Comparing the performance of graduate-entry and school-leaver medical students

Between 2000 and 2006 Leicester-Warwick Medical Schools (LWMS) provided parallel courses for graduate and school-leaver entrants into medicine. The parallel courses were based upon a single curriculum with ;identical teaching programmes and assessment methods over the two sites (Warwick and Leicester). Warwick runs the curriculum over an accelerated 4-year period for its graduate-entry students. LWMS hence provides a unique opportunity to compare outcomes for these two contrasting groups of students.

We carried out an observational, quantitative cohort study over a 6-year period covering three cohorts of students who graduated in 2004, 2005 and 2006, respectively, using examination scores as outcome measures. We compared the examination performance of school-leaver and graduate-entry students in written and clinical examinations. These included intermediate clinical examinations, final clinical and final written examinations for both sets of students. Examination data were collected from original mark sheets and university databases at Warwick and Leicester. A-level data were collected from the national University College Admissions Service (UCAS) and compared against examination performance throughout medical school examinations.

Graduate-entry students performed as well as school-leaver students prior to entering the full-time clinical element of the course despite having significantly lower A-level grades. School-leaver entrants performed better on midpoint examinations, but had lost this advantage by the time they sat final professional examinations.

This is the first large-scale UK study to compare the performance of graduate-entry and school-leaver medical students following the same clinical curriculum and using the same assessments. Graduate-entry students performed as well as undergraduates in final examinations despite lower A-level grades and a shorter 4-year accelerated course.