Has the UK Clinical Aptitude Test improved medical student selection?

OBJECTIVES: In 2006, the United Kingdom Clinical Aptitude Test (UKCAT) was introduced as a new medical school admissions tool. The aim of this cohort study was to determine whether the UKCAT has made any improvements to the way medical students are selected. METHODS: Regression analysis was performed in order to study the ability of previous school type and gender to predict UKCAT, personal statement or interview scores in two cohorts of accepted students. The ability of admissions scores and demographic data to predict performance on knowledge and skills examinations was also studied. RESULTS: Previous school type was not a significant predictor of either interview or UKCAT scores amongst students who had been accepted onto the programme (n = 307). However, it was a significant predictor of personal statement score, with students from independent and grammar schools performing better than students from state-maintained schools. Previous school type, personal statements and interviews were not significant predictors of knowledge examination performance. UKCAT scores were significant predictors of knowledge examination performance for all but one examination administered in the first 2 years of medical school. Admissions data explained very little about performance on skills (objective structured clinical examinations [OSCEs]) assessments. CONCLUSIONS: The use of personal statements as a basis for selection results in a bias towards students from independent and grammar schools. However, no evidence was found to suggest that students accepted from these schools perform any better than students from maintained schools on Year 1 and 2 medical school examinations. Previous school type did not predict interview or UKCAT scores of accepted students. UKCAT scores are predictive of Year 1 and 2 examination performance at this medical school, whereas interview scores are not. The results of this study challenge claims made by other authors that aptitude tests do not have a place in medical school selection in the UK.

Quantitative features of the nucleus rotundus in the brain of pre- and post-hatch chicks.

The nucleus rotundus (ROT) is a major relay station in the tectofugal pathway of the avian visual system. In this study, some quantitative features of ROT in developing chicks were analysed using new stereological methods. Total neuron number (N) and mean volume (V) of ROT were estimated by the optical fractionator method and by the Cavalieri principle, respectively. Neuronal density of neurons in ROT was calculated from these data. The eyes of the chick embryo are not normally stimulated by light until days E19/20. Therefore in this study, chicks at three developmental stages were investigated: on the 17th embryonic day (E17), that is before light stimulation of the visual system, at the time of hatch (0-day, stimulated by light) and 10 days after hatch (10-day). The results showed that N was reduced by 27% between E17 and 0-day, and 7.8% between 0- and 10-day while neuronal density was reduced by 15% and 32% over the same periods. It is concluded that the reduction of neuronal density during the pre-hatch period may be due to neuron loss, whereas the post-hatch decrease of neuronal density may be the result of an increase in ROT total volume. Cell loss was more prominent in the pre-hatch than in the post-hatch period. Estimates of neuronal density in the developing ROT are not useful indicators of developmental status, since they do not relate to total neuron number.

Estimation of numerical density and mean synaptic height in chick hippocampus 24 and 48 hours after passive avoidance training.

The effects of passive avoidance learning on synaptic morphology and number in the dorsolateral hippocampus of chick were investigated at 24 and 48 h after training. Chicks of both sexes were used. The numerical density of synapses and mean synaptic height were determined using design-based quantitative electron microscopic techniques. Our results suggest that after training there is a significant increase in synaptic density in the dorsolateral hippocampus of chicks at both 24 and 48 h, and also that the mean synaptic height was significantly different between trained and control groups. The increase in synaptic density was due to shaft (type II) synapses. It is known that during synaptogenesis, shaft synapses are formed first and are then converted to spine synapses. The only hemispheric asymmetry was found in the 24 h water-trained (W-trained) males where the numerical density of spine synapses was significantly higher in the left hippocampus. No significant differences due to gender in either numerical synaptic density or synapse height were observed at either 24 and 48 h. Comparison of the 24 h with 48 h groups showed an increase in shaft synaptic density over time in the W-trained groups, and an increased density of both shaft and spine synapses with time in methylanthranilate-trained (MeA-trained) chicks. These results demonstrate that the dorsolateral hippocampus of the chick shows synaptic changes at both 24 and 48 h after training and implicates this region in the long-term memory process.