Abstract
Many different medical school selection processes are used worldwide. In this paper, we examine the effect of (1) participation, and (2) selection in a voluntary selection process on study performance. We included data from two cohorts of medical students admitted to Erasmus MC, Rotterdam and VUmc, Amsterdam, The Netherlands and compared them to previously published data from Groningen medical school, The Netherlands. All included students were admitted based on either (1) a top pre-university grade point average, or (2) a voluntary selection process, or (3) weighted lottery. We distinguished between lottery-admitted students who had participated in the voluntary selection process and had been rejected, and lottery-admitted students who had not participated. Knowledge test scores, study progress, and professionalism scores were examined using ANCOVA modelling, logistic regression, and Bonferroni post hoc multiple-comparison tests, controlling for gender and cohort. For written test grades, results showed a participation effect at Groningen medical school and Erasmus MC (p < 0.001), and a selection effect at VUmc (p < 0.05). For obtained course credits, results showed a participation effect at all universities (p < 0.01) and a selection effect at Groningen medical school (p < 0.005). At Groningen medical school, a participation effect seemed apparent in on time first-year completion (p < 0.05). Earlier reported selection and participation effects in professionalism scores at Groningen medical school were not apparent at VUmc. Top pre-university students performed well on all outcome measures. For both the participation effect and the selection effect, results differed between universities. Institutional differences in curricula and in the design of the selection process seem to mediate relations between the different admissions processes and performance. Further research is needed for a deeper understanding of the influence of institutional differences on selection outcomes.
Highlights
In the search for better ways to select the most suitable students, medical schools worldwide have developed a variety of selection instruments (Salvatori 2001; Siu and Reiter 2009)
At Groningen medical school, the percentage of females was higher in the selection-accepted group than in the lottery-admitted group that had not participated in selection (p \ 0.05) (Schripsema et al 2014)
At Erasmus MC, Bonferroni correction for multiple comparisons rendered the results of post hoc tests nonsignificant
Summary
In the search for better ways to select the most suitable students, medical schools worldwide have developed a variety of selection instruments (Salvatori 2001; Siu and Reiter 2009). Correlations between selection scores and performance can only be calculated for applicants who were accepted into medical training. In the multi-process Dutch admissions system, applicants who are initially rejected in a selection process for which participation is voluntary, still have a chance of admission through lottery in the same year (Schripsema et al 2014; Urlings-Strop et al 2013). This situation offers unique possibilities to study the effects of selection processes
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