Medical student selection process enhanced by improving selection algorithms and changing the focus of interviews in Australia: a descriptive study

Abstract

Purpose The study investigates the efficacy of new features introduced to the selection process for medical school at the University of New South Wales, Australia: (1) considering the relative ranks rather than scores of the Undergraduate Medicine and Health Sciences Admission Test and Australian Tertiary Admission Rank; (2) structured interview focusing on interpersonal interaction and concerns should the applicants become students; and (3) embracing interviewers’ diverse perspectives. Methods Data from 5 cohorts of students were analyzed, comparing outcomes of the second year in the medicine program of 4 cohorts of the old selection process and 1 of the new process. The main analysis comprised multiple linear regression models for predicting academic, clinical, and professional outcomes, by section tools and demographic variables. Results Selection interview marks from the new interview (512 applicants, 2 interviewers each) were analyzed for inter-rater reliability, which identified a high level of agreement (kappa=0.639). No such analysis was possible for the old interview since it required interviewers to reach a consensus. Multivariate linear regression models utilizing outcomes for 5 cohorts (N=905) revealed that the new selection process was much more effective in predicting academic and clinical achievement in the program (R2=9.4%–17.8% vs. R2=1.5%–8.4%). Conclusion The results suggest that the medical student selection process can be significantly enhanced by employing a non-compensatory selection algorithm; and using a structured interview focusing on interpersonal interaction and concerns should the applicants become students; as well as embracing interviewers’ diverse perspectives.