Entry tests for graduate medical programs: is it time to re-think?

OBJECTIVE

To examine the relationship between medical school applicants' performances in the Graduate Australian Medical School Admissions Test (GAMSAT) and structured interviews and their subsequent performance in medical school.

DESIGN

Students in Years 2-4 of two graduate-entry medical programs were invited to complete two previously validated tests of clinical reasoning. These results and their Year 2 examination results were compared with their previous performance in GAMSAT and at interview.

SETTING

The graduate-entry programs at the Universities of Queensland and Sydney.

PARTICIPANTS

189 student volunteers (13.6% response rate).

MAIN OUTCOME MEASURES: Students' test results on a set of Clinical Reasoning Problems (CRPs) and a Diagnostic Thinking Inventory (DTI) and their Year 2 examination results.

RESULTS

There was no association between performance in GAMSAT and performance in the CRPs; there was a weak negative correlation between performance in GAMSAT and the DTI (- 0.05 > r > - 0.31, P = 0.03). The correlation between GAMSAT and examination results was weak (r < 0.24, P = 0.02). The correlation between GAMSAT and interview scores for each school was weakly negative for University of Queensland (r = - 0.34, P < 0.01) and weakly positive for University of Sydney (r = 0.11), with a combined significance level P < 0.01.

CONCLUSIONS

We did not find evidence that GAMSAT and structured interviews are good predictors of performance in medical school. Our study highlights a need for more rigorous evaluation of Australian medical school admissions tests.