BJS.02Graduates from different medical schools vary in their performance on the Intercollegiate Membership of the Royal College of Surgeons (MRCS) Examinations

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.

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

British Journal of Surgery ◽

10.1093/bjs/znab134.538 ◽

2021 ◽

Vol 108 (Supplement_2) ◽

Author(s):

R Ellis ◽

D Scrimgeour ◽

J Cleland ◽

A Lee ◽

P Brennan

Keyword(s):

Medical School ◽

Univariate Analysis ◽

Medical Schools ◽

Individual Factors ◽

Pass Rates ◽

Medical Graduates ◽

Regression Modelling ◽

Gateway Courses ◽

The Impact ◽

The Relationship

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.

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Variation in Performance on Common Content Items at UK Medical Schools

10.21203/rs.3.rs-153247/v1 ◽

2021 ◽

Author(s):

David Hope ◽

David Kluth ◽

Matthew Homer ◽

Avril Dewar ◽

Richard Fuller ◽

...

Keyword(s):

Medical School ◽

Standard Setting ◽

Medical Schools ◽

Cross Sectional Study ◽

Pass Rates ◽

Cross Sectional ◽

Study Results ◽

The Uk ◽

Common Content ◽

The Impact

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.

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51 The Impact of Disability on Performance in the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS)

British Journal of Surgery ◽

10.1093/bjs/znab258.041 ◽

2021 ◽

Vol 108 (Supplement_6) ◽

Author(s):

R Ellis ◽

D Scrimgeour ◽

J Cleland ◽

A Lee ◽

P Brennan

Keyword(s):

Univariate Analysis ◽

Testing Accommodations ◽

Pass Rates ◽

Logistic Regression Models ◽

Medical Graduates ◽

Significant Difference ◽

Disability Status ◽

Similar Part ◽

The Uk ◽

The Impact

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.

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Radiology and the medical student: do increased hours of teaching translate to more radiologists?

BJR|Open ◽

10.1259/bjro.20210074 ◽

2021 ◽

Author(s):

Cindy Chew ◽

Patrick J O'Dwyer ◽

David Young

Keyword(s):

Medical Students ◽

Medical School ◽

General Medical Council ◽

Medical Schools ◽

Medical Council ◽

Chi Square ◽

Medical Graduates ◽

Increasing Demand ◽

Radiology Teaching ◽

The Uk

Objectives: The UK has a shortage of Radiologists to meet the increasing demand for radiologic examinations. To encourage more medical students to consider Radiology as a career, increased exposure at undergraduate level has been advocated. The aim of this study was to evaluate if formal Radiology teaching hours at medical school had any association with the number of qualified Radiologists joining the General Medical Council Specialist Register. Methods: Total number of doctors joining the GMC Specialist Register as Clinical Radiologists, and those with a primary medical qualifications awarded in Scotland, was obtained from the GMC (2010–2020). Graduate numbers from all 4 Scottish Medical Schools (2000–2011) were also obtained. Hours of Radiology teaching for medical schools in Scotland were obtained from validated AToMS study. Results: Two hundred and twenty three (6.6%) of 3347 Radiologists added to the GMC Specialist Register between 2010 and 2020 received their primary medical qualification (PMQ) from Scottish Universities. The number of Radiologists from Scottish Universities joining the GMC specialist register was 2.6% of the total number of Scottish Medical Graduates. There was no association between the number of hours (Range 1–30) Radiology was taught to medical students and the number that joined the specialist register as Radiologists (p = 0.54 chi square trend). Conclusion: Increased exposure to Radiology teaching does not influence medical students’ decision to take up Radiology as a career. While continued Radiology exposure remains important, other strategies are required in both the short and long term to ensure radiology services are maintained without detriment to patients. Advances in knowledge: Increased hours of Radiology teaching in medical school was not associated with increased radiologists joining the profession.

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A survey of ENT undergraduate teaching in the UK

The Journal of Laryngology & Otology ◽

10.1017/s0022215120000936 ◽

2020 ◽

Vol 134 (6) ◽

pp. 553-557

Author(s):

A W Mayer ◽

K A Smith ◽

S Carrie ◽

Keyword(s):

Medical School ◽

Learning Outcomes ◽

Undergraduate Curriculum ◽

Medical Schools ◽

School Curriculum ◽

Careful Consideration ◽

Undergraduate Teaching ◽

Medical Graduates ◽

Wide Variability ◽

The Uk

AbstractBackgroundENT presentations are prevalent in clinical practice but feature little in undergraduate curricula. Consequently, most medical graduates are not confident managing common ENT conditions. In 2014, the first evidence-based ENT undergraduate curriculum was published to guide medical schools.ObjectiveTo assess the extent that current UK medical school learning outcomes correlate with the syllabus of the ENT undergraduate curriculum.MethodTwo students from each participating medical school independently reviewed all ENT-related curriculum documents to determine whether learning outcomes from the suggested curriculum were met.ResultsSixteen of 34 curricula were reviewed. Only a minority of medical schools delivered teaching on laryngectomy or tracheostomy, nasal packing or cautery, and ENT medications or surgical procedures.ConclusionThere is wide variability in ENT undergraduate education in UK medical schools. Careful consideration of which topics are prioritised, and the teaching modalities utilised, is essential. In addition, ENT learning opportunities for undergraduates outside of the medical school curriculum should be augmented.

