Supporting student-doctors from under-resourced educational backgrounds: an academic development programme

Increased student diversity in medical schools is considered necessary. However, very few medical school applicants from under-resourced educational backgrounds achieve competitive academic entrance scores. Pre-admission development programmes that aim to produce competitive applicants may be inefficient in countries where under-represented communities are majority populations. This study set out to determine: (i) whether an academic development programme (ADP) integrated into an existing South African medical training programme retained ADP students and enabled them to graduate within a reasonable period of time; (ii) the academic impact of the ADP, and (iii) whether performance in high school matriculation examinations predicted performance in medical school.

This retrospective study analysed records of medical students admitted between 1991 and 2001. Non-ADP and ADP students were compared with respect to: student retention; time to graduation; matriculation scores, and performance in medical school. The association between matriculation scores and third-year examination results was determined.

The average student retention rates for the non-ADP (1992-2001) and ADP (1991-2000) cohorts were 92% and 70%, respectively. Non-ADP and ADP students who graduated were compared with respect to four parameters: the mean additional time required to graduate by each group was 0.16 years (95% confidence interval [CI] 0.13-0.18) and 0.38 years (0.27-0.48), respectively. Mean matriculation scores were 44.5 (95% CI 44.4-44.7) and 37.4 (95% CI 37.0-37.7) points, respectively (effect size = 3.2). Mean marks for third-year courses were 65.0% (95% CI 64.6-65.4) and 58.7% (95% CI 57.7-59.6), respectively (effect size = 1.0). Mean marks for final-year courses were 68.3% (95% CI 68.1-68.5) and 64.2% (95% CI 63.6-64.7), respectively; the effect size remained constant at 1.2. Third-year marks for non-ADP and ADP students, respectively, showed moderate (11%) and low (3%) association with matriculation scores.

Although the retention of ADP students was lower than that of non-ADP students, the ADP enabled those who graduated to overcome the effects of under-resourced schooling and to perform well in final-year examinations.