Role of students’ context in predicting academic performance at a medical school: a retrospective cohort study
Tamara Thiele; Daniel Pope; A Singleton; D Stanistreet (2016). BMJ Open, 6(3), e010169. DOI: 10.1136/bmjopen-2015-010169
Abstract
Objectives
This study examines associations between medical students’ background characteristics (postcode-based measures of disadvantage, high school attended, sociodemographic characteristics), and academic achievement at a Russell Group University.
Design
Retrospective cohort analysis.
Setting
Applicants accepted at the University of Liverpool medical school between 2004 and 2006, finalising their studies between 2010 and 2011.
Participants
571 students (with an English home postcode) registered on the full-time Medicine and Surgery programme, who successfully completed their medical degree.
Main outcome measures
Final average at year 4 of the medical programme (represented as a percentage).
Results
Entry grades were positively associated with final attainment (p<0.001). Students from high-performing schools entered university with higher qualifications than students from low-performing schools (p<0.001), though these differences did not persist at university. Comprehensive school students entered university with higher grades than independent school students (p<0.01), and attained higher averages at university, though differences were not significant after controlling for multiple effects. Associations between school type and achievement differed between sexes. Females attained higher averages than males at university. Significant academic differences were observed between ethnic groups at entry level and university. Neither of the postcode-based measures of disadvantage predicted significant differences in attainment at school or university.
Conclusions
The findings of this study suggest that educational attainment at school is a good, albeit imperfect, predictor of academic attainment at medical school. Most attainment differences observed between students either decreased or disappeared during university. Unlike previous studies, independent school students did not enter university with the highest grades, but achieved the lowest attainment at university. Such variations depict how patterns may differ between subjects and higher-education institutions. Findings advocate for further evidence to help guide the implementation of changes in admissions processes and widen participation at medical schools fairly.
Extended Summary
This research investigates how students’ social backgrounds influence their academic performance at the University of Liverpool Medical School. The study analysed 571 medical students who entered between 2004-2006 and completed their degrees between 2010-2011, using a retrospective cohort design to examine relationships between contextual background characteristics and academic achievement. The research employed both postcode-based measures of disadvantage (Index of Multiple Deprivation and POLAR 3 neighbourhood participation data) alongside educational background information including school type, school performance, and demographic characteristics. Academic performance was measured using entry-level UCAS tariff points and final year 4 averages as a percentage. The study found that entry grades remained the strongest predictor of university performance, with every unit increase in UCAS tariff points associated with a 0.18% increase in final year average. Contrary to previous research, comprehensive school students entered university with higher qualifications than independent school students and maintained better performance throughout their studies, though differences became non-significant when controlling for multiple variables. Female students significantly outperformed male students at university level, despite showing no differences in entry qualifications. The research revealed concerning ethnic disparities, with Chinese and Asian students achieving lower final averages despite entering with competitive grades, particularly affecting female Chinese students. Surprisingly, neither postcode-based measure of disadvantage (socioeconomic deprivation or neighbourhood higher education participation rates) predicted significant differences in academic attainment. Most background-related performance gaps observed at entry level either diminished or disappeared entirely during university studies, suggesting that contextual factors may be less predictive of medical school success than previously assumed. The findings challenge conventional assumptions about independent school advantages in medical education and highlight the complexity of widening participation initiatives. The research demonstrates that only 18% of students came from the most deprived areas and just 8% from neighbourhoods with lowest higher education participation, reflecting persistent inequalities in medical school access. These results have important implications for medical school admissions policies, particularly regarding the use of contextual data in selection processes. The study suggests that while school grades remain important predictors, contextual information could help identify students from disadvantaged backgrounds who may require additional support rather than simply serving as admission criteria. The research advocates for more sophisticated approaches to widening participation that consider the multifaceted nature of disadvantage and the potential for academic performance to improve during university studies.
Key Findings
- Entry grades strongly predicted university performance, but most background-related attainment differences decreased or disappeared during medical school
- Comprehensive school students outperformed independent school students both at entry and throughout university, contrary to previous research findings
- Female students achieved significantly higher averages than male students at university despite no differences in entry qualifications
- Chinese and Asian students achieved lower final averages despite entering with competitive grades, with particularly pronounced effects for female Chinese students
- Postcode-based measures of disadvantage did not predict significant differences in academic attainment at either school or university level
Citation
@article{thiele2016role,
author = {Tamara Thiele; Daniel Pope; A Singleton; D Stanistreet},
title = {Role of students’ context in predicting academic performance at a medical school: a retrospective cohort study},
journal = {BMJ Open},
year = {2016},
volume = {6(3)},
pages = {e010169},
doi = {10.1136/bmjopen-2015-010169}
}