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Does performance at the intercollegiate Membership of the Royal Colleges of Surgeons (MRCS) examination vary according to UK medical school and course type? A retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2021-054616 ◽

2022 ◽

Vol 12 (1) ◽

pp. e054616

Author(s):

Ricky Ellis ◽

Peter A Brennan ◽

Duncan S G Scrimgeour ◽

Amanda J Lee ◽

Jennifer Cleland

Keyword(s):

Cohort Study ◽

Medical School ◽

Regression Models ◽

Medical Training ◽

Medical Schools ◽

School Factors ◽

Logistic Regression Models ◽

Individual Level ◽

Medical Graduates ◽

The Uk

ObjectivesThe knowledge, skills and behaviours required of new UK medical graduates are the same but how these are achieved differs given medical schools vary in their mission, curricula and pedagogy. Medical school differences seem to influence performance on postgraduate assessments. To date, the relationship between medical schools, course types and performance at the Membership of the Royal Colleges of Surgeons examination (MRCS) has not been investigated. Understanding this relationship is vital to achieving alignment across undergraduate and postgraduate training, learning and assessment values.Design and participantsA retrospective longitudinal cohort study of UK medical graduates who attempted MRCS Part A (n=9730) and MRCS Part B (n=4645) between 2007 and 2017, using individual-level linked sociodemographic and prior academic attainment data from the UK Medical Education Database.MethodsWe studied MRCS performance across all UK medical schools and examined relationships between potential predictors and MRCS performance using χ2 analysis. Multivariate logistic regression models identified independent predictors of MRCS success at first attempt.ResultsMRCS pass rates differed significantly between individual medical schools (p<0.001) but not after adjusting for prior A-Level performance. Candidates from courses other than those described as problem-based learning (PBL) were 53% more likely to pass MRCS Part A (OR 1.53 (95% CI 1.25 to 1.87) and 54% more likely to pass Part B (OR 1.54 (1.05 to 2.25)) at first attempt after adjusting for prior academic performance. Attending a Standard-Entry 5-year medicine programme, having no prior degree and attending a Russell Group university were independent predictors of MRCS success in regression models (p<0.05).ConclusionsThere are significant differences in MRCS performance between medical schools. However, this variation is largely due to individual factors such as academic ability, rather than medical school factors. This study also highlights group level attainment differences that warrant further investigation to ensure equity within medical training.

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Does performance at medical school predict success at the Intercollegiate Membership of the Royal College of Surgeons (MRCS) examination? A retrospective cohort study

BMJ Open ◽

10.1136/bmjopen-2020-046615 ◽

2021 ◽

Vol 11 (8) ◽

pp. e046615

Author(s):

Ricky Ellis ◽

Duncan S G Scrimgeour ◽

Peter A Brennan ◽

Amanda J Lee ◽

Jennifer Cleland

Keyword(s):

Cohort Study ◽

Medical School ◽

School Performance ◽

Royal College ◽

Sociodemographic Factors ◽

Significant Independent Predictor ◽

Situational Judgement Test ◽

Medical School Performance ◽

Significant Measure ◽

The Uk

BackgroundIdentifying predictors of success in postgraduate examinations can help guide the career choices of medical students and may aid early identification of trainees requiring extra support to progress in specialty training. We assessed whether performance on the educational performance measurement (EPM) and situational judgement test (SJT) used for selection into foundation training predicted success at the Membership of the Royal College of Surgeons (MRCS) examination.MethodsThis was a longitudinal, cohort study using data from the UK Medical Education Database (https://www.ukmed.ac.uk). UK medical graduates who had attempted Part A (n=2585) and Part B (n=755) of the MRCS between 2014 and 2017 were included. χ2 and independent t-tests were used to examine the relationship between medical school performance and sociodemographic factors with first-attempt success at MRCS Part A and B. Multivariate logistic regression was employed to identify independent predictors of MRCS performance.ResultsThe odds of passing MRCS increased by 55% for Part A (OR 1.55 (95% CI 1.48 to 1.61)) and 23% for Part B (1.23 (1.14 to 1.32)) for every additional EPM decile point gained. For every point awarded for additional degrees in the EPM, candidates were 20% more likely to pass MRCS Part A (1.20 (1.13 to 1.29)) and 17% more likely to pass Part B (1.17 (1.04 to 1.33)). For every point awarded for publications in the EPM, candidates were 14% more likely to pass MRCS Part A (1.14 (1.01 to 1.28)). SJT score was not a statistically significant independent predictor of MRCS success.ConclusionThis study has demonstrated the EPM’s independent predictive power and found that medical school performance deciles are the most significant measure of predicting later success in the MRCS. These findings can be used by medical schools, training boards and workforce planners to inform evidence-based and contemporary selection and assessment strategies.

