What is the impact of medical education in the early years?

Abstract

I read with interest Calvert et al.'s study from the University of Birmingham and was encouraged to read that graduate entry students are out-performing mainstream counterparts in medical school examinations in the later stages.1 Their discussion did allude to different teaching methods used in the first phase of the Birmingham course but did not suggest how much of a contribution this makes to performance in the second stage. They did not discuss how big the groups used for teaching were in both the graduate and mainstream programmes. The results included 161 graduate entry and 1386 mainstream students. If class size is potentially a factor in early years education, might the Birmingham group consider looking at their own class sizes and assessing whether or not this might also be a factor in medical education? If Birmingham is educating graduates in its mainstream programme, it may be interesting to see how these students perform in relation to their graduate course peers. In addition, might it be possible for school-leavers to be educated in the graduate entry programme for phase 1, to act as a comparison? Presumably, when there are two different models for delivering the early years of medical education in the same medical school, there must be a reason for this and one wonders why it is not considered appropriate to apply the graduate course model to mainstream programmes. When people who entered medical school as school-leavers read sentences such as: ‘Graduate entry students are generally more mature than non-graduate entry students’ it may get their heckles up, so I was particularly pleased to read that the Birmingham group did not suggest that graduate entry students make ‘better’ doctors on the basis of good exam results.