RESUMO
Medical professionals who represent the communities they serve are in a better position to understand patients' social circumstances and communicate in a more patient-centered way. International studies show limited diversity and underrepresentation of certain social groups in the population of physicians and medical students. We designed an observational study to investigate the cultural and socio-economic diversity of physicians and medical applicants in comparison to the general population in Germany. We invited 15,195 physicians in Hamburg and 11,287 medical applicants in Germany to participate in an online survey between June and August 2022. The lower three quintiles of objective socio-economic background (SEB) were vastly underrepresented in all subsamples of the study and in particular amongst applicants and students admitted in Hamburg: 57.9% of physicians and 73.8% of medical students in Hamburg originate from the top quintile of SEB. The Turkish and Polish communities were particularly underrepresented in the group of physicians from Hamburg and medical applicants and students in Germany (p = 0.02; p < 0.001). In line with existing evidence, the vast majority of physicians and medical students come from the most affluent households when entering medical school. Widening participation strategies are needed to facilitate fairer access to the study of medicine in Germany.
RESUMO
Non-technical skills (NTS) in medical care are essential to ensure patient safety. Focussing on applicants' NTS during medical school admission could be a promising approach to ensure that future physicians master NTS at a high level. Next to pre-university educational attainment, many selection tests have been developed worldwide to facilitate and standardise the selection process of medical students. The predictive validity of these tests regarding NTS performance in clinical settings has not been investigated (yet). Therefore, we explored the predictive validities and prognosis of the Hamburg MMI (HAM-Int), HAM-Nat, PEA, and waiting as well as other quota (as example) designated by the Federal Armed Forces) for NTS performance in clinical emergency medicine training of medical students. During 2017 and 2020, N = 729 second, third, and fourth year students were enrolled within the study. The mean age of participants was 26.68 years (SD 3.96) and 49% were female students. NTS of these students were assessed during simulation scenarios of emergency training with a validated rating tool. Students admitted via waiting quota and designated by the Armed Forces performed significantly better than students admitted by excellent PEA (p = 0.026). Non-EU students performed significantly inferior (p = 0.003). Our findings provide further insight to explain how and if admission to medical school could predict NTS performance of further physicians.