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EP.TU.6The Impact of Disability on Performance in the Intercollegiate Membership of the Royal College of Surgeons examination (MRCS)

British Journal of Surgery ◽

10.1093/bjs/znab311.002 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Ricky Ellis ◽

Peter Brennan ◽

Jennifer Cleland ◽

Amanda Lee ◽

Duncan Scrimgeour

Keyword(s):

Univariate Analysis ◽

Testing Accommodations ◽

Pass Rates ◽

Logistic Regression Models ◽

Medical Graduates ◽

Significant Difference ◽

Disability Status ◽

Similar Part ◽

The Uk ◽

The Impact

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.

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EP.TU.4Performance at Medical School predicts success in the Intercollegiate Membership of the Royal College of Surgery (MRCS) examination

British Journal of Surgery ◽

10.1093/bjs/znab311.001 ◽

2021 ◽

Vol 108 (Supplement_7) ◽

Author(s):

Ricky Ellis ◽

Duncan Scrimgeour ◽

Jennifer Cleland ◽

Amanda Lee ◽

Peter Brennan

Keyword(s):

Medical School ◽

Royal College ◽

Univariate Analysis ◽

Sociodemographic Factors ◽

High Stakes ◽

Significant Independent Predictor ◽

Situational Judgement Test ◽

Significant Measure ◽

First Time ◽

The Relationship

Abstract Aims Identifying predictors of success in post-graduate examinations can help guide the career choices of medical students and may aid early identification of trainees requiring extra support to progress in specialty training. We assessed whether performance at medical school as quantified by the Educational Performance Measurement (EPM) and scores from the Situational Judgement Test (SJT) used for selection into Foundation Training predicted success at the Membership of the Royal College of Surgeons (MRCS) examination. Methods We analysed data from the UKMED Database for UK graduates who had attempted MRCS Part A (n = 1,975) and Part B n = 630) between 2013-2017. Univariate analysis examined the relationship between performance and the likelihood of passing MRCS at first-attempt. Logistic regression identified independent predictors of MRCS success. Results For every additional EPM decile point gained the chances of passing MRCS at first attempt increased by 52% for Part A (odds ratio 1.52 [95% confidence interval (CI) 1.46-1.60]) and 27% for Part B (1.27 [1.18-1.38]). For every point awarded for additional degrees in the EPM, candidates were 29% more likely to pass MRCS Part A first time (1.29 [1.12-1.48]). SJT score was not a statistically significant independent predictor of MRCS Part A or Part B success after adjusting for sociodemographic factors (P = 0.182 and P = 0.125 respectively). Conclusions This, the first study to investigate the relationship between medical school and success at a high stakes UK postgraduate surgical examination found that medical school performance deciles are the most significant measure of predicting later success in the MRCS.

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Are there differences between those doctors who apply for a training post in Foundation Year 2 and those who take time out of the training pathway? A UK multicohort study

BMJ Open ◽

10.1136/bmjopen-2019-032021 ◽

2019 ◽

Vol 9 (11) ◽

pp. e032021 ◽

Cited By ~ 3

Author(s):

Jennifer Cleland ◽

Gordon Prescott ◽

Kim Walker ◽

Peter Johnston ◽

Ben Kumwenda

Keyword(s):

Medical School ◽

Workforce Planning ◽

Sociodemographic Factors ◽

Specialty Training ◽

Time Out ◽

Foundation Programme ◽

Training Post ◽

Multivariable Regression ◽

The Uk ◽

Participation In Higher Education

IntroductionKnowledge about the career decisions of doctors in relation to specialty (residency) training is essential in terms of UK workforce planning. However, little is known about which doctors elect to progress directly from Foundation Year 2 (F2) into core/specialty/general practice training and those who instead opt for an alternative next career step.ObjectiveTo identify if there were any individual differences between these two groups of doctors.DesignThis was a longitudinal, cohort study of ‘home’ students who graduated from UK medical schools between 2010 and 2015 and completed the Foundation Programme (FP) between 2012 and 2017.We used the UK Medical Education Database (UKMED) to access linked data from different sources, including medical school performance, specialty training applications and career preferences. Multivariable regression analyses were used to predict the odds of taking time out of training based on various sociodemographic factors.Results18 380/38 905 (47.2%) of F2 doctors applied for, and accepted, a training post offer immediately after completing F2. The most common pattern for doctors taking time out of the training pathway after FP was to have a 1-year (7155: 38.8%) or a 2-year break (2605: 14.0%) from training. The odds of not proceeding directly into core or specialty training were higher for those who were male, white, entered medical school as (high) school leavers and whose parents were educated to degree level. Doctors from areas of low participation in higher education were significantly (0.001) more likely to proceed directly into core or specialty training.ConclusionThe results show that UK doctors from higher socioeconomic groups are less likely to choose to progress directly from the FP into specialty training. The data suggest that widening access and encouraging more socioeconomic diversity in our medical students may be helpful in terms of attracting F2s into core/specialty training posts.

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