The BioMedical Admissions Test for medical student selection: Issues of fairness and bias

Abstract

Background: The BioMedical Admissions Test (BMAT) forms part of the undergraduate medical admission process at the University of Cambridge. The fairness of admissions tests is an important issue.Aims: Aims were to investigate the relationships between applicants’ background variables and BMAT scores, whether they were offered a place or rejected and, for those admitted, performance on the first year course examinations.Method: Multilevel regression models were employed with data from three combined applicant cohorts. Admission rates for different groups were investigated with and without controlling for BMAT performance. The fairness of the BMAT was investigated by determining, for those admitted, whether scores predicted examination performance equitably.Results: Despite some differences in applicants’ BMAT performance (e.g. by school type and gender), BMAT scores predicted mean examination marks equitably for all background variables considered. The probability of achieving a 1st class examination result, however, was slightly under-predicted for those admitted from schools and colleges entering relatively few applicants. Not all differences in admission rates were accounted for by BMAT performance. However, the test constitutes only one part of a compensatory admission system in which other factors, such as interview performance, are important considerations.Conclusion: Results are in support of the equity of the BMAT.