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Table 1 Graduate entry vs undergraduate entry into medical school – comparative studies of academic performance and progression

From: Relative progress and academic performance of graduate vs undergraduate entrants to an Australian medical school

Institution

Programme duration

Students

Selection Pre-requisites

Methodology

Confounding variables

Performance

Progression

University of Nottingham [5]

UG – 5 yr.

GE – 4 yr

All graduates from 2007 and 2008

UG N = 450

GE N = 171 (27.5%)

No data on selection process

Comparison of final 2.5 yr. of clinical training.

Exclusion from the study of those who had taken longer than the standard 4 (or 5) years to complete.

Substantially different demographic profile for GE and UG (higher age, more females).

Cohort effects.

Lower prior educational attainment by GE

Lower performance on 4 of 5 knowledge-based exams by GE.

Similar levels of performance for GE and UG on all skills-based and attitudinal assessments

Completion rates significantly higher for GE vs UG (94% vs 90%).

Similar failure rates in assessments overall

University of Birmingham [6]

UG – 5 yr.

GE – 4 yr

Four successive student cohorts (2003–4 to 2006–7)

UG N = 1386

GE N = 161 (10.4%)

Pre-requisites for selection - an A-level in chemistry and first degree must be in a life science

Comparison of clinical or non-clinical assessments during final 3 yr. of training

Differences in ethnicity, gender and number of international students between GE and UG

Higher average marks in the GE cohort compared to UG, mainly in the clinical examinations.

Poorer performance by students from overseas, students of South Asian background or male students

Proportion of students graduating with honours was higher in the GE group.

Newcastle University, UK [7]

UG – 5 yr.

GE – 4 yr

Five cohorts of students from 2001 onwards

UG N = 1254

GE N = 140 (10.0%)

GE - 2.1 degree or higher in any subject, or a practising healthcare professional with equivalent academic achievement

Comparison of knowledge and critical thought assessments during final 3 yr of training

Also compared GE to graduates who entered the 5 yr. programme

Background degree for GE students

GE students had consistently higher assessment scores than both UG and graduates in the 5 yr. programmeNo influence on scores of background degree

Not reported

Leicester-Warwick Medical School [8]

UG – 5 yr.

GE – 4 yr

3 cohorts who completed from 2004 to 2006.

UG N = 316

GE N = 285 (47.0%)

No data on selection process

Comparison at the end of the pre-clinical phase (1.5 yr. for GE, 2.5 yr. for UG).

Comparison of identical 2.5 yr. clinical phase.

More UG students did not consent to take part (27% vs 11% for GE)

UG students with previous degrees excluded.

UG with prior degrees were excluded from the analysis.

GE students had weaker prior academic performance as assessed by A-levels at secondary school.

No differences between the scores on the written examination at the end of the pre-clinical phase.

UG students performed better in the intermediate clinical examination but there were no differences in the final clinical assessment.

GE students performed better in the final written examinations at the end of the clinical phase.

Any student who did not complete the course to finals stage was removed from the analysis. Relative attrition rates were not compared.

Royal College of Surgeons in Ireland [9]

UG – 5-6 yr.

GE – 4 yr

4 consecutive cohorts who underwent their final 2 year examinations 2008 to 2013.

UG N = 703

GE N = 233 (24.9%)

GE - a level 8 honours degree with a minimum 2:1 honours classification (in any subject). Must also achieve a competitive score on either GAMSAT or MCAT.

Comparison of the final 2 yr. of the programme.

Background degree for GE students

Nationality

MCAT/GAMSAT entry test scores

For all years examined consistent evidence of significantly better outcomes for GE vs UG.

No difference in performance between those with a science vs a non-science background.

Not reported

College of Medicine, King Saud bin Abdulaziz University of Health Sciences [10]

UG – 6 yr.

GE – 4 Mth bridging course, then 4 yr

3 consecutive cohorts of male medical students 2010–2014.

UG N = 196

GE N = 54 (21.6%)

 

Compared final 4 yr. − 2 yr. pre-clinical and 2 yr. clinical

All GE students had a health science background.

UG performed significantly better than GE on a few pre-clinical courses.

No significant difference in performance between UG and GE in clinical rotations.

Not reported

University of Melbourne [11]

UG – 5-6 yr.

GE – 4 yr

4 successive cohorts of medical students who entered from 2002 to 2005

UG N = 464

GE N = 240 (34.1%)

UG – performance in final secondary school assessment and the UMAT.

GE - tertiary academic performance using GPA, GAMSAT score and a structured interview. All background degrees eligible.

Compared over 2 yr. during the pre-clinical component of the course.

Excluded students who did not have a consecutive sequence of assessments (leave of absence, enrolment in combined degree, withdrawal from the course).

Higher proportion of GE (60%) rather than UG (52%) were female.

Excluded international students.

GE performed consistently better, (but only marginally) than UG on assessments of bioscience knowledge and clinical skills.

Comparison was restricted to those students who had passed each subject on their first attempt.

GE were no more likely than UG to have an interrupted sequence of subjects, to transfer course or withdraw.

GE were less likely than UG to take a supplementary examination

University of Melbourne [12]

UG – 6 yr.

GE – 4 yr

4 successive cohorts of medical students who completed from 2004 to 2008

UG N = 471

GE N = 242 (33.9%)

As above.

Comparison of initial and final assessments during 2 yr. of clinical training.

Only students who had completed their initial and final clinical assessments in consecutive years were included.

Higher proportion of GE (58%) rather than UG (51%) were female.

Excluded international students.

No differences in performance between GE and UG were seen.

The performance of female students was better at both the initial and final assessments during clinical training.

All students passed their assessments on the first attempt.