stirling ◽  
Asveny Rajananthanan ◽  
Hibatallah Altaher ◽  
...  

Abstract Background COVID-19 has disrupted medical education in the United Kingdom (UK). The pandemic may result in a long-term disproportionate negative impact to students applying to Medical School from a low-socioeconomic background. In addition, the upsurge in Medical School applications increases the likelihood of stricter University entry criteria over the coming years. There is no current research to determine how widening participation of Medicine to students from low-socioeconomic backgrounds can be improved virtually. The aim of this study is to establish the impact of COVID-19 on students enrolled in UK widening access schemes and the role of virtual student led initiatives in widening participation. Methods A voluntary online survey was distributed to UK Sixth Form students (N = 31) enrolled in a widening access scheme who attended Sheffield Neuroscience Society International Virtual Conference in February 2021. The event was free to attend. The five-domain survey consisted of questions determining demographics, career aspirations, impact of COVID-19, academic skillsets and an educational manipulation check. Results There were 30 pre-conference and 26 post-conference responses. 76.7 % had work experience cancelled due to COVID-19. A total of 36.7 % of participants reported participating in virtual work experience. ‘Observe GP’ and ‘Medic Mentor’ were each specified as attended virtual opportunities in 20 % of answers. Post conference, students felt significantly more confident in applying to Medical School (p = 0.008) and more prepared to undertake a presentation (p = 0.002). Educational manipulation check scores increased significantly (p = 0.003). 100 % of students felt inspired to do further CV building activities. Conclusions COVID-19 has negatively impacted pupils enrolled in UK Medical School widening access schemes. Virtual student led initiatives can instill confidence in delegates from low socio-economic backgrounds, increase their career knowledge and inspire them to take part in further CV building exercises. Both Medical Schools and medical students play a key role in widening participation. This study recommends Medical Schools promote access to virtual events, urge private and state schools to declare offered opportunities and act mindfully when determining student’s academic potential in the context of their socioeconomic and/or educational background.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Yann Combret ◽  
Guillaume Prieur ◽  
Roger Hilfiker ◽  
Francis-Edouard Gravier ◽  
Pauline Smondack ◽  
...  

Abstract Background Little interest has been paid to expiratory muscle strength, and the impact of expiratory muscle weakness on critical outcomes is not known. Very few studies assessed the relationship between maximal expiratory pressure (MEP) and critical outcomes. The aim of this study was to investigate the relationship between MEP and critical outcomes. Methods This work was a secondary analysis of a prospective, observational study of adult patients who required mechanical ventilation for ≥ 24 h in an 18-bed ICU. MEP was assessed before extubation after a successful, spontaneous breathing trial. The relationships between MEP and extubation failure, and short-term (30 days) mortality, were investigated. Univariate logistic regressions were computed to investigate the relationship between MEP values and critical outcomes. Two multivariate analyses, with and without maximal inspiratory pressure (MIP), both adjusted using principal component analysis, were undertaken. Unadjusted and adjusted ROC curves were computed to compare the respective ability of MEP, MIP and the combination of both measures to discriminate patients with and without extubation failure or premature death. Results One hundred and twenty-four patients were included. Median age was 66 years (IQR 18) and median mechanical ventilation duration was 7 days (IQR 6). Extubation failure rate was 15% (18/124 patients) and the rate for 30-day mortality was 11% (14/124 patient). Higher MEP values were significantly associated with a lower risk of extubation failure in the univariate analysis [OR 0.96 95% CI (0.93–0.98)], but not with short-term mortality. MEP was independently linked with extubation failure when MIP was not included in the multivariate model, but not when it was included, despite limited collinearity between these variables. This study was not able to differentiate the respective abilities of MEP, MIP, and their combination to discriminate patients with extubation failure or premature death (adjusted AUC for the combination of MEP and MIP: 0.825 and 0.650 for extubation failure and premature death, respectively). Conclusions MEP is related to extubation failure. But, the results did not support its use as a substitute for MIP, since the relationship between MEP and critical outcomes was no longer significant when MIP was included. The use of MIP and MEP measurements combined did not reach higher discriminative capacities for critical outcomes that MEP or MIP alone. Trial Registration This study was retrospectively registered at https://clinicaltrials.gov/ct2/show/NCT02363231?cond=NCT02363231&draw=2&rank=1 (NCT02363231) in 13 February 2015


2021 ◽  
pp. 105382592110486
Author(s):  
Jacquelyn B. Kercheval ◽  
Alec Bernard ◽  
Hanna Berlin ◽  
Nicole Byl ◽  
Boone Marois ◽  
...  

Background: Undergraduate outdoor orientation programs facilitate students’ transition into college. Research has yet to be conducted on the few programs at medical schools, which may have unique benefits given the specific challenges of transitioning to medical school and high rates of burnout among medical students. Purpose: This mixed methods study examines the impact of one medical school's outdoor orientation program on its participants. Methodology/Approach: A survey was administered immediately following the 2018 trip ( N = 56 responses). Follow-up focus groups were conducted with a sample of the same participants ( N = 18) in 2019. Responses were analyzed using descriptive statistics and thematic analysis. Findings/Conclusions: Participants felt that the program helped ease their transition into medical school, establish a support system, and hone personal development and wellness skills. Many of these effects persisted up to one year later. Implications: These findings are of particular interest to the medical and experiential education communities because many outcomes persisted for at least one year after the original trip and aligned with factors believed to protect against medical student burnout. There is opportunity for additional research as well as expansion of similar programs to other medical schools.


2018 ◽  
Vol 5 (1) ◽  
pp. 16-22
Author(s):  
Jaenudin ◽  
Sandi Aprianto ◽  
Citra Setyo Dwi Andini

Background: Garbage is something material or solid objects that is no used by humans. The impact or risk of improper handling of garbage can cause to environmental damages that can cause health problems and disesase, one of them is diarrhea disease. According to the health profile of West Java Province (2012) showed that the 1.906.886 diarrhea incidence. Cirebon City is ranked ninth with 88,702 diarrhea incidence. Purpose: The purpose of this research is to know the relationship of waste management with the incidence of diarrhea In Argasunya Village Cirebon City. Method: This research used descriptive correlation with kohort retrospekif approach. The population in this study that is all the people who suffer from diarrhea in the Argasunya Village with 72 respondents. The sample in this study using total sampling with 72 respondents who suffer from diarrhea. The research instrument used the observation sheet of waste management and the result of the status of the patient according the medical record data in Sitopeng Public Health Center. The analysis used univariate and bivariate used Chi Square test. Result: The result of univariate analysis showed that most of the waste management did not fulfill the requirement of 59 respondents (81,9%) and most of the acute diarrhea was 62 respondents (86,1%). There was no significant relationship of waste management with the incidence of diarrhea In Argasunya Village Cirebon City, p-value = 0,677.


2003 ◽  
Vol 27 (12) ◽  
pp. 461-462
Author(s):  
Riadh T. Abed

In the 1970s, Iraq made strides towards building a comprehensive, well-equipped health system free at the point of delivery. Medical education in Iraq was originally modelled on the British system and started with Baghdad Medical School in 1927. Two more medical schools were founded in Mosul and Basrah, providing Iraq with good numbers of high-calibre medical graduates. After 1968, several other medical schools were set up in various parts of Iraq, including three in Iraqi Kurdistan.


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