Learning in practice Factors associated with success in medical school: systematic review of the literature

Selection of medical students in the United Kingdom has come under intense scrutiny in recent years. Some authors have claimed that discrimination occurs in favour of white applicants, female applicants, and applicants from independent schools. High profile cases, such as that of Laura Spence, have led to a public questioning of the selection, training, and validation of doctors. The process of selecting medical students is unsatisfactory from a logistical point of view (approximately 40 000 applications are allowed from 10 000 students for just 5000 places) and leads to chance playing a big part and to apparent unfairness. The criteria medical schools use to select future doctors are similar across the country. They include academic ability, insight into medicine (including work experience), extracurricular activities and interests, personality, motivation, and linguistic and communication skills. But what is the evidence base for using these criteria? The Committee of Deans and Heads of Medical Schools commissioned a systematic review of factors believed to be significant predictors of success in medicine. We report the results of that systematic review, which was carried out from June to August 2000. The review examines data on the predictive validity of the eight criteria that have been studied in relation to the selection of medical students: cognitive factors (previous academic ability), non-cognitive factors (personality, learning styles, interviews, references, personal statements), and demographic factors (sex, ethnicity). Previous academic ability, personal statements, references, and interviews are all traditionally used in selection, but how good are they at predicting future performance? Personality and learning styles are not traditionally used, but should they be?