Abstract
BackgroundGateway courses are increasingly popular widening participation routes into medicine. These six year courses provide a more accessible entry route into medical school and aim to support under-represented students’ progress and graduation as doctors. There is little evidence on the performance of gateway students and this study compares attainment and aptitude on entry, and outcomes at graduation of students on the UK’s three longest running gateway courses with students studying on a standard entry medical degree (SEMED) course at the same institutions.MethodsData were obtained from the UK Medical Education Database for students starting between 2007 and 2012 at three UK institutions. These data included A-levels and Universities Clinical Aptitude Test scores on entry to medical school and the Educational Performance Measure (EPM) decile, Situational Judgement Test (SJT) and Prescribing Safety Assessment (PSA) scores as outcomes measures. Multiple regression models were used to test for difference in outcomes between the two types of course, controlling for attainment and aptitude on entry.ResultsFour thounsand three hundred forty students were included in the analysis, 560 on gateway courses and 3785 on SEMED courses. Students on SEMED courses had higher attainment (Cohen’s d = 1.338) and aptitude (Cohen’s d = 1.078) on entry. On exit SEMED students had higher EPM scores (Cohen’s d = 0.616) and PSA scores (Cohen’s d = 0.653). When accounting for attainment and aptitude on entry course type is still a significant predictor of EPM and PSA, but the proportion of the variation in outcome explained by course type drops from 6.4 to 1.6% for EPM Decile and from 5.3% to less than 1% for the PSA score.There is a smaller significant difference in SJT scores, with SEMED having higher scores (Cohen’s d = 0.114). However, when measures of performance on entry are accounted for, course type is no longer a significant predictor of SJT scores.ConclusionsThis study shows the differences of the available measures between gateway students and SEMED students on entry to their medical degrees are greater than the differences on exit. This provides modest evidence that gateway courses allow students from under-represented groups to achieve greater academic potential.
Highlights
Gateway courses are increasingly popular widening participation routes into medicine
The entry profiles of the 4340 cases with at least one graduation outcome were compared across the two course types for the three medical schools
Throughout the results Higher Education Statistics Agency (HESA)’s statistical disclosure controls have been applied as required by the UK Medical Education Database (UKMED) research process [38]: All Ns are reported to the nearest 5
Summary
Gateway courses are increasingly popular widening participation routes into medicine. Gateway courses, designed to attract students underrepresented in medicine, are becoming an increasingly popular widening participation (WP) route into medicine in the UK [1] Their aims are to provide entry to medical schools, not normally accessible without the highest grades in secondary education, for students with educational and social disadvantage and to support these students to succeed. The General Medical Council (GMC) have set a requirement in ‘Promoting excellence: Standards for medical education’ that processes of recruitment, selection and appointment of learners and educators are open, fair and transparent. To meet this standard medical schools must publish the criteria used for widening participation courses [10]
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