Predictive validity of medical and dental colleges' entrance test in Punjab: the way forward.

OBJECTIVE To identify the strengths and weaknesses of the current selection process for admissions to public medical colleges being followed in the province of Punjab and to suggest changes. METHODS The prospective study comprised candidates sitting the Medical and Dental Colleges Entrance Tests administered by the University of Health Sciences, Lahore, from 2008 to 2011. The marks of pre- and post-admission examinations were entered in SPSS 17 and performance of candidates in different examinations up to 2012 was compared using parametric statistical tests. P ≤ 0.05 was considered statistically significant. Reliability of the entrance test question paper was calculated through Cronbach's Alpha. RESULTS Overall 1,01,273 candidates sat in the entrance test during the study period, and of them 14, 995 (14.8%) students were admitted to public and private medical colleges in Punjab affiliated with the University of Health Sciences, Lahore. Cronbach's Alpha showed excellent internal consistency reliability of the question paper of 220 items for all these four years. Overall, students scored significantly lower marks (p < 0.05) in all their MBBS Professional Examinations than their pre-admission tests. A similar pattern of difference was seen in entrance test marks in different geographical localities as in the case with MBBS Professional Examination. Students from Islamabad and Rawalpindi regions scored significantly higher marks in all MBBS examinations as well as in the entrance test and aptitude test, but lower in the Higher Secondary School Certificate examination. Internal consistency reliability of the aptitude test was found to be 0.83. Linear regression analysis showed that Estimated Regression Coefficient of the Higher Secondary School Certificate marks was negative, but positive for entrance test and indicated that the latter results were a good positive predictor for the post-selection performance. In the sub-components, only the Biology and Chemistry regression coefficient section was found to be positive. CONCLUSIONS Entrance and aptitude tests in Punjab were found to be valid and reliable with incremental predictive validity at least for performance in the pre-clinical years. It is suggested that Higher Secondary School Certificate-marks should have little, if any, weightage in the selection process.