Abstract
BackgroundWhether graduate entrants to medical school perform better academically than undergraduate entrants remains controversial. Differences in the discipline backgrounds of graduates may, at least in part, have accounted for differences in the results of comparative studies reported to date. This study aimed to address the dual issues of whether academic performance and progression rates were different between GE and UG students and the extent to which the discipline background of GE students may underpin any differences observed.MethodsRelative academic performance as well as indicators of student progression (supplementary examinations, repeat years, leave of absence, withdrawal from the programme) were compared between graduate entrants (GE) (N = 410) and both school leaver entrants (SLE) (N = 865) and non-standard entrants (some prior tertiary education) (NSE) (N = 148) who combined for the final 4 yr. of a 6 yr. MBBS undergraduate programme in 8 consecutive cohorts from 2006 to 2013 in Western Australia.ResultsExamination scores were generally at or very close to a distinction grade or higher across all groups. Higher mean examination scores were seen for GE versus both SLE and NSE in the first 2 years with no significant differences in the final 2 years. GE from biological science / science backgrounds (N = 241) or physical science backgrounds (N = 26) performed the same as SLE and NSE throughout the programme. GE with a health / allied health background (N = 91), however, performed better throughout. They also performed better when compared to their GE counterparts from a humanities (N = 32) or a biological science / science background. GE had increased odds of withdrawing when compared to SLE (OR 2.50, 95% CI 1.30, 4.79, P = 0.006), but not compared to NSE. NSE had increased odds of repeating at least one level when compared to either GE (OR 2.74, 95% CI 1.21, 6.21, P = 0.016) or SLE (OR 4.10, 95% CI 1.93, 8.70, P < 0.001). There were no differences by entry category in the odds of sitting at least one supplementary examination during the programme. There was an increase in the odds of taking at least one leave of absence in both SLE (OR 2.55, 95% CI 1.79, 3.63, P < 0.001) and NSE (OR 2.47, 95% CI 1.50, 4.07, P < 0.001) compared to GE.ConclusionsBetter academic performance by GE compared to SLE and NSE was predominantly due to higher scores for GE with a health / allied health background. GE were also less likely to have impeded progress during the course.
Highlights
Whether graduate entrants to medical school perform better academically than undergraduate entrants remains controversial
We aimed to address the dual issues of whether academic performance and progression rates were different between graduate entry (GE) and UG students and the extent to which the discipline background of GE students may underpin any differences observed
Non-standard entrants (NSE) were represented by a higher proportion of students who had entered via quarantined entry pathways for students of rural or socio-educationally disadvantaged backgrounds
Summary
Whether graduate entrants to medical school perform better academically than undergraduate entrants remains controversial. There have been 8 comparative studies of the performance of graduate entry (GE) vs undergraduate entry medical students who have been participating in programmes with identical curriculum content and assessment, but the results as summarised in Table 1 have been mixed [5,6,7,8,9,10,11,12]. No differences between the scores on the written examination at the end of the pre-clinical phase. GE students performed better in the final written examinations at the end of the clinical phase. UG performed significantly better than GE on a few pre-clinical courses. No significant difference in University of Health Sciences [10]
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