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News
New selection method to the UK Foundation
Programme set to begin for students
graduating in 2013
Bibek Das
Sub-editor
In November 2010, the initial pilots of a
new selection method to the UK Foundation
Programme were completed. This
new method is comprised of an Educational
Performance Measure (EPM) and
a Situational Judgement Test (SJT). If
further piloting demonstrates that these
selections methods are an improvement
on the current system, they will
be used for applicants to the Foundation
Programme beginning in August 2013.
The current ranking system of medical
schools in the UK for selection to
Foundation Schools uses a combined
score derived from answers to a set
of white space questions (weighted
60%) and an academic quartile ranking
(40%) provided by the applicant’s
medical school. This score is then
used to allocate applicants to one of
several foundation schools, which applicants
rank according to preference.
The Medical Schools Council had
been commissioned by the Department
of Health (DH) to carry out an appraisal
of the current system of selection. This
revealed concerns about ‘the reliability,
validity, comparability, NHS consultant
time required, possible plagiarism
and the longevity of the current online
application system’. Following on from
this, a Project Group was commissioned
by the DH to appraise all the possible
options for a new selection programme.
After nine months of consultation
and literature reviews, this group,
chaired by Professor Paul O’Neill,
head of Manchester Medical School
and Professor of Medical Education,
recommended that a new selection
method should be piloted. The EPM
would replace the current quartile
rankings and the SJT would replace
the current white space questions.
The EPM is aimed at assessing
medical students’ performance
throughout medical school. This may
encompass separate scores for clinical
skills and written knowledge and
aims to be ‘more robust than quartiles,
with all schools providing scores
to a standard specification’. The SJT
will be an invigilated multiple-choice
test based on situations that applicants
will face as foundation doctors,
and will not require prior revision.
Professor O’Neill, in an online interview
with Nick Deakin, co-chair of
the BMA Medical Students Committee,
explains why this will be a fairer
system for medical students: ‘In the
current system, academic quartiles are
done differently by different medical
schools in a way that is not known to
everyone. The EPM will replace that
with a transparent framework consistent
between medical schools.’ Furthermore,
‘the concerns about white space
questions are that they’re done in a two-
Tackling the last taboo
in student welfare
Oliver Woolf
Guest writer
Doctors don’t need doctors right? Not
according to Medgroup who have been
working on plans to increase access to
important welfare services that Medical
students can often miss out on due
to their working hours. There is great
stigma attached to mental health issues,
with many students unwilling or
unable to seek help. Fears can range
from how others will view them, ‘fitness
to practice’ issues and the impact
it might have on a future career.
The GMC states that in order to demonstrate
fitness to practice, students
should seek medical or occupational
health advice, or both, if there is a
concern about their health, including
mental health. So what barriers exist?
Students are often unaware of the
wealth of services available to them to
deal with welfare issues. Advice and
counselling services can offer both
week period and there are concerns that
these might not be [the students’] own
words, that they are done collaboratively
or they had help. The SJT has now
been used more widely across postgraduate
training such as in General
Practice. It looks at people’s judgements
and their likely behaviour in situations
that they will encounter as F1 doctors.’
Details of the framework of the assessments
used to calculate the EPM remain
unclear. Furthermore, the weightings
of the EPM and SJT scores have yet
to be decided. Later this year independent
experts will be commissioned to offer
advice on the best way to do this.
Small-scale pilots of the SJT have
been completed at Cardiff, Cambridge
and Keele Medical Schools. The results
from these pilots will be out be analysed
and will help inform a larger pilot
of 8-10 medical schools which will
run in Spring 2011. The pilots, involving
only final year medical students,
comprise an invigilated test of approximately
65 SJT questions completed
practical and health support which users
would agree has been invaluable.
“More than 50 per
cent of medical students
admit that they
have sought help
for depression or
other mental health
problems”
Another fear might be how understanding
a consultant will be if you
say: “I need to take some time off for
mental health reasons.” Students who
were interviewed but wished to remain
anonymous said they were “worried
whether my consultant will accept
this reason” whilst others stated that
it would feel like “admitting defeat”.
within 2 hours. If medical schools agree
to pilot SJTs, there is no obligation for
students to take part. However students
are strongly encouraged to take part to
increase the reliability of the findings
as well as being a beneficial experience
since SJTs are being increasingly used
for selection into speciality training.
Nick Deakin stated the position of
the BMA is that any changes should
only come in to place ‘if they are shown
to improve the system as it stands now,
and if they have the confidence of students’.
Professor O’Neill replied that
there would be no change ‘unless we
can show that it is a definite improvement
on what we currently do. The
proposed alterations are about how the
score is actually devised rather than how
people are actually matched to posts.’
Medical students can express their
views on the new system on the ISFP
website. For now, however, Professor
O’Neill states that ‘nothing will
change, other than intense piloting
and evaluation of the proposals’ .
It is well known that medical students
are at increased risk of encountering
mental health issues during their
course, the BMA says that more than
50 per cent of medical students admit
that they have sought help for depression
or other mental health problems.
Access to services is often a big barrier.
BLSA president Laura Brenner said:
“It’s time to really get the message out
February 2011 medicalstudent
Research in
brief
Robyn Jacobs
Culture editor
ICSM: Anti-prostate cancer protein
discovered. Researchers have discovered
an intracellular protein that suppresses
the growth of prostate cancer
cells. There research can be propel
led into future treatments of the disease.
Published in Cancer Research.
BL: Heart attack paradox solved. Folic
acid lowers homocysteine levels which
should, theoretically, prevent heart attacks.
Research shows that the mechanism
of action is the same as that of
Aspirin, so folic acid may provide no
extra benefit. Published in the current
issue of the Public Library of Science.
GKT: Research shows that low selfcontrol
in children leads to physical
health problems. Research by KCL,
Duke University and the University
of Otago showed that children with
lower self-control were more likely
to have physical health problems, financial
difficulties and a criminal record
regardless of their background.
RUMS: Breast is best? Current guidelines
suggesting that breast feeding is
best for the first 6 months of a child’s
life is being questioned. The Child Institute
of health at UCL has published a report
saying that exclusive breastfeeding
could lead to iron deficiency anemia and
coeliac disease. Published in the BMJ
St Georges: Artesunate combined with
cancer drugs to improve efficacy. In vitro
studies have shown that Artesunate, a
commonly used anti-malarial combined
with cancer drugs make them work
more effectively than when used alone.
Treatment breaks were also shown
to improve success levels. Published
in International Journal of Cancer .
there that these services are available”.
She went onto raise the issue of
out-of-hours services for those on outfirms:
“it hasn’t been possible up until
now to support those on placements
outside London so well but this is something
we are looking to change”. Issues
regarding funding prevail but there is
clearly a case here for more to be done